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What are condoms used for? Insights from Orissa

Accurate information is vitally important for condom promotion strategies. Who currently uses condoms and why? What is the potential need for condoms for family planning or disease prevention? A study by the London School of Hygiene and Tropical Medicine addressed these issues among men in Orissa, Eastern India.

They found that nearly 90 percent of condoms are currently used within marriage and most of the unmet need for condoms is among single men. In areas with low HIV prevalence, health programmes should promote condoms differently to the three main target groups: people with high-risk behaviour, young single men and married couples.

Condoms can prevent unwanted pregnancies and sexually transmitted infections (STIs) including HIV. The threat of AIDS has rekindled interest in condom promotion, and wider method choice is important in family planning programmes. HIV prevalence is relatively low in Orissa. Is there a need to expand the use of condoms in this population?

This study assessed fertility preferences, sexual behaviour and condom use within and outside marriage among 2087 married and single men aged 18 - 35 years.

Research findings include:

Nearly half of couples use some method of family planning and three percent rely on condoms for birth control. Couples who want to delay their next birth are more likely to use traditional methods than those who want to limit childbearing
Sex outside of marriage is uncommon - in the year before the survey only 9.2 percent of single men reported sex and fewer than five percent of married men had extra-marital sex. The frequency of non-marital sex is also low.
About 15 percent of non-marital sex is protected by condoms, but when the partner is a sex worker this is higher (27.6 percent). Pregnancy prevention is the main reason for condom use among single men.
Nearly 90 percent of all condoms are used for family planning within marriage.

Although levels of non-marital sex are low, nearly two-thirds of all unmet need for condoms is for these encounters. However, the demand for condoms would increase dramatically if married couples were encouraged to switch from traditional to modern family planning methods or if all non-procreative sex within marriage needed to be protected by condoms.

The authors recommend that health planners developing behaviour change activities in low HIV settings like Orissa should:

target STI control efforts at the minority of men who engage in high risk behaviour
promote the dual pregnancy and STI prevention properties of condoms to young unmarried men through social marketing
encourage married couples to use condoms for birth spacing
closely involve the main target audiences in developing culturally appropriate and non-stigmatising messages.

Source(s):
'Why are condoms used, and how many are needed? Estimates from Orissa, India' by M. Collumbien, B. Das and O. Campbell, International Family Planning Perspectives 27 (2001)
Other related sources: 'Closing the condom gap' by R. Gardner, R. Blackburn and U. Upadhyay, Population Reports H9 (1999)
'Prevention first: a three-pronged strategy to integrate family planning program efforts against HIV and sexually transmitted infections' by J. Shelton, International Family Planning Perspectives 25 (1999)

Funded by: UK Department for International Development

id21 Research Highlight: 11 December 2001

Further Information:
Martine Collumbien
Centre for Population Studies
London School of Hygiene and Tropical Medicine
49-51 Bedford Square
London WC1B 3DP
UK

Tel: +44 (0)20 7299 4670
Fax: +44 (0)20 7299 4637
Contact the contributor: m.collumbien@lshtm.ac.uk

London School of Hygiene and Tropical Medicine, UK

Braj Das
General Manager
AIMS Research Bhubaneswar
26 Forest Park
Bhubaneswar 751 009
India

Tel: +91 (0)674 532125
Fax: +91 (0)674 532212
Contact the contributor: brajdas@rediffmail.com

Oona Campbell
London School of Hygiene and Tropical Medicine
Keppel Street
London WC1E 7HT
UK

Tel: +44 (0)207 927 2210
Fax: +44 (0)207 637 4314
Contact the contributor: oona.campbell@lshtm.ac.uk

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