Condoms and sexual health problems among men in rural India: lessons learned from a mixed method approach

Minna Säävälä, Population Research Institute, Väestöliitto
Arundhati Char, University of Tampere

Since the virulence of the HIV/Aids was acknowledged, increased use of condoms has been adopted as a policy objective in developing societies such as India as well as in many post industrialist societies. Despite this policy interest, popularizing the use of condoms has proved to be far from easy. This paper analyses primary data from rural India from a mixed method study, using two cross-sectional surveys (one among adolescent men and one among married men) and focus group and individual interview data. We have two objectives: first, to examine how rural Indian men see condoms and their role in the context of their sexuality, and second, to make methodological recommendations on how to study male sexual health in starkly patriarchal and traditionalist contexts such as India. The data was collected in the state of Madhya Pradesh in 2005. The data of the paper shows that the unpopularity of the condom relates to the lack of attention and services to men’s sexual health problems more generally. Rural men experience a wide range of functional situations which are culturally defined as health problems, such as ‘weakness’, ‘bending of penis’, ‘nocturnal ejaculations’ and ‘loss of semen’ – issues known to have a wide geographical and social relevance in India. When there is no attention paid on experienced sexual problems, no trust is created between the local health providers and the male clientele. This lack of trust and accountability in turn is reflected in the misinformation and mistrust on condoms. In the methodological side, this paper shows the usefulness of mixing qualitative and quantitative methods in the study of sexual health issues particularly in developing societies. Skeptical preconceptions relating to the study of sexuality in traditionalist societies do not hold: by using inventive and thought-out methods, inhibitions and prudery can be overcome.