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IN INDIA, CONDOMS ARE RARELY USED DURING PREMARITAL SEX

In India, most youth who are having premarital sex are not using condoms, according to "Condom Use Before Marriage and Its Correlates: Evidence from India,” a new study by K.G. Santhya, Rajib Acharya and Shireen J. Jejeebhoy, of the Population Council, New Delhi. The study, published in the December issue of International Perspectives on Sexual and Reproductive Health, found that only 7% of young women and 27% of young men who reported having had premarital sexual relationships said they had ever used condoms. The analysis, which used survey data from 2,408 married and unmarried men and women aged 15–24 who had had premarital sex, found that just 3% of women and 13% of men surveyed reported having always used condoms in premarital relationships.

Discomfort about approaching a pharmacist or other provider for contraception was identified as an important obstacle to condom use for both sexes. According to the study, sexually experienced unmarried youth who felt uncomfortable obtaining contraceptives were much less likely to have used a condom than youth who felt no discomfort.

Data drawn from in-depth interviews suggest that a perceived lack of risk of contracting a sexually transmitted disease or of becoming or getting someone pregnant was a factor in nonuse of condoms. Only 40% of the 106 women who discussed the risk of pregnancy reported having worried about becoming pregnant. Similarly, only eight of the 51 men who discussed pregnancy reported they had been worried about their partner becoming pregnant.

Together, the survey data and the in-depth interviews suggest that peers served as a major source of information on contraceptive methods and condom use and that peer relationships were a key factor in the decision to use condoms. Both men and women who reported being able to confide in peers about problems with male-female relationships and those who had peers who had had premarital sex were more likely to have ever used a condom, and such men were more likely to have always used condoms. Young women who reported confiding in peers were more likely than those who did not to have ever used a condom.

Partner type was also associated with condom use. Young women who had had sex only with romantic partners were more likely to report condom use than young women who had had sex only with nonromantic partners. According to the researchers, this is likely because women with romantic partners had more time to plan for protection, while those who had had sex only with other types of partners may have been unable to negotiate condom use. In contrast, young men who had had sex only with nonromantic partners were more likely to have used condoms. This is likely due to a heightened concern about contracting infections from nonromantic partners.

Given the findings, the authors suggest that communication and education programs aimed at promoting condom use among youth are needed, along with adaptations to the service delivery structure that would enable youth to obtain condoms easily and confidentially. They add that there is a need for better training to ensure that providers are both comfortable about offering a range of services to youth and sensitive to the special needs of unmarried young men and women.

The study, "Condom Use Before Marriage and Its Correlates: Evidence from India,” is currently available online and appears in the December 2011 issue of International Perspectives on Sexual and Reproductive Health.

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