Academic journal article International Perspectives on Sexual and Reproductive Health

Condom Use before Marriage and Its Correlates: Evidence from India

Academic journal article International Perspectives on Sexual and Reproductive Health

Condom Use before Marriage and Its Correlates: Evidence from India

Article excerpt

CONTEXT: Little evidence is available from India concerning young people's use of condoms in premarital relationships.

METHODS: Data from a subnationally representative study of Indian youth conducted in 2006-2008 were used to assess condom use in premarital relationships. Analyses used survey data from 2,408 married or unmarried youth aged 15-24 who had had premarital sex, and qualitative data from 271 such youth who completed in-depth interviews. Logistic regression was used to identify characteristics associated with four measures of condom use (ever-use, consistent use, use at first sex and use at last sex).

RESULTS: Only 7% of young women and 27% of young men who had had premarital sex had ever used condoms. Among both sexes, discomfort with approaching a provider or pharmacist for condoms was inversely correlated with most measures of condom use (odds ratios, 0.5), while having peers who had had premarital sex was generally positively correlated (1.6-2.9). Females who had had premarital sex only with nonromantic partners were less likely than those with only romantic partners to have used a condom at last sex (0.2), while males were generally more likely to use condoms with nonromantic than romantic partners (1.5-1.6). Among men, education level, age at sexual initiation and neighborhood economic status were positively associated with use.

CONCLUSION: Programs that encourage condom use are needed. Service delivery structures should be modified to enable youth to obtain condoms easily and privately.

International Perspectives on Sexual and Reproductive Health, 2011,37(4): 170-180, doi: 10.1363/3717011

India has a long history of promoting condom use. It did so initially as part of its family welfare and STD control programs, and later, with the emergence of the HIV epidemic, as part of its HIV/AIDS control program. Nonetheless, condom use, in both premarital and marital relationships, remains limited in India. Findings from the 2005-2006 National Family Health Survey revealed that among unmarried women and men aged 15-24 who had had sex in the past year, just 18% and 37%, respectively, had used a condom the last time they had had sex; (1) among married young women, just 5% were currently using condoms. (2) Several small and large-scale studies that explored the premarital sexual behavior of Indian youth have also found that condom use is limited. (3-8)

Studies exploring correlates of condom use in India have generally focused on married men and women of reproductive age, or on such vulnerable groups as female sex workers, clients of sex workers, people living with HIV, migrants and men who have sex with men. (9-18) Few studies have examined factors associated with young people's use of condoms, particularly in premarital relationships. (6), (19), (20)

Evidence from studies conducted in other countries suggests that condom use among youth in premarital sexual relationships is correlated with a number of individual, partner, relationship and family factors. At the individual level, such factors as education, self-efficacy, perceptions about the benefits of condom use, perceived infection risk, household economic status and urban residence are positively associated with condom use, (21-25) while early sexual initiation and substance use are negatively associated. (21), (22), (24-27) Partnei and relationship characteristics are also important: Condom use is less likely in casual than in steady relationships, and among young women who had initiated sex with an older rather than sameage partner. (22), (25), (28), (29) At the family level, such factors as parental disapproval of premarital sex, as well as higher levels of parental involvement, connectedness and communication, are associated with condom use among youth. (30), (31)

The few available Indian studies on this topic have found that among young men, condom use within premarital relationships is positively associated with urban residence, older age at first sex and type of sexual partner (condom use is less likely with acquaintances or neighbors, and more likely with sex workers, than with girlfriends). …

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