Condom use during anal sex among young men who have sex with men

Export Indicator

The proportion of young men who report using a condom on the last occasion when they had anal sex with a male partner in the preceding six months.
What it measures

Both unprotected anal sex and multiple partners put MSM at higher risk of being infected with HIV. The monitoring of both the proportion of MSM who have protected anal sex and the proportion who avoid multiple partners is important, however, in the age range 15-24. Because young men are less likely to remain with one partner, protected anal sex is the more critical indicator to monitor.

Rationale
Numerator

The number of young MSM who report using a condom on the last occasion when they had anal sex with a male partner in the preceding six months

Denominator

All young MSM who have had anal sex with a man in the preceding six months.

Calculation
Method of measurement

In a behavioural survey of a sample of MSM the respondents are questioned about their sexual partnerships with other men in the preceding six months. The respondents are asked about the last time they had anal or oral sex and whether they or their partners used a condom. This indicator should be reported as a percentage and broken down for the age groups 15–19, 20–24 and 15–24 years.

Measurement frequency
Disaggregation

Age group: 15 years - 19 years

Education: N/A

Gender: N/A

Geographic location: N/A

Pregnancy status: N/A

Sector: N/A

Target: N/A

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

The time reference is six months because most surveys of MSM use a sampling strategy that interviews respondents in areas where men congregate in order to meet male partners. These men are thus at the high end of the spectrum of risk behaviours and are also likely to have a high turnover of partners. The smaller time frame reduces any recall bias in respect of the number of partners. A limitation of surveys among high-risk groups is that it is not usually possible to find a representative probability sample. This means that it is difficult to estimate the extent to which an indicator based on the data describes all members of such a group. Furthermore, it is difficult to duplicate this type of survey in order to examine trends. This indicator gives no idea of risk behaviour in sex with women on the part of men who have sex with both men and women. In countries where men in the subpopulation surveyed are likely to have partners of both sexes it is necessary to consider the prevalence of sex between men and women as well as the frequency of condom use with partners of each sex. Reporting may be biased as a result of the stigma associated with homosexual behaviour in many communities, resulting in the underreporting of frequency or in non-admission.

Further information