Levels and Determinants of Self-Reported STIs among Men in India: Evidence from National Family Health Surveys

Sexually transmitted infections (STIs) remain a public health concern, particularly in low- and middle-income countries. Despite the availability of nationally representative data, evidence on self-reported STIs (SR-STIs) among men in India remains limited. This study examines the prevalence of SR-STI symptoms and associated factors among sexually active men in India.

The data used in this study were drawn from the National Family Health Surveys; NFHS-4 (2015-16) and NFHS-5 (2019-21). The analysis included men aged 15-54 years who ever had sexual intercourse (NFHS-4: n = 78,085; NFHS-5: n = 71,128). Descriptive and bivariate analyses were conducted, followed by binary logistic regressions to estimate adjusted odds ratios (aORs) with 95% confidence intervals. Geographic variation in SR-STIs was examined using choropleth maps.

The proportion of men who had ever heard of any sexually transmitted infection (STI) increased from 89% in 2015-16 to 95% in 2019-21, while the prevalence of SR-STIs rose from 7% to 9%. Substantial inter-state variation in prevalence of SR-STIs was observed across both survey rounds. Younger age, Muslims, men with higher age at marriage and lower wealth status, alcohol and tobacco use, multiple sexual partners, and higher mass media exposure were significantly associated with SR-STI symptoms. The positive association of reported symptoms with mass media exposure may reflect greater awareness and reporting of symptoms rather than increased biological risk. Men residing in central, southern and eastern states showed higher odds of SR-STIs compared with those in northern states.

Self-reported STI symptoms remain a notable public health concern among sexually active men in India, with nearly one in ten men reporting such symptoms. Interventions should prioritize younger less educated men and those engaging in high-risk sexual behaviours, strengthen condom promotion and risk-reduction counselling, and improve access to confidential STI screening and treatment services. Targeted, male-centered and region-specific strategies are essential to reducing STI burden and improving sexual health outcomes.