Condom use among people who inject drugs

Export Indicator

Percentage of people who inject drugs reporting using a condom the last time they had sexual intercourse
What it measures

Progress in preventing sexual transmission of HIV among people who inject drugs

Rationale

Safer injecting and sexual practices among people who inject drugs are essential, even in countries in which other modes of HIV transmission predominate, because the risk of HIV transmission from contaminated injecting equipment is extremely high, and people who inject drugs can spread HIV (such as through sexual transmission) to the wider population.

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

Numerator

Number of people who inject drugs who reported using a condom the last time they had sex

Denominator

Number of people who inject drugs who report having injected drugs and having had sexual intercourse in the past month

Calculation

Numerator/denominator

Method of measurement

Behavioural surveillance or other special surveys

People who inject drugs are asked the following sequence of questions:

1. Have you injected drugs at any time in the past month?

2. If yes, have you had sexual intercourse in the past month?

If they answer yes to both 1 and 2:

3. Did you use a condom when you last had sexual intercourse?

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

Access to survey respondents and the data collected from them must remain confidential and secure.

Measurement frequency

Every two years

Disaggregation
  • ƒSex (female, male and transgender)
  • Age (<25 and 25+ years) ƒ
  • Cities and other administrative areas of importance
Additional information requested

Additional information requested for GAM 2017 reporting;

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.

Explanation of the numerator

This includes both regular and non-regular partners, and both paid and unpaid sex. As with all indicators this indicator only provides a limited piece of information. For a comprehensive assessment of patterns of risk associated with sex and injecting drug use further information is needed, including information on the types and numbers of partners.

Strengths and weaknesses

Surveying people who inject drugs can be challenging. Consequently, the data obtained may not be based on a representative national sample of the people who inject drugs 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.

The extent of HIV transmission associated with injecting drug use within a country depends on four factors: (1) the size, stage and pattern of dissemination of the national AIDS epidemic; (2) the extent of injecting drug use; (3) the degree to which people who inject drugs use contaminated injecting equipment; and (4) the patterns of sexual mixing and condom use among people who inject drugs and between people who inject drugs and the wider population. This indicator provides information on the third factor. To maximize the utility of these data, it is recommended that the same sample used for calculating this indicator be used for the calculating the other indicators related to these populations.

Further information

WHO, UNODC and UNAIDS. Technical guide for countries to set targets for universal access to HIV prevention, treatment and care for injecting drug users. Geneva: World Health Organization; 2012 (http://www.who.int/hiv/pub/idu/targets_universal_access/en/index.html).

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.

UNAIDS, WHO, Measure Evaluation, CDC, USAID, ICASO, UNODC. Operational Guidelines for Monitoring and Evaluation of HIV Programmes for People who Inject Drugs. https://www.measureevaluation.org/resources/tools/hiv-aids/operational-g...