Condom use among young people who had higher-risk sex in the preceding year

Export Indicator

The percentage of young people who had higher-risk sex in the preceding year and who used a condom on the last occasion of higher-risk sex.
What it measures

This indicator shows the extent to which condoms are used by young people who engage in nonregular sexual relationships.
When trends in this indicator are being interpreted it should be noted that changes may reflect variations in the numbers of persons having higher-risk sex and not necessarily variations in condom use during higher-risk sex. The indicator should therefore be analysed carefully. This means considering changes in the proportion of young people having higher-risk sex, i.e. with a noncohabiting partner, in order to understand the programmatic implications.

Rationale
Numerator

The number of respondents aged 15-24 years who had sex with a non-cohabiting, non-marital partner in the preceding 12 months and used a condom the last time they had sex with such a partner.

Denominator

The number of respondents aged 15-24 years who had sex with a non-cohabiting partner in the preceding 12 months.

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) is used to determine whether they had higher-risk sex in the preceding 12 months (sex with anyone other than a spouse or live-in partner) and thus are counted in the denominator.
Respondents are also asked about condom use with their last three partners in the preceding 12 months. If they had higher-risk sex, and used a condom with the last higher-risk partner they are included in the numerator.
This indicator should be presented as separate percentages for males and females in the age groups 15–19, 20–24 and 15–24 years. When progress towards the UNGASS goals is being reported the results for urban and rural residents should be given separately for the 15–24 age group.

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: Urban, Rural

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

This indicator is measured among people who have had sex in the preceding 12 months with a partner not living with or not married to them. This group provides the most relevant denominator for the indicator because condom use is of paramount importance in the group.
In the population as a whole there are measures that reduce the risk of HIV infection in uninfected people. If people can delay first sex, abstain from sex and reduce the number of partners they have, the spread of HIV infection can be reduced. However, in the group already identified as having higher-risk sex, condom use is the most pertinent prevention measure.
Use at last higher-risk sex is a good measure because it is a definite occasion and recent sex should be recalled most accurately. Thus the data should be subject to less reporting and recall bias than other types of data on condom use. However, condom use at last sex provides no measure of the consistency of condom use. To some extent, more consistent condom use in the population as a whole is reflected as an increase in use at last sex. Even so, this can be affected by the type of partner and the rate at which new partners are acquired, especially if condoms are used more often with new partners than in more established relationships. If new partners are acquired at a high rate, and condoms are used on the first, but not subsequent, occasions with each new partner, the cross-sectional prevalence of reported condom use at last sex could rise while the consistency of use remains the same. Increases in the prevalence of condom use at last sex, therefore, while a positive sign, do not mean that the people reporting condom use have not placed themselves at risk of acquiring HIV infection at any time in the preceding 12 months.

Further information