Vol.:(0123456789) 1 3 Archives of Sexual Behavior https://doi.org/10.1007/s10508-020-01814-8 ORIGINAL PAPER Covariates of Multiplicity of High‑Risk Sexual Behavior Among Men in India: Evidence from the Latest Indian Demographic and Health Survey Shri Kant Singh 1  · Santosh Kumar Sharma 1  · Deepanjali Vishwakarma 1 Received: 9 September 2019 / Revised: 28 July 2020 / Accepted: 1 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020 Abstract Modern Indian society has witnessed rapid sociocultural transformation where loosening of cultural values is observed at all levels. In the era of transition, traditional norms and values are changing where young male individuals are found to be associ- ated with high-risk multi-partner sexual behavior. Findings are based on a nationally representative sample of 45,231 and 65,704 men aged 15–54 during the period 2005–2006 and 2015–2016, respectively. The burden of high-risk sexual behaviors among men aged 15–54 years in India over the last decade remains disproportionately higher among younger, unmarried, and urban men, who are mainly from economically better-of households. Despite tremendous eforts of the government of India as well as various state governments in condom promotion as part of the HIV/AIDS prevention program, the improvements in condom use over the last decade are not impressive as it has not yet reached the desired threshold level. The disparities in high-risk sexual behavior among men aged 15–54 years, coming from rich and poor households, have narrowed. The fndings of the study also underline an apparent paradox in the relationship between knowledge of HIV/AIDS and indulgence in high-risk sexual behavior and adopting safe sexual practices. It is recommended that all the HIV prevention programs in India should promote the concept of men as the responsible sexual partner. This concept may be promoted among young and unmarried men by reinforcing the shift from violence to respect and projecting the condom as a sexual stimulus rather than a means of disease prevention. Keywords High-risk sexual behavior · Condom use · Socioeconomic inequality · Men · India Introduction Understanding sexual behavior is fundamental to the efective prevention, planning of sexually transmitted diseases (STDs) and developing efective intervention programs (Aral & Ward, 2005). A study suggests that men and women express their sexuality diferently and behave diferently when engaging in high-risk sexual practices. More specifcally, young men tend to become sexually active earlier (Romero-Estudillo, González- Jiménez, Mesa-Franco, & García-García, 2014). In many com- munities, men are infuenced by cultural norms regarding man- hood, some of which are very negative in the context of HIV (Fleming, DiClemente, & Barrington, 2016; Kennedy et al., 2013). For social, cultural and economic reasons, men are often in a stronger position in their relationships with women, which gives them the authority and audacity and become the decisive one among the partners regarding the time and venue for sex- ual intercourse, or the willingness to use condoms (Dworkin, Treves-Kagan, & Lippman, 2013; Fleming, Lee, & Dworkin, 2014). Because of their position, men can be real advocates for behavioral change and social responsibility (Macia & Gresh, 2011). India with its patriarchal society encouraging male domi- nance, the power structure entitles male to organize the commu- nity and individual relationships. Societal gender roles further empower masculinity, wherein male tend to follow high-risk behavior (Khurana, 2018). Women become more exposed to HIV-prone infections through the diverse culturally infested machismo of power dynamics of decision making for utilization of condom and often they get subjected to undesirable sexual relationships where their male counterparts don’t seek their consent (Fleming et al., 2014, Khurana, 2018). These attitudes also make men vulnerable to HIV infection since they often * Santosh Kumar Sharma santoshiips88@gmail.com 1 Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400088, India