Prevalence and Determinants of Contraceptive Use Among Married Men Engaged in Extramarital Relationships: Evidence from the NFHS-5, India

Background Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) remains a major global public health concern because of its persistent disease burden, lifelong treatment requirements, and substantial healthcare resource utilization. Although remarkable progress has been achieved through expanded access to antiretroviral therapy, preventing new infections remains a public health priority, particularly among populations engaging in high-risk sexual behaviors. This article examines the prevalence and determinates of condom use among men engaged in extramarital relationships.Methods This study utilized data from the fifth round of the National Family Health Survey (NFHS-5), conducted in 2019–21. The analysis was restricted to 497 married men who reported engaging in extramarital sex in the 12 months preceding the survey. Logistic regression was employed to explore potential determinants of condom use during extramarital sex.Results The findings reveal that 81% (404) of men engaged in extramarital relationships with unmarried women, followed by 14.9% (74) with married women. Among these, 53% of men reported using a condom during their most recent extramarital sexual encounter. The mean age of extramarital sex among men was 24 years. Age, education, caste, internet use, and awareness of family planning were found to have statistically significant associations with condom use during extramarital sex. Logistic regression analysis showed that internet use and awareness of family planning through the internet were strongly associated with increased condom use during extramarital sex (OR = 1.27, 95% CI: 1.19–1.35, p < 0.001; and OR = 1.77, 95% CI: 1.68–1.88, p < 0.001, respectively).Conclusion These findings underscore the need for tailored interventions addressing the specific vulnerabilities of men involved in extramarital relationships. Digital platforms should be effectively utilized to disseminate information on family planning and sexually transmitted infections (STI) prevention.