Condom use before marriage and its correlates: evidence from India.

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.