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GOAL AND TARGET ADDRESSED

Goal 6. Combat HIV/AIDS, malaria and other diseases
Target 6.A. Have halted by 2015 and begun to reverse the spread of HIV/AIDS

DEFINITION AND METHOD OF COMPUTATION

Definition
Condom use at last higher-risk sex is the percentage of young men and women aged 15–24 reporting the use of a condom the last time they had sexual intercourse with a non-marital, non-cohabiting sexual partner of those who had sex with such a partner in the last 12 months.

Concepts
Higher-risk sex is defined as sex with a non-marital, non-cohabiting sexual partner.

Method of computation
The indicator is calculated by dividing the number of respondents aged 15–24 reporting using a condom the last time they had sex with a non-marital and non-cohabiting sexual partner, by the total number of respondents aged 15–24 reporting having had sex with a non-marital, non-cohabitating sexual partner in the last 12 months and multiplying by 100.

RATIONALE AND INTERPRETATION

Consistent use of condoms in non-regular sexual partnerships substantially reduces the risk of sexual HIV transmission. Condom use is especially important for young people, who often experience the highest rates of HIV infection because they have low prior exposure to infection and (typically) relatively high numbers of non-regular sexual partnerships. Consistent condom use with non-regular sexual partners is important even in countries where HIV prevalence is low, because it can prevent the spread of HIV where higher-risk sex is common. Condom use is one measure of protection against HIV/AIDS, but it is not the only measure. Equally important are delaying age of first sex, reducing the number of higher-risk sexual partners and being faithful to one partner.

This indicator shows the extent to which condoms are used by young people aged 15-24 who engage in non-regular sexual relationships. However, the broader significance of this indicator will depend upon the extent to which young people engage in such relationships. Thus, levels and trends of condom use should be interpreted carefully using the data obtained on percentages of young people who have started sex and that have engaged in a non-regular partnership within the last year.

A rise in this indicator is an extremely powerful sign that condom promotion campaigns are having the desired effect on their main target population.

SOURCES AND DATA COLLECTION

Data on the use of condoms during high-risk sex are collected every 3-5 years through household surveys, such as Multiple Indicator Cluster Surveys (MICS), Demographic and Health Surveys (DHS), Reproductive and Health Surveys (RHS), Behavioural Surveillance Surveys (BSS), and other nationally representative household surveys. Nationally representative population-based surveys, such as DHS and MICS, are conducted by national statistical offices or other relevant government offices, generally with the collaboration of international agencies.

DISAGGREGATION

The indicator could be presented separately for males and females, and disaggregated by the age groups 15–19 and 20–24, urban and rural residence, wealth quintiles, education levels, and by geographical regions. This will enable policy makers to better characterize HIV risk groups.

COMMENTS AND LIMITATIONS

The maximum protective effect of condoms is achieved when their use is consistent rather than occasional. The current indicator does not provide information on levels of consistent condom use. However, the alternative data collection method of asking whether condoms were always/sometimes/never used in sexual encounters with high-risk partners in a specified period is subject to recall bias. Furthermore, trends in condom use during the most recent sex act will generally reflect trends in consistent condom use. The current indicator is therefore considered adequate to address the target since it is assumed that if use at last higher-risk sex rises, consistent use will also increase.

GENDER EQUALITY ISSUES

Women’s risk of becoming infected with HIV during unprotected sexual intercourse is higher than that of men. And the risk is even higher for younger women. Social and cultural factors may increase women’s vulnerability to HIV infection. For instance, cultural norms related to sexuality often prevent girls from taking active steps to protect themselves.

DATA FOR GLOBAL AND REGIONAL MONITORING

The United Nations Children’s Fund (UNICEF) is the international agency responsible for the indicator at the international level. Data are collected through household surveys, such as Multiple Indicator Cluster Surveys (MICS), Demographic and Health Surveys (DHS), Rural Household Surveys, Reproductive and Health Surveys, and Behavioural Surveillance Surveys. The results are reported regularly in the final reports of these surveys.

As part of routine data quality control, survey results are checked for inconsistencies and to ensure that data are collected using a clearly defined population-based sampling frame, permitting inferences to be drawn for the entire population. UNICEF also conducts an annual exercise called the Country Reports on Indicators for the Goals (CRING), in which data maintained in the global databases at UNICEF for indicators regularly reported by UNICEF, are sent to countries for validation and updating. Updates from countries must be accompanied by original source documentation, e.g. survey reports.

No adjustments are made to the data compiled from DHS, MICS and other surveys that are statistically sound and nationally representative.

There is no treatment of missing values. When the information needed to calculate the indicator is not available, the indicator is not estimated.

Regional and global estimates are based on population-weighted averages weighted by the total number of young women and men 15–24 years of age. These estimates are presented only if available data cover at least 50 per cent of total men and women aged 15–24 years in the regional or global groupings.

SUPPLEMENTARY INFORMATION



EXAMPLES



REFERENCES

See “REFERENCES” for Indicator 6.1.

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