In places where CSWs are important sources of new HIV infections it is a priority to reduce
the number of young people having sex with them. This indicator measures the prevalence of
commercial sex in the preceding year which, although not a good estimate of the lifetime prevalence
of this behaviour, is more able to detect changes in such behaviour over time.
Attempts to collect and analyse data on the basis of a wider definition of commercial sex, with the
use of questions such as “Have you given or received money or gifts in exchange for sex?”, have
not yielded useful information. In the context of the HIV/AIDS epidemic, sex workers are of interest
because they have a high turnover of partners and are therefore at high risk of being exposed to
infection, becoming infected and passing on the infection to others. In many cultures, this is true of
only a fraction of those who have “received money or gifts in exchange for sex”. If there is no locally
specific term for prostitution, this indicator is unlikely to be relevant to the programme and should
not be used.
The inclusion in the denominator of all young people makes it simple to describe and monitor the
size of a group of young people who may be especially vulnerable to HIV infection. If the denominator
were the number of sexually active young people, a shift in the number sexually active could affect the
proportion visiting commercial sex workers. This would complicate the analysis of the indicator.