Core Group 2: Use of condom at last intercourse

toolkit material

Title and definition:

  1. Use of condom at last intercourse among people having had sexual intercourse  in the last 12 months
  2. Identification of the type of partner at last intercourse (stable / casual / paid)

 

Purpose and rationale  To assess the proportion of people having had potential exposure to HIV through unprotected sex, according to the type of partner. Research has shown that the protection varies according to the type of partner, and that the proportion of respondents having casual or paid partners varies according the different populations.
Method of measurement

Respondents who mentioned having one or more partners in the last 12 months are asked:  a) Did you or your partner use a condom the last time you had sexual intercourse with penetration

Numerator: Number of respondents who used a condom at last intercourse

Denominator: Number of respondents who have had sexual intercourse with penetration with one or more partners in the last 12 months

Caveat: for the construction of UNGASS indicator 17 – 20, the denominator is the number of respondents who have had sexual intercourse with more than one partner in the last 12 months

b) Was this person a stable partner, a casual partner, or a paid partner

For each type of partner:

Numerator: Number of respondents who used a condom at last intercourse overall and with a specific type of partner

Denominator: Number of respondents who have had sexual intercourse with one or more partners in the last 12 months and had this specific type of partner at last intercourse

Collection method  Population-based surveys in the general population and young people, population–based or  convenience samples in other, higher risk populations
Measurement frequency  Every 4-5 years in the general population and in young people; more frequently in higher risk populations; context-dependent
Details of Disaggregation The indicator should be presented separately for males and for females; it should be disaggregated: in the general population by the age groups 15–19, 20–24 and 25–49, 50+ years; in specific populations (MSM, IDU, SW), by. <25, 25+.
Guidelines on how to interpret changes in the indicator 

This indicator shows the extent to which condoms are used (a) by people in general  and (b) with various types of partners

Accessing and/or surveying populations at highest risk can be challenging. Consequently, data obtained may not be based on a representative sample of the national population at highest risk being surveyed. If there are concerns that the data are not based on a representative sample, these concerns should be reflected in the interpretation of the survey data. Where different sources of data exist, the best available estimate should be used.

Information on the sample size, the quality and reliability of the data, and any related issues should be included in the report submitted with this indicator. Tracking populations at highest risk over time to measure progress may be difficult due to mobility and the hard-to-reach nature of these populations with many groups being hidden populations. Thus, information about the nature of the sample should be reported in the narrative to facilitate interpretation and analysis over time.

Strengths and weaknesses Simple. The current indicator does not provide the level of consistent condom use. However, the alternative method of asking whether condoms were always/sometimes/never used in sexual encounters with non-regular partners in a specified period is subject to recall bias. Furthermore, the trend in condom use during the most recent sex act will generally reflect the trend in consistent condom use
Additional sources of information   Allows for construction of UNGASS indicators No. 17 (and also of No. 18 for sex workers, No.19 for MSM, and No.20 or IDU) «Condom Use During Higher-risk Sex»: Percentage of women and men aged 15–49 who had more than one partner in the past 12 months who used a condom during their last sexual intercourse. See this Guidelines on contruction of core indicators from the United Nations General Assembly Special Session on HIV/AIDS