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Indian Journal of Community Medicine

Sexual Practices other than Peno-Vaginal Sex: Perceptions and Practices in an Urban Community

Author(s): Anupam Raizada, S.B. Gupta, Arun Kumar

Vol. 27, No. 4 (2002-10 - 2002-12)

Deptt. of Social and Preventive Medicine, M.L.B. Medical College, Jhansi (U.P.)

Abstract:

Research question: What are the perceptions and practices of urban community about some of the sexual practices?

Objective: To identify the perceptions and practices of urban residents regarding sexual practices other than peno-vaginal sex.

Study design: Community based cross-sectional study.

Setting: An urban area of Jhansi.

Participants: Married couples having wife within reproductive age group.

Study variables: Sexual practices other than peno-vaginal sex.

Sample size: 417 couples of the area.

Statistical analysis: Proportions, chi-square test.

Results: Response rate was 63.8%. Only 27% respondents felt that masturbation is a normal activity, while 55.2% experienced it and 70.7% of them had their first experience between 10-15 years of age. Further, 34% respondents thought that some homosexual behaviour is normal part of growing up. Fifty four percent respondents had experience of homosexual relation and 77% of them had it first between 13-18 years. About half of the respondents, who experienced oral sex, found it enjoyable and only 24% respondents had experience of anal sex.

Conclusion: Correct knowledge about masturbation and homosexuality was low. Practice of masturbation, homosexual contacts and oral sex was more in comparison to anal sex.

Keywords: Urban, Couples, Non-penovaginal sex, Practices, Perceptions

Introduction:

With the advent of AIDS, researchers have found new emergence of an old and forbidden topic for consideration, that is, 'Sex'. Since long, the subject was neglected and considered as taboo by Indian Society and researchers as well. But, as a chief mode of spread of Acquired Immuno Deficiency Syndrome (AIDS), sex came in limelight, Peno-vaginal sex, certainly because of its universality in all countries and races, was identified as main culprit for the transmission of Human Immuno deficiency Virus (HIV).

Due to absence of any vaccine or treatment against HIV, prevention was identified as main tool for the arrest of its rapid spread. Masturbation provides safety against AIDS as it includes sexual relations with oneself, whereas, homosexual relations and anal sex pose grave risk of spreading AIDS. Oral sex also has some theoretical risk, but is not of much importance.

Present paper, part of a large KAP (Knowledge, Attitude, Practices) survey on sexuality of urban married couples1, is concentrated on perceptions and practices of urban people regarding sexual practices other than peno-vaginal sex, i.e. masturbation, homosexuality, anal sex and oral sex.

Material and Methods:

The present study was carried out in the urban field practice area of Department of Social and Preventive Medicine, M.L.B. Medical College, Jhansi (UP). The unit of study was a couple, having wife within the age group 15-45 years and both partners living together. Data were collected with the help of a pre-tested, self-administered questionnaire. The questionnaires were distributed among all the relevant couples of the area by door-to-door visits.

Couples were briefed about necessity and nature of the survey and filling of questionnaire. They were also told that the questionnaire has to be filled-up by either of the spouse. Social class of the respondents was identified by the criteria given by Kumar2. Chi-square test was used for statistical significance, wherever required. For calculation of significance, persons giving 'no response' were not taken into account.

Results:

In all, 417 couples were identified in the area and questionnaires were given to all of them. However, only 266(63.8%) filled in questionaires could be received back and rest of them were either misplaced by couples or they were non-cooperative.

Table I: Socio-demographic characteristics of the respondents (n=266).

Characteristic No. %
Sex    
Male 196 73.7
Female 70 26.3
Religion    
Hindu 167 62.8
Christian 49 18.4
Muslim 38 14.3
Sikh 12 4.5
Caste    
Upper 151 56.8
Backward 61 22.9
Scheduled 54 20.3
Family    
Nuclear 127 47.7
Joint 139 52.3
Social class (per capita monthly income in rupees)    
I(>1000) 79 29.7
II(500-999) 90 33.8
III(300-499) 59 22.2
IV(150-299) 26 9.8
V(<150) 12 4.5

Out of 266, 196(73.7%) questionnaire were filed up by husband and 70(26.3%) by wives. Maximum respondents were Hindus (62.8%), followed by Christians (18.4%). Fifty seven percent of the respondents were of upper caste (56.8%) and nearly half of the respondents belonged to nuclear families (47.7%). About two-third of the respondents (63.5%) were of upper social classes (I and II)2. Almost 60% of the respondents were of less than 34 years of age. Maximum number (45.1%) of respondents were educated upto Intermediate and Graduation and occupation-wise 53% belonged to service class.

