Table 1 shows the prevalence of ever had sexual intercourse among young men (15-24) during 2005-06 and 2015-16. Total 6,881 in 2005-06 and 7,851 adolescent boys and young men in 2015-16 ever had sexual intercourse. Figure 1 shows that ever had sexual intercourse has substantially decreased among adolescent boys (from 11% to 8%) and young men (from 44% to 38%) during the last decade. It is found that ever had sexual intercourse has decreased among uneducated young men from 48 percent to 36 percent during NFHS-3 to NFHS-4; however, it has slightly increased among higher educated men during the last decade. Figure 3 shows that the ever had sexual intercourse is higher among young men residing in urban areas than the rural areas in both the consecutive survey; however, the prevalence of ever had sexual intercourse decreased from 32 percent in 2005-06 to 25 percent in 2015-16 among young man residing in urban areas. It is observed that around three-fifths of young men belonging to SC/ST had ever sexually active during 2005-06, whereas this proportion decreased in 2015-16 (Figure 2). In the case of socioeconomic status, as wealth index increases, ever had sexual activity among adolescent boys and young men also reduced in both the consecutive surveys (Figure 1). A Central region of India shows the highest proportions of adolescent boys and young men involved in sexual activity in both the consecutive surveys than the other geographic regions; however, the percentage has substantially declined in all the geographic areas in India during the last decade (Figure 3).
Table 2 shows the transition of mean age at first sex and condom use at first sex among adolescent boys (15-19) and young men (20-24) in India over the last decade. Results show that the initiation of sexual activity is still early among adolescent boys (16 years) and young men (19 years) over the last decade. Condom use at first sex among adolescent boys (from 19% to 34%) and young men (from 14% to 26%) have considerably increased almost double from 2005-06 to 2015-16 respectively. Findings evident that condom use at first sex is higher among adolescent boys and young men residing in an urban setting, belonging to other castes of the social group (OBC), and who have regular exposure of media than their counterparts in both the survey.
Adolescent boys and young men belonging to better-off households are more likely to use a condom at first sex in both the survey. The magnitude of change in the prevalence of condom use at first sex is also observed over the last decade, among adolescent boys and young men who have comprehensive knowledge about HIV/AIDS, from 26 percent and 20 percent in 2005-06 to 41 percent and 33 percent in 2015-16 respectively. Condom use at first sex has increased among adolescent boys (from 21% to 40%) and young men (from 16% to 32%) even those who consumed alcohol during the last decade. It is observed that in the Eastern and Southern region, condom use at first sex among adolescent boys has rapidly increased in the previous decade, although other geographic region also showed the increased prevalence of condom use at first sex from NFHS-3 to NFHS-4.
Multi-partner sexual behaviour
Table 3 shows the percentage distribution of adolescent boys and young men having multiple sexual partners in the last 12 months and the results of zero-inflated poison regression of having multiple sexual partners in 2005-06 and 2015-16 in India. The findings evident that multi-partner sexual behaviour among adolescent boys decreased (from 15% to 10%) during the last ten years. It is found that 17 percent of educated adolescents (10 and above) reported multiple sexual partners in 2005-06 while, this proportion decreased by ten percent in 2015-16. In the case of residence, adolescent boys from the urban setting (21%) are having more multiple sexual partners than rural setting (13%) in 2005-06 whereas, in 2015-16 the situation is just opposite, adolescent boys residing in rural setting (7%) are having more multiple sexual partners than the urban setting (11%). An estimated seven percent of adolescent boys belonging to other religion (Christian, Sikhs, Buddhism, Jain, etc.) have multiple sexual partners in 2015-16 while in 2005-06 this proportion was almost four times higher.
Multi-partner sexual behaviour among adolescent boys who have regular exposure of mass shows the decreased pattern from 2005-06 (15%) to 2015-16 (10%). Adolescent boys belonging to the affluent class of households are having more sexual partners however, it had rapidly decreased from 29 percent in 2005-06 to seven percent in 2015-16. Adolescent boys who have comprehensive knowledge of HIV/AIDS are more likely (IRR=1.67; p<0.001) to have more than one partner in 2005-06 whereas in 2015-16, they are less likely to report multiple sexual partners. It is observed that alcohol using adolescent boys and young men are more likely to have more than one partner in both the survey, the rate of decrement is also observed over the last one decade.
Regional differences are also observed among adolescent boys and young men. During NFHS-4, Central (12%), Eastern (11%) and Western region of adolescent boys shows the higher multi-partner sexual behaviour, whereas in NFHS-3, Northern (18%), Eastern (16%) and Western (24%) region of adolescent boys show the higher multi-partner behaviour than the other geographic regions of India. Zero-inflated Poisson regression results also revealed that adolescent boys belonging to Central (IRR= 1.77; p<0.001) and Western region (IRR=1.56; p<0.001) are more likely to have more than one partner in 2015-16 than the other counterparts.
