India seems to be inching towards another major health crisis, which is attributed to the lack of safe sex awareness, not using contraceptives such as condoms. The practise of unsafe sex could lead the country towards the humongous spread of sexually transmitted diseases. The problem has amplified during the lockdown due to the Covid-19 pandemic.
India’s current population in 2021 is 1,393,409,038, in short 139 crores, which witnessed a 0.97% increase from 1,380,004,385 people in 2020. The current population density of the country in 2021 is 423.88 people per square kilometre, which is up 0.97% 419.80 of 2020. This huge population certainly comes with both advantages and disadvantages as well. While there have been several attempts by the government of India to tame the pace of the rapidly surging population, the ultimate result remained unsuccessful.
Some of the reasons behind that include the lack of awareness about family planning, lack of education, stigma about using birth control measures. According to the country’s first-ever Condomology Report, which has been published on May 27 by Condom Alliance, a group of the country’s key condom manufacturers and suppliers, the most popular birth control measure, condom usage in India is as low as 5.6%.
Despite the government bodies and other institutions promoting campaigns to encourage the use of contraceptives, over the past 6 years, the condom market in India has witnessed only 2% Compound Annual Growth Rate (CAGR) in volume. While the awareness and information about the usage of condoms have increased steadily since 2014, that didn’t translate product sales and actual use.
The study shows that the Covid-19 pandemic and the lockdowns because of that have limited nearly 25 million Indian’s access to contraceptives like a condom, with sales slumped during the three-month lockdown in 2020 slumped by 48%, while the annual sales plummeted by 35%. In terms of volume sales, the Indian condom market grew 11% on a year-on-year (YoY) basis in 2019 but plummeted 1% in 2020. The Market value during the same periods increased 17% and 5% respectively.
Only 7% of women and 27% of men ever used a condom during their pre-marital sex.~ Condomology report
Demographically speaking, a UN survey highlights that condoms have emerged as the preferred contraceptive method for the 33% of the total 143 million unmarried women in India. The Condomology report states that in India, only 7% of women and 27% of men ever used a condom during their pre-marital sex, while just 3% of women and 13% of men always used a condom.
Urban areas account for 65% of the total condom sales volume in India, and 72% of value.~ Condomology report
Geographically, the urban areas account for 65% of the total condom sales volume in India, and 72% of value. The research also points that while metro cities and rural areas don’t differ much in terms of value contribution, the rural areas contribute considerably more to the total sales volume.
While there have been discussions around the sudden surge in birth rate this year, which is directly related to the phenomenon called lockdown imposed intimacy, which took place due to people staying at home for a longer period, people working from homes, migrant workers coming back to their own places; the study predicts that there would be nearly 1 crore unwanted pregnancies in a year, and these are the results of lack of accessibility to the contraceptives.
NordVPN, a virtual private network provider has found that the number of pregnancy tracking app downloads had increased in January-September 2020 as against the same period in 2019. The VPN provider also noted that countries such as India and South Korea were more interested in pregnancy trackers in September 2020, as they recovered from the first wave of the pandemic more quickly than the other countries.
As it further said, while the global number of tracker downloads went up against 208% in September last year, in India the number was surged 32% in March 2020, followed by 15% in April 2020. These statistics clearly indicate, how the pregnancies increased during Covid induced lockdowns and a significant number of them were caused by the lack of availability of contraceptives.
This is not only the story of India, but the whole world, as the Covid-19 pandemic is a global crisis and lockdowns too were announced across the world. Not only unwanted pregnancies during Covid, but the other side of the story is the sexually transmitted diseases are about to rise significantly across the country.
What comes as very alarming information, according to the World AIDS Day report 2020, there could be an estimated 123,000 to 293,000 new HIV infections around the world. Also, there could be a huge number of AIDS-related deaths between 2020 and 2022 globally, with the number ranging between 69,000 to 148,000. A significant number of these infections and deaths could be in India, as the country is already ranking third highest in HIV cases across the world.
What drives such low usage of condoms in India?
There are multiple reasons behind the low usage of condoms in India. The major one is certainly the taboo around it. The stigma around sex and sexuality and any conversation related to that in India exists in great volume, which doesn’t exist in the liberal western countries. Topics such as sex, sexuality, desire, sexual needs, especially those of women, don’t make easy conversations in the Indian society that still majorly believes in sexually regulating one half of its population more than the other.
