Indicators

toolkit material

This page includes indicators proposed for behavioural surveillance in Europe, providing definitions of each indicator and relevant references and web resources.

The mapping report on HIV/STI behavioural surveillance in Europe stressed the need for a harmonisation process and proposed a series of indicators (see table below). This proposal is the result of:

  • Analysis of the survey topics most frequently mentioned by countries
  • Proposals made by the experts covering each of the specific populations
  • Discussions during the Behavioural Surveillance Expert Meeting in Montreux
  • Existing internationally agreed indicators (such as UNGASS indicators)

Where there is already some kind of consensus, the precise definition of the indicator is given below. However, in many cases, there is still a lot of diversity regarding the age groups concerned, the period of reference or the precise wording of the indicator, and further reflection and harmonisation are needed. These indicators are therefore less precisely defined.

Two groups of indicators are proposed:

  • Core Common Indicators  that are to be used with all (or almost all) populations and, wherever possible, by all countries.
  • Secondary and/or population-specific indicators: some are proposed for use in several populations; others are very specific and may be used in only one or in few populations. These indicators are proposed for use in all countries. However, for some topics, more research is needed before a satisfactory indicator (as regards content, wording or validation status) can be made available.

Proposed list of indicators

 

Core indicators, common to all populations GP     Youth MSM  IDU PLWHAs Sex workers STI clients   Migrants
 

 1. Partners  

Number of sexual partners in the last 12 months (b)

(x)

x

x

x

x

 
2. Use of condom     

a) Use of condom at last intercourse (c) (in the last 12 months)  

 x

x

x

x

x

x

x

x

                 
b) With identification of the type of partner: stable / casual / paid 

x

x

x

x

x

x

x

x

 
3.  HIV test   
a) Ever and date of the last test or whether tested in the last 12 months (d)

x

x

x

x

x

x

x

x

                 
b) Result of the test (reported or measured)  

(x)

(x)

x

x

x

x

x

(x)

 
4.  Sex work
a) Having paid for sex in the last 12 months 

x

(a)

x

(x)

x

x

x

x

                 
b) Use of condom at last paid intercourse (in the last 12 months)

x

(a)

x

(x)

x

x

x

x

 
5.  Contextual indicators
Level of education (ISCED classification)

x

x

x

x

x

x

x

x

                 
Nationality/ethnic origin*

x

x

x

(x)

x

x

x

x

                 
Sexual orientation (modified Kinsey classification)

x

a

x

(x)

x

x

x

x

 
6.  Knowledge** 
UNGASS indicator: being able both to identify correctly ways of preventing the sexual transmission of HIV and to reject major misconceptions about HIV transmission

x

x

x

x

 (x)

x

x

x

 
Secondary and/or population-specific indicators
 
Age at first intercourse and/or being sexually active (e)

x

x

x

 

x

x

x

x

                 
Condom use /contraceptive method at first and last intercourse

 

x

 

 

 

 

 

 
                 
Recent STI * 

x

a

x

 

x

x

x

x

                 
Condom use with different types of partners 

(x)

(x)

x

(x)

x

x

x

x

                 
Having been paid for sex in the last 12 months 

 

 

x

x

x

x

x

x

                 
Concurrency *

x

a

x

 

 

 

x

x

                 
Condom use for different types of sexual practices  

 

x

 

 

x

x

 
                 
Comprehensive indicator of exposure to risk (last 12 months)  

 

x

 

 

 

 

 
                 
Sharing equipment (last month)  

 

 

x

 

 

 

 
                 
Number of times injected (last month)

 

 

 

x

 

     
                 
Number of clean needles obtained (last month)

 

 

 

x

 

 

   
                 
Substitution therapy (last month)

 

 

 

x

 

 

 

 
                 
Hepatitis C test a) Ever and date of the last test b) Result of the test (reported or measured) 

 

 

x

x

x

x

x

x

                 
Types of drugs consumed*** 

x

x

x

x

x

x

x

x

                 
Variables related to HIV treatment (being in treatment, CD4 count, viral load)  

 

 

x

x (f)

x

 

 

 

 

a = Asked only for sexually-active youth(x) = Depends on the context(a) = Asked only for sexually-active youth  +  depends on the context

*  Seen as important; however, as no commonly agreed satisfactory indicator is currently available, more research is needed **  Since the relevance of different questions varies according to context, it is difficult to ensure comparability over time and between countries for this indicator. More research is needed *** Seen as important in certain groups; however its wording is unsatisfactory, sometimes not adapted to the situation, and should be improved

(b) Allows for construction of UNGASS indicator No. 16.(c) Allows for construction of UNGASS indicator No. 17/18/19/20.(d) Allows  for construction of UNGASS indicator No. 7/8.(e) Allows for construction of UNGASS indicator No. 15.(f) in low prevalence countries, may be irrelevant due to small numbers