Condom use among transgender people

Export Indicator

Percentage of transgender people reporting using a condom during their most recent sexual intercourse or anal sex
What it measures

Progress in preventing exposure to HIV among transgender people through unprotected sex with partners

Rationale

Condoms can substantially reduce the risk of sexually transmitting HIV. Consistently and correctly using condoms is therefore important for transgender people, particularly trans-women, because of the high risk of HIV transmission during unprotected anal sex. Condom use with the most recent penetrative sex partner is considered a reliable indicator of longer-term behaviour.

Note: countries with generalized epidemics may also have a concentrated subepidemic among transgender people. If so, calculating and reporting on this indicator for this population would be valuable.

Numerator

Number of transgender people who reported using a condom in their last sexual intercourse or anal sex

Denominator

Number of transgender people surveyed

Calculation

Numerator/denominator

Method of measurement

Behavioural surveillance or other special surveys

Respondents are asked the following question:

Did you use a condom with your most recent sexual intercourse or anal sex? 

Whenever possible, data for transgender people should be collected with civil society organizations that have worked closely with this population in the field.

Access to transgender people and the data collected from them must remain confidential and secure.

Measurement frequency

Every two years

Disaggregation
  • Gender (transman or transwoman) 
  • Age (<25 and 25+ years)
  • Cities
Additional information requested

If there are subnational data available, please provide the disaggregation by administrative area, city, or site in the space provided. Submit the digital version of any available survey reports using the upload tool.

Strengths and weaknesses

For transgender people, condom use at last sexual intercourse or anal sex with any partner indicates well the overall levels of and trends in protected and unprotected sex in this population. In countries in which transgender people in the subpopulation surveyed are likely to have partners of both sexes (including transgender people), condom use with female, male and transgender partners should be investigated. In these cases, data on condom use should always be presented separately for female, male and transgender partners. 

This indicator asks about sexual intercourse or anal sex in the past six months. If you have data available on another time period, such as the last three or 12 months, please include this additional data in the comments section of the reporting tool. 

Surveying transgender people can be challenging. Consequently, the data obtained may not be based on a representative national sample of the key populations at higher risk being surveyed. If there are concerns that the data are not based on a representative sample, the interpretation of the survey data should reflect these concerns. If there are different sources of data, the best available estimate should be used. The report submitted with this indicator should include information on the sample size, the quality and reliability of the data and any related issues. 

In previous reporting rounds, several countries have reported condom use among subpopulations of transgender women through the additional comments field in the Global AIDS Response Progress Reporting online reporting tool. This demonstrates that the data are feasible to obtain in different settings. 

To maximize the utility of these data, it is recommended that the same sample used for calculating this indicator be used for calculating the other indicators related to these populations.

Further information

A framework for monitoring and evaluating HIV prevention programmes for most-at-risk populations. Geneva: UNAIDS; 2007 (http://www.unaids.org/ sites/default/files/sub_landing/files/17_Framework_ME_Prevention_Prog_MARP_E.pdf).

Practical guidelines for intensifying HIV prevention: towards universal access. Geneva: UNAIDS; 2007 (http://data.unaids.org/pub/ Manual/2007/20070306_Prevention_Guidelines_Towards_Universal_Access_en.pdf.

Operational guidelines for monitoring and evaluation of HIV programmes for sex workers, men who have sex with men, and transgender people. Chapel Hill (NC): MEASURE Evaluation; 2011 (http://www.cpc.unc.edu/measure/publications/ms-11-49a).