Despite India moving forward in terms of many aspects of social and economic spheres, several issues still persist. One among them is the stigma about sex and sexuality. People shy away from talking about it openly despite it being just another biological need. While Indians are very vocal about the stomach’s craving for food but pretend there is no physical desire at all.
Despite having a large young population in India, many Indian youths are not properly educated about sexuality like in several other parts of the world. Safe sex remains a faraway land for them. They face primary barriers such as fear of shame in regards to the use or procurement of condoms. Unlike the western youth, the Indian youth can not just walk through the aisle of departmental stores and pick up condoms and place them before the cashier. There are fears of being judged by the chemist, attracting glares and being the centre of attention and whispering.
Around 75% of the 18-24-year-olds in India agree that they need more information about sexual safety, privacy and consent.~Global Sex Survey: India
Among Indian adolescents, a 1983 study found that the youth have their first sexual experience between the ages of 15 and 24 years. But that doesn’t necessarily come in a safer way. The Indian youth lack the proper guidance from people they trust and mediums, which they can easily access. According to the Global Sex Survey: India, by Durex, around 75% of the 18-24-year-olds agree that they need more information about sexual safety, privacy and consent. This points out the stark cultural and societal differences between the Indian youth and their western counterparts when it comes to sex and the usage of contraceptives like a condom.
Internet and friends serve as the key sources for sex education and information about sexuality for the majority of Indian youths, especially in small towns and rural areas. Around 36% of them get the information about sexuality from pornography, which does more harm than good by leading the youth to misconceptions and unrealistic expectations. The social media boom and dating apps can be partly blamed for bringing the casual dating and casual sex culture into mainstream society, but that just a minuscule part of the bigger picture.
Nearly 80% of young men aged between 20 and 24 years did not use any kind of safe sex measures with their last sexual partner.~ NFHS 4
Another prevailing myth and misconception the Condomology Report throws light on is the lack of pleasure in using condoms. As the study states, the young might be aware of the existence of condoms, but they remain blissfully unaware of the serious repercussions of not using those. It also reveals that around 70% of male adolescents aged between 15-19 and 78% of the young males between the age of 20-24, did not use safe sex measures with their last sexual partner.
Major health crisis ahead
Data from the National Family Health Survey 4 (NFHS 4) says nearly 80% of young men aged between 20 and 24 years did not use any kind of safe sex measures with their last sexual partner. This indicates the need to urgently address an imminent crisis in the reproductive and sexual health of the country. As the study suggests, India is heading towards a major reproductive and sexual health crisis due to the culture of unsafe sex, condom hesitancy, as the report has sounded the alarm bell.
The increasing number of unplanned pregnancies, unsafe abortions and the rise in the number of sexually transmitted diseases are creating significant barriers ahead of the country’s goal of sustainable development for the youth.~ Condomology report
The study also says that the increasing number of unplanned pregnancies, unsafe abortions and the rise in the number of sexually transmitted diseases are creating significant barriers ahead of the country’s goal of sustainable development for the youth. All of these are connected to condom hesitancy.
Despite the country being ranked with the 3rd highest cases of HIV cases by the UN, it registered more than 101,000 unwanted pregnancies in 2020. Pointing to this data, the report also adds that the hesitancy and lack of awareness are only making the situation worse. There should be a proper system to make people aware of the need for a condom, the correct way to use them, and how to buy them.
As a call of action, the study suggests many ways to mitigate the crisis impact. These include imparting proper sex education, making condoms more visible, increasing access to encouraging condom uptake, encouraging conversations around sexuality, and challenging misinformation about condoms. Learnings from the challenges against the stigma against sanitary napkins can be reviewed to adopt best practices for this case.
According to Ravi Bhatnagar, Founding Member, Condom Alliance, to increase the accessibility during the pandemic, the last-mile home delivery startups can play key roles, as they have already come up for delivering consumable and non-consumable products to the consumers. To create more awareness and educate people about the use of contraceptives and to promote safe sex, online dating applications can play a significant role.
Infographics: Condomology Report 2021