Knowledge of HIV prevention among men having sex with men

Export Indicator

Percent of men who, in response to prompting, correctly identify avoiding anal sex and using condoms during anal sex as means of preventing HIV infection
What it measures

In HIV epidemics where there is a concentration of HIV infection or risk behaviours among men who have sex with other men, IEC campaigns are often designed to meet the specific needs of this population. Most of these campaigns promote non-penetrative sex and condom use during anal sex as ways of avoiding HIV infection. This indicator measures the extent to which those messages have reached members of a sub-population of men who have sex with men. It is intended for use only within that sub-population.

Rationale
Numerator

Number of respondents who answer all survey questions correctly

Denominator

All respondents

Calculation
Method of measurement

In a behavioural survey of men who have sex with other men, respondents are asked about their knowledge of AIDS, and whether it can be prevented. They are then prompted for various correct and incorrect means of prevention, including non-penetrative sex and condom use during anal sex. The indicator is derived from correct answers given for these two methods of preventing HIV transmission during sex between men. Someone giving correct answers to only one of the two is not counted in the numerator of the indicator. All respondents are included in the denominator, regardless of whether they have ever heard of AIDS or not.

Measurement frequency
Disaggregation

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 greatest difficulty in collecting information for this indicator is likely to be accessing a representative sample of men who have sex with other men. Sampling issues for subpopulation (target group) and population-based surveys are discussed in greater detail in FHI guidelines on behavioural surveillance surveys. Clearly, there are many other ways of preventing HIV transmission in male-male sex. These include abstinence, condom use during oral sex, and mutually faithful partnerships among men who have tested HIV-negative and had no other partners since the test. The extent to which these different messages are stressed depends very much on the context in which male-male sex takes place. The “mutual faithfulness” message is, for example, much more likely to be emphasised in countries with well established gay communities in which long term partnerships are common. It will be of far less importance in countries where a majority of men who have sex with men are also married, or where male-male sex is dominated by commercial exchanges. In order to make the indicator more comparable across different situations, the areas of knowledge cited are those that are a focus of prevention programmes for men who have sex with men in almost all contexts. This indicator does not include common misconceptions about HIV transmission or prevention. However, similar to knowledge questions in general population surveys, the question sequence in a behavioural survey among men who have sex with men is likely to contain incorrect as well as correct prevention options, for example that the insertive partner is at no risk of HIV infection during anal sex. These questions will provide important information in improving IEC messages and preventative interventions. Again care must be taken to avoid introducing new misconceptions.  Limitations of the use of prompted data were discussed in the introduction to this section; while the primary indicator should be constructed using prompted data, a comparison between prompted and non-prompted data where possible may yield interesting information. To be of additional use to programme managers, data for this indicator may be disaggregated by prevention method, highlighting strengths and weaknesses in existing IEC campaigns.

Further information