Core Group 4: Paid Sex

toolkit material

Title and definition

Having paid for sex in the last 12 months (as a client of sex work)

  1. Having paid for sex in the last 12 months
  2. Use of condom at last paid intercourse (among those having paid for sex in the  last 12 months)

 

Purpose and rationale  To measure the prevalence of clients of sex workers and their use of condoms; indirect or surrogate indicator of risk among sex workers; useful when no behavioural surveillance among sex workers is available
Method of measurement

Male respondents are asked if they ever had intercourse and if yes, a) are asked if they have paid for (penetrative) sex in the last 12 months

Numerator: Number of male respondents who paid for (penetrative) sex in the last 12 months

Denominator: Number of respondents who had at least one partner in the last 12 months (sexually active men)

b) if the respondent answered yes, they had penetrative sex with a paid partner, they are asked "did you use a condom the last time you had (penetrative) sex with a paid partner"

Numerator: Number of respondents who used a condom the last time they had (penetrative) sex with a paid partner

Denominator: Number of male respondents who paid for (penetrative) sex in the last 12 months

Collection method  Population-based surveys in the general population and young people, population–based or  convenient samples in other specific populations
Measurement frequency  Every 4-5 years in the general population and in young people; more frequently in specific 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 for interpretation 

This is an indirect way of measuring use of condoms by sex workers. However, this does not allow to differentiate between the various characteristics and situations of sex workers.

In populations data collection is not conducted in a representative sample of the population. Information about the nature of the sample should be reported in the narrative to facilitate interpretation and analysis over time.

Strengths and weaknesses Easier to measure than sex workers’ behaviour; social desirability bias possible (probably not more than among sex workers)
Additional sources of information   Used in several EU countries