Relationship status with the most recent sexual partners
Table 4a portrays the status of relationship with the most recent partner among adolescent boys and young men according to their place of residence in 2005-06 and 2015-16 in India. Results show that relationship status with girlfriends/fiancé (57%), commercial sex workers (8.4%), and live-in partner (11%) is higher among adolescent boys residing in urban areas than the young men living in urban areas during 2015-16. It is observed that the percentage has increased in rural areas among adolescent boys having girlfriends/fiancé (from 29.6% to 48.6%), casual acquaintance (from 2.3% to 10.6 %), commercial sex workers (from 2.3% to 5.5%) and live-in partner (from 0.6% to 6%) during the last one decade.
Relationships status with most recent sexual partners has also been analysed with the socioeconomic status of the adolescent boys and young men in both the survey (Table 4b). Adolescent boys belonging to the poorest quantile (41%) are more likely to have girlfriends/fiancé in 2015-16 than the adolescent boys in 2005-06 however, the culture of girlfriends/fiancé among adolescent boys have considerably increased in each category of wealth quantile from 2005-06 to 2015-16. During the last ten years, live-in partner relationships have also increased among adolescent boys either they belong to poor socioeconomic status of households (from 0.0 % to 6.3%) or high socioeconomic status (from 1.4% to 13%) from NFHS-3 to NFHS-4.
Condom use during last sexual intercourse
Overall, condom use during last sexual intercourse among adolescent boys (from 23% to 69%) and young men (from 13% to 65%) has rapidly increased over the last one decade. Adolescent boys are significantly (p<0.001) more likely to use a condom during the last sexual intercourse than the young men in both the survey (Table 5). It is observed that as the level of education increases, condom use during last sexual intercourse increased among adolescent boys and young men in both the survey. In the case of place of residence, there are no significant rural-urban differences observed in the prevalence of condom use during the last sexual intercourse among adolescent boys and young men in both the survey. Those who have comprehensive knowledge of HIV/AIDS, the prevalence of condom use during last sexual intercourse increased among adolescent boys (from 37% to 72%) and young men (from 20% to 67%) from NFHS-3 to NFHS-4.
The results also reported that the prevalence of condom use during last sexual intercourse increased among alcohol-using adolescent boys and young men over the last one decade. Regional differences in the prevalence of condom use during last sexual intercourse have also been observed during the last decade, as Southern region of adolescent boys and young men are reporting higher prevalence than the other geographic regions of India during 2015-16. Condom use during last sexual intercourse in Central (20% and 12% to 66% and 58%), Eastern (14% and 7% to 66% and 65%) have rapidly increased among adolescent boys and young men from 2005-06 to 2015-16 respectively.
High-risk sexual behaviour in the past 12 months
Table 6 estimated the high-risk sexual behaviour in the past 12 months among adolescent boys and young men in India. Overall, high-risk sexual behaviour has increased among adolescent boys (64% to 70%) and young men (18% to 27%) from 2005-06 to 2015-16. Binary logistic regression analysis evident that adolescent boys (AOR=1.98; p<0.001) and young men (AOR= 2.74; p<0.001) are more likely to engage in high-risk sexual behaviour in the past 12 months in 2015-16 (Table 7). High-risk sexual behaviour among adolescent boys residing in urban areas (85% to 74%) has decreased during the last decade, while among young men it has increased from 26 percent in 2005-06 to 38 percent in 2015-16. The results of the binary logistic regression analysis revealed that adolescent boys and young men residing in the urban setting are significantly two times (p<0.001) and three times (p<0.001) more prone to engaged in high-risk sexual behaviour in the past 12 months during 2015-16.
It is observed that as wealth index increases; high-risk sexual behaviour increased among adolescent boys and young men in both the survey, although the magnitude of change has also been reported. The richest quantile of adolescent boys shows the declining trend from 90 percent in 2005-06 to 75 percent in 2015-16. The results depict that adolescent boys and young men having comprehensive knowledge of HIV/AIDS are more involved in high-risk sexual behaviour in both the survey. High-risk sexual behaviour among alcohol-using adolescent boys and young men is higher than the men who are not addicted to alcohol.
It is observed that high-risk sexual behaviour among adolescent boys and young men belonging to Northern, Central, and Eastern region has substantially increased from 2005-06 to 2015-16, which was lower in 2005-06 than the other geographical regions of India. The results of the multivariate analysis also revealed that adolescent boys and young men belonging to the Central region are three times (p<0.001) and two times (p<0.001) more likely to engage in high-risk sexual behaviour in the past 12 months in 2015-16 (Table 7).