Safe sexual behaviour among young people

Export Indicator

A composite of safe sexual behaviour among young people
What it measures

This indicator describes the proportions of people having no partner, one partner and multiple partners over 12 months, and the prevalence of condom use at the last sex among those people who have had only one partner or more than one. These aspects of behaviour are considered together here because each component affects the other and each is of progressively riskier behaviour. Programme managers are thus encouraged to consider all aspects of sexual behaviour in order to understand what portion of the population is vulnerable to HIV. Moreover, changes in this composite indicator over time can be expected to be much more informative than changes in a single indicator.  In the example illustrated below there were changes over time that resulted in a smaller fraction of the population being in the highest category of risk. There was an initial increase in sex with only one partner between 1996 and 2000. This was followed by an increase in the number of respondents reporting abstinence or no sex in the preceding year between 2000 and 2003.

Rationale
Numerator

Part 1 Number of respondents who have never had sex Part 2 Number of respondents who have had sex but not in the preceding 12 months Part 3 Number of respondents who had sex with only one partner in the preceding 12 months and who used a condom the last time Part 4 Number of respondents who had sex with only one partner in the preceding 12 months and who did not use a condom the last time Part 5 Number of respondents who had sex with more than one partner in the preceding 12 months and who used a condom the last time Part 6 Number of respondents who had sex with more than one partner in the preceding 12 months and who did not use a condom the last time

Denominator

Number of respondents aged 15-24 NOTE: This denominator is to be used for each part of the numerator

Calculation
Method of measurement

The respondents are first asked if they have ever had sex. Among those who have, questions are asked about their last three partners. Information on the type of partner (e.g. spouse, live-in partner, boyfriend/girlfriend, acquaintance or commercial sex worker) and whether a condom was used at last sex is requested for each of the last three partners in the preceding 12 months. (The information on partner type is used for calculating the previous indicator.) This indicator should be presented as a stacked bar graph, separately for men and women, in the age groups 15–19, 20–24 and 15–24 years.

Measurement frequency
Disaggregation

Age group: 15 years - 19 years, 15 years - 24 years, 20 years - 24 years

Education: N/A

Gender: Male, Female

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

Delaying sexual initiation, reducing the number of partners, and protecting against HIV through the use of condoms are ways of preventing HIV infection which form the central message of many AIDS control programmes. This indicator describes the extent to which this message is understood and put into practice. (In some settings, these behaviours are also referred to as “ABC” or “abstinence, being faithful, and using condoms.”) The indicator highlights the size of the group of people who have sex with more than one partner and who do not consistently use condoms. It also illustrates the prevalence of one-sided monogamy and of condom use in sexual relationships. This is important because the classification for this indicator is based only on the behaviour of the survey respondents. A respondent’s partner may not be similar to the respondent in this respect, i.e. the only partner of a survey respondent may have other partners as well. Condom use among people who report only one partner is therefore important because the partner may present a risk. Having more than one partner in a year may be common and may not indicate multiple or concurrent partnerships but merely that the end of one partnership and the start of the next occurred within 12 months of each other. This indicator assigns people to the same category who regularly have several concurrent sexual partners and people who have ended one relationship and begun another in the same year. The limitation on measuring condom use which was discussed in respect of the previous indicator also applies to the present one.

Further information