According to the World Health Organisation (WHO), more than one million curable STIs are acquired every day among people aged 15–49, most of which remain asymptomatic. In 2020, an estimated 374 million new infections were reported in this age group due to one of four curable STIs: chlamydia, gonorrhoea, syphilis, and trichomoniasis.

In addition to curable STIs, viral infections such as herpes simplex virus type 2 (HSV-2) and human papillomavirus (HPV) add to the global burden. Approximately 520 million people aged 15–49 are infected with HSV-2, the main cause of genital herpes, while HPV infection contributes to over 311,000 cervical cancer deaths annually. Maternal syphilis is particularly concerning, with 1.1 million pregnant women estimated to be infected in 2022, leading to over 390,000 adverse birth outcomes. These infections not only affect sexual and reproductive health but can also increase susceptibility to HIV, infertility, cancers, pregnancy complications, and psychosocial stigma.

Despite these risks, contraception remains underutilised in many parts of the world. WHO estimates that among 1.9 billion women of reproductive age globally, 1.1 billion need family planning services, yet 164 million experience an unmet need for contraception. Barriers include limited access, restricted choice of methods, fear or experience of side effects, cultural or religious opposition, poor quality of available services, and gender-based constraints.

Considering the persistent global burden of STIs and unmet contraceptive needs, promoting awareness about the benefits of contraception in protecting sexual health is crucial. Experts suggest that greater investment in sex education, breaking stigmas, and the active involvement of both men and women in contraceptive decision-making are essential to address existing gaps.

Which contraceptives prevent sexually transmitted infections?

While many contraceptive methods prevent pregnancy, only barrier methods effectively reduce the risk of STIs. These methods work by creating a physical barrier that blocks the exchange of bodily fluids during sexual activity.

Male condoms are among the most accessible and widely used methods. They prevent the exchange of vaginal, anal, and oral secretions during intercourse, reducing the risk of transmission of gonorrhea, chlamydia, and HIV. However, male condoms do not provide full protection against STIs spread via skin-to-skin contact, such as genital herpes, syphilis, or genital warts.

Female condoms, which line the vagina or anus, offer broader coverage than male condoms and potentially provide greater protection against external genital sores or lesions. Dental dams, made of latex or polyurethane, are placed between the mouth and the vagina or anus during oral sex and, when used consistently and correctly, are highly effective in reducing the risk of STI transmission.

According to the Centers for Disease Control and Prevention (CDC), barrier methods such as external and internal condoms and dental dams are highly effective in preventing pregnancy and many STIs, but consistent and correct usage is essential to maximise their protective benefits.

The situation in India

Contraceptive awareness and use in India have shown significant improvement in recent years. According to the National Family Health Survey (NFHS-5, 2019–21), the overall contraceptive prevalence rate among currently married women aged 15–49 rose from 54% to 67%. Modern methods—including sterilisation, pills, injectables, intrauterine devices (IUDs), implants, and condoms—are increasingly used across most states. Female sterilisation remains the most common method, practised by 38% of currently married women, followed by male condoms (10%) and contraceptive pills (5%). Among sexually active unmarried women, condoms are the most frequently used (27%). Knowledge of contraceptive methods is almost universal, with over 99% of men and women aware of at least one method.

Yet, family planning in India is largely shouldered by women. UNFPA’s analysis of NFHS-5 shows that while the use of modern contraceptives by men has risen slightly (by about four percentage points since 2015–16), a large majority (76%) remain non-users. Contraceptives used by men, like condoms and male sterilisation, make up just 17% of the modern contraceptive prevalence rate (mCPR), while women account for 83%. Female sterilisation alone contributes 67%. Even in the high-fertility age group of 20–29, where spacing methods are more relevant, women’s share in the method mix was more than double that of men. States with high contraceptive prevalence rates (above 50%) also show this imbalance, except Goa and Delhi, where men’s participation is slightly higher. This highlights the disproportionate burden placed on women in contraceptive use.

Discontinuation rates also remain a concern. According to the NFHS report, in the five years preceding the survey, one in two episodes of contraceptive use ended within 12 months. Discontinuation was highest for “other methods” (79%), injectables (66%), condoms (61%), rhythm (60%), withdrawal (59%), and pills (55%), while IUDs/PPIUDs saw lower rates (35%). The main reason was a desire for pregnancy, with only 7% discontinuing because they switched to another method.

Although the report notes that “since NFHS-4, knowledge of HIV/AIDS has increased more among women than men.” 87% of women and 94% of men have heard of HIV/AIDS, only 68% of women and 82% of men know that consistent condom use reduces transmission, and just 60% of women and 71% of men are aware that both condom use and limiting intercourse to one uninfected partner can prevent it.

However, it is important to note that HIV remains a public health challenge in India, with an estimated 25.44 lakh people living with HIV (PLHIV) in 2023, according to the India HIV Estimations report.

Commenting on these patterns, Dr Mansi Sharma, Consultant Obstetrician and Gynaecologist at Motherhood Hospitals, Pune, agrees that male participation remains a major gap and highlights similar concerns. “Many men are still uncomfortable with condoms, especially male condoms. The compliance is not as high as we would like. A common misconception is that condoms reduce pleasure, which discourages men from using them regularly. Although ultra-thin and lubricated varieties are available now, this belief persists,” she notes.

She explains that social stigma also plays a strong role in shaping behaviour. “People often associate condoms with casual or promiscuous sex. This makes many feel embarrassed to purchase them, which is still a major hurdle. For some men, it even becomes an issue of masculinity or ego, making them reluctant to use condoms,” she observes. In some cases, she says, men are so resistant that they insist their partners adopt invasive methods like intrauterine devices (IUDs) rather than use condoms themselves.

She adds that another widespread misconception is that couples in long-term or stable relationships do not need condoms. “Condoms remain useful if you want double protection against STIs. Unless both partners have been tested and their sexual history is clear, condoms provide essential safety.”

The way ahead 

To curb HIV and promote awareness of contraception, the Government of India has taken multiple measures. Under the National AIDS Control Programme (NACP), the National AIDS Control Organisation (NACO) coordinates HIV prevention, surveillance, and education, supported by State AIDS Control Societies (SACS).

The government has expanded the contraceptive basket to include condoms, combined oral contraceptive pills, emergency contraceptive pills, intrauterine contraceptive devices (IUCDs), sterilisation, injectable contraceptives under the Antara Programme (MPA), and Centchroman (Chhaya). Condoms are distributed widely, including through the Home Delivery of Contraceptives Scheme by Accredited Social Health Activists (ASHAs).

Dr Sharma acknowledges that awareness has improved, particularly among women, compared to earlier years. “I see more patients who are educated and proactive. Whether married or unmarried, they are aware that condoms protect against STIs, they ask questions, and many even come for STI testing on their own,” she says.

She also points to the role of changing platforms and spaces in driving awareness. Social media and medical influencers, she notes, are increasingly helping break taboos, while schools and parents can also play a stronger role in normalising conversations about sexual health and encouraging young people to seek medical advice when needed.

Drawing from her clinical practice, Dr Sharma explains that hospital visits often serve as opportunities for awareness. For example, women who come with complaints such as white discharge or for routine antenatal checkups are also counselled about contraceptive options and STI prevention. “Whenever a sexually active woman comes with such concerns, we take it as an opportunity to discuss prevention, available tests, and the importance of barrier methods. These conversations help increase awareness in practical, everyday settings,” she adds.