Time to Play a Safe Game

Let's talk about sex, baby
Let's talk about you and me
Let's talk about all the good things
And the bad things that may be….

These were the catchy lyrics of the 1990s hit song by Salt-N-Pepa, but it’s high time we all talked about sex. Especially “safe sex” in India. As per National AIDS Control Organization (NACO) latest report, nearly 31% of the AIDS burden in India is due to youth (15 to 29 age group). These figures are worrisome because almost half the population in India is under 25 years of age.

Modern Relations

With a gamut of relationships floating around on social media – open relationships, sex pals, bed buddies, hook-ups, and ONS (one-night stand) – many youngsters are open to casual sexual encounters. Shockingly, over 73% of the youth in India have misconceptions about HIV transmission. No wonder sexually transmitted infections (STI) like syphilis, chlamydia, gonorrhoea, herpes, and genital warts are at a record high not just in India, but across the world. This indicates that young people are at high risk of contracting HIV infection. The presence of STI enhances the HIV acquisition and transmission risk by 4-10 times.

Sex A Taboo Subject

Murugesan Sivasubramanian, Technical Director, NETREACH (Global Fund Project) says many parents, political leaders, and elders simply shy away from talking about ‘safe sex’ as they consider it a taboo subject. “Many Indian men do not know how to wear a condom. They complain that the condom does not roll properly or tears off. The condoms that we get in the Indian market are of excellent quality, but what many men do not realize is that lubrication matters,” explains Murugesan.

With no one to clear their doubts, several youngsters log on to the Internet and gather half-baked knowledge about sex, safe sex, condoms, and PrEP pills (pre-exposure prophylaxis). The PrEP pill prevents some infections but condoms are a safe bet as they are easily available in most shops.

According to the UNFPA’s State of World Population Report 2023, India has the largest population in the world (142.86 crore). Over 600 million Indians are between 18 and 35 years old. Yet, there is very little discussion on “sex”, “safe sex” or “condom use” at home or in social spaces. There are several men, who swear by “double protection” in their excitement and wear two condoms. “But double production is a myth because all condoms are lubricated. During sex, the top condom often slips away,” explains Murugesan, adding, “A single condom if rolled properly on an erect penis can provide excellent proper protection.”

HIV in India

As per NACO’s latest estimates, approximately 2.4 million people are living with HIV in India. The prevalence of HIV among the adult population is 0.3%. The prevalence of HIV is high in the 15-49 age group and accounts for 88.7% of all infections.

More men are HIV positive than women. Nationally, the prevalence rate for adult females is 0.29 %, while for males it is 0.43 %. For those who are unaware, the modes of transmission of (STI) and HIV are the same.

Despite repeated attempts via Whatsapp, mobile and email, Dr Shobini Rajan, CMO (SAG)/DDG, NACO, Ministry of Health & Family Welfare did not respond. An email sent to the dgoffice@naco.gov.in also did not get any response.

A senior doctor on the condition of anonymity from a government hospital in Maharashtra says that there needs to be more awareness of safe sex among the youth. “Today, the condom is viewed as a “disease prevention” tool. Many conservatives (politicians and government officials) view it as an item that promotes promiscuity,” the doctor says.

Societal Double Standards

Some politicians objected to hoardings of a condom ad featuring adult actor Sunny Leone. They argued that it was against our culture and “promoted sex.”

As a result, there are hardly any condom ads on social marketing, the media, television, or OTT platforms. “It is a global issue, not just in India. With conservative governments coming across the world, the money for condom marketing has been reduced,” says Rajiv Dua, chief executive of Alliance India (India HIV/Aids Alliance).

The popularity of dating apps, the lack of HIV/AIDS awareness among youth, and the rise in the number of sexually transmitted infections (STIs) have once again put health officials across the world on their toes. Earlier, a condom was the only male-applicable method to prevent pregnancy.

“When HIV came into the focus that’s when STIs and condoms became very important. It became a commodity for social good. The condom social marketing campaign money tripled across the globe. However, conservatives across the world started viewing condom marketing as a medium promoting promiscuity,” rues Dua, who has spearheaded HIV/AIDS awareness and prevention programmes in Liberia, South Africa, and several other countries.

Gender imbalances, patriarchal societal norms, and economic dependence contribute to this risk. Those who are vulnerable and under the high-risk behaviour category include poor, unemployed, under-employed, mobile/ migrant youth, adolescents in sex work, young drug users, and street children. “It’s high time, the government and we as a society start some healthy conversation on ‘safe sex’,” Dua concludes.