India’s Complicated Relationship with Condoms

When it comes to safe sex, the most popular form of contraception is condoms.

However, India’s journey with condoms is a narrative woven with threads of cultural stigma and social dynamics.

Despite their proven effectiveness in preventing sexually transmitted infections (STIs) and unwanted pregnancies, condoms remain underutilised in many parts of the country.

This reluctance stems from deep-seated cultural beliefs, misconceptions about their use, and a complex interplay of trust within relationships.

As India strides forward in its economic and social development, the challenge remains to reconcile these traditional perceptions with modern health imperatives.

Understanding the nuanced reasons behind the resistance to condoms is crucial for devising effective strategies to promote safe sex.

We delve into the factors that contribute to India’s complicated relationship with condoms.

Most Indian Men don’t Use Condoms

According to the latest National Family Health Survey (2019-2021), just 9.5% of Indian men used condoms.

This is an improvement from 2018 when Durex India tweeted that 95% of Indians do not use condoms.

Although condom use in urban India is better than in rural parts, the overall trend is similar – 7.6% men in rural India and 13.6% men in urban India use condoms.

In 23 of the 36 states/union territories, condom use was less than 10%.

The state with the highest usage was Uttarakhand (25.6%) while Chandigarh (31.1%) was the highest Union Territory.

But the lack of usage is not due to the lack of awareness.

Data shows that 82% of men are aware that condom use can reduce the risk of contracting a sexually transmitted infection.

However, studies show that the promotion of condoms for the protection of STIs creates confusion in their acceptance among married couples.

Poonam Muttreja, Executive Director at the Population Foundation of India, says:

“Condom usage is also low because family planning is considered the responsibility of women.

“For men, sex stands purely for pleasure. For women, it is often either about procreation or involves the fear of getting pregnant.

“Men also believe that condoms reduce pleasure. According to NFHS-4 data, 40% of men think it is a woman’s responsibility to avoid getting pregnant.”

Other barriers include the lack of privacy in shops when buying condoms, perceived ineffectiveness, less comfort and the lack of sexual satisfaction.

‘Family Planning’ still relies on Women

‘Family planning’ is essentially the use of contraception to properly plan when to grow a family.

However, this aspect is still reliant on women.

Sixty-seven per cent of married women aged 15–49 used at least one method of contraception.

The most common method is female sterilisation, which involves a medical procedure to block or seal a woman’s fallopian tubes, preventing eggs from reaching the uterus for fertilisation.

It is a permanent method and is more common than other reversible methods such as pills (5.1%), injectables (0.6%) and intra-uterine devices (2.1%).

According to Poonam, the high prevalence is due to misinformation surrounding male sterilisation. She explains:

“A reason for high prevalence of female sterilisation is widespread misinformation on male sterilisation.

“Male sterilisation’s share in family planning methods has always been extremely low, despite the fact that it’s safer, quicker and easier.

“People believe that it can affect their virility and weaken them physically, rendering them unfit to work. These are myths and misconceptions that need to be addressed.”

Vinod Manning, CEO of the Ipas Development Foundation, says:

“Most women tend to think of family planning not for delaying and spacing but for completing the family size, though the trend is changing.”

Poonam adds: “We need to change behaviours and social norms.

“Mass media campaigns are needed to promote a greater involvement of men in family planning.”

“Social and behaviour change communication should not only promote condoms but also break gender stereotypes and position men as responsible partners.

“Values such as spousal communication and shared decision-making should be inculcated.

“We should also try to reach people when they are young and when it’s easier to change mindsets.”

Internationally Made Condoms are too big for Indian Men

When it comes to condoms, there is a large variety to suit men of all different sizes.

However, a 2006 survey gained some traction in India because it revealed that internationally made condoms were too large for most Indian men.

Responses from 1,200 men were valuable in collecting data on penis length “down to the last millimetre”.

What the survey found is that 60% of Indian men have penises that are three to five centimetres shorter than the international manufacturing standards.

This led to concerns about a high condom failure rate due to breaking or slipping.

Addressing performance anxiety due to small size, Dr Chander Puri, said:

“It’s not size, it’s what you do with it that matters… From our population, the evidence is Indians are doing pretty well.”

This survey may be nearly two decades old but it has continued to impact many Indian men.

Despite there being condoms to suit all sizes, men in India avoid them over fears that they will be ill-fitting.

Therefore, it is important to choose the right condom size for your penis.

Most Family Planning Messages come via TV

A move by the Information and Broadcasting Ministry to curb condom adverts brought to light interesting data.

When the ministry demanded that condom adverts only be aired between 6 am and 10 pm on TV, the National Family Health Survey found that 59% of women and 61% of men receive family planning education through TV.

Labelling condom ads “indecent” for child viewing, the government body sought to remove condom ads that were explicit from daytime airing.

It found that although elderly women, Muslim women, women from rural areas, women with basic or no education, and those in the lowest wealth brackets lack exposure to family planning messages, the little information they do receive is through TV.

Trust & Relationship Dynamics

Trust and relationship dynamics play a significant role in the avoidance of condom use among Indian men.

In many long-term relationships, there is a prevalent assumption of mutual exclusivity and monogamy, leading partners to see condoms as unnecessary.

This assumption is reinforced by the belief that suggesting condom use implies a lack of trust or suspicion of infidelity, which can strain the relationship.

Additionally, within the context of marital relationships, there is often an expectation of unquestioned loyalty.

Subsequently, this makes the introduction of condoms into the relationship difficult.

It is indicated that these dynamics are compounded by cultural norms and societal expectations, which prioritise trust and fidelity as cornerstones of a stable marriage, further discouraging condom use.

Studies have shown that couples in long-term relationships are less likely to use condoms compared to those in casual relationships, as trust is perceived to mitigate the risks associated with unprotected sex.

This interplay between trust, cultural expectations and relationship dynamics creates a complex barrier to condom use, necessitating targeted interventions that address these specific relational and cultural factors.

India’s relationship with condoms is undeniably complex, marked by cultural, social and educational barriers that have historically hindered their widespread acceptance.

However, there are promising signs of change.

Increasing awareness through education campaigns, greater accessibility and a gradual shift in cultural attitudes are encouraging more Indian men to use this form of contraception.

Initiatives by public health organisations and government policies aimed at normalizing conversations about sexual health are making a significant impact.

Nevertheless, much work remains to be done.

Efforts must continue to focus on dismantling the deep-rooted misconceptions that persist, particularly in rural and conservative areas.