Condom use among sex workers

Export Indicator

Percentage of sex workers reporting using a condom with their most recent client
What it measures

Progress in preventing exposure to HIV among sex workers through unprotected sex with clients

Rationale

Various factors increase the risk of exposure to HIV among sex workers, including multiple, non-regular partners and more frequent sexual intercourse. However, sex workers can substantially reduce the risk of HIV transmission, both from clients and to clients, by consistently and correctly using condoms.

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

Numerator

Number of sex workers who reported using a condom with their last client

Denominator

Number of sex workers who reported having commercial sex in the past 12 months

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 client with whom you had sexual intercourse?

Whenever possible, data for sex workers should be collected through or with civil society organizations that have worked closely with this population in the field.

Access to sex workers and the data collected from them must remain confidential and secure.

Measurement frequency

Every two years

Disaggregation
  • Sex (female, male and transgender) ƒ
  • 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.

Strengths and weaknesses

Condoms are most effective when they are used consistently rather than occasionally. The current indicator will overestimate the level of consistent condom use. However, the alternative method of asking whether condoms are always, sometimes or never used in sexual encounters with clients in a specified period is subject to recall bias. Further, the trend in condom use in the most recent sexual act will generally reflect the trend in recent consistent condom use.

This indicator asks about commercial sex in the past 12 months. If data are available on another time period, such as the past three or six months, please include the alternate indicator definition in the metadata in the comments section of the reporting tool.

Surveying sex workers 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 the 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_To....

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).