Table II: Respondents by their perceptions about masturbation.

Response Husbands
(n=196)
Wives
(n=70)
Total
(n=266)
No. (%) No. (%) No. (%)
Normal activity 66 (33.7) 6 (8.6) 72 (27.1)
Bad to health 86 (43.9) 30 (43.9) 116 (43.6)
Can cause impotance 26 (13.3) 6 (8.6) 32 (12.0)
Good to health 12 (6.1) 8 (11.4) 20 (7.5)
No response 6 (3.1) 20 (28.6) 26 (9.8)

p<0.05

Regarding masturbation, only 27% respondents felt it as normal activity, whereas, majority of respondents (55.6%) either took it as bad for health (43.6%) or that it can cause impotance (12.0%). More males (33.7%) considered it as normal activity than females (8.6%).

Table III: Respondents by their experience of masturbation and age at first experience.

Experience Husbands
(n=196)
Wives
(n=70)
Total
(n=266)
No. (%) No. (%) No. (%)
Ever experienced 134(68.3)   13(18.5)   147(55.2)  
Never experienced 62(31.6)   57(81.4)   119(44.7)  
p<0.05
Age at first Experience (n=147) No. %
10-12 13 8.8
13-15 91 61.9
16-18 36 24.5
19-21 07 4.8
Mean age at first experience of masturbation = 14.26 years

Fifty five percent respondents reported having experience of masturbation and out of them, 70.7% had done it for the first time before the age of 15 years. Experience was higher in males (68.3%) in comparison to females (18.5%). The responses between the sexes were significantly different, whether it is perception about masturbation or its experience (p<0.05).

Table IV: Respondents by their perceptions about homosexual behaviour - whether it is normal part of growing up.

Response Husbands
(n=196)
Wives
(n=70)
Total
(n=266)
No. (%) No. (%) No. (%)
Yes 77 (39.3) 14 (20.0) 91 (34.2)
No/It is a sin 106 (54.1) 46 (65.7) 152 (57.1)
No response 13 (6.6) 10 (14.3) 23 (8.6)

p<0.05

About one-third of the respondents (34.2%) thought that some homosexual behaviour is the normal part of growing up.

Table V: Respondents by their experience of homosexual relations and age at first homosexual experience.

Experience
(n=266)
Husbands
(n=196)
Wives
(n=70)
Total
(n=266)
  No. (%) No. (%) No. (%)
Ever experienced 117 (59.7) 26 (37.1) 143 (53.8)
Never experienced 77 (39.3) 39 (55.7) 116 (43.6)
No response 2 (1.0) 5 (7.1) 7 (2.6)

p<0.05

Age at first Experience (n=143) No. %
10 - 12 12 8.4
13 - 15 51 35.7
16 - 18 59 41.3
19 - 21 15 10.5
22 - 24 06 4.2
Mean age at first experience of homo- sexual relations = 15.16 years

On the contrary, such relations were experienced by 53.8% of the respondents and out of them, 77% had it first between 13-18 years. More males had considered it as normal (39.3%) and also more males had experience of it (59.7%) in comparison to females (20% and 37.1% respectively). Moreover, in both the cases responses of males and females differed significantly (p<0.05).

Table VI: Respondents by their perceptions and practices of oral sex.

Respondents/practices Husbands
(n=196)
Wives
(n=70)
Total
(n=266)
No. (%) No. (%) No. (%)
Sin/should not be done 34 (17.3) 9 (12.9) 43 (16.2)
Enjoyable experience 56 (28.6) 12 (17.1) 68 (25.6)
Done for partner's enjoyment 47 (24.0) 13 (18.6) 60 (22.6)
Never experienced 56 (28.6) 30 (42.9) 86 (32.3)
No response 3 (1.5) 6 (8.6) 9 (3.4)

p>0.05

Experience of oral sex was enjoyable for 25.6% respondents, whereas, 22.6% respondents practised it for the enjoyment of partner. The difference between males and females was not statistically significant (p>0.05).

Table VII: Respondents by their experience of anal sex.

Experience Husbands
(n=196)
Wives
(n=70)
Total
(n=266)
No. (%) No. (%) No. (%)
Good 25 (12.8) 3 (4.3) 28 (10.5)
Bad 25 (12.8) 11 (15.7) 36 (13.5)
Never experienced 140 (71.4) 49 (70.0) 189 (71.1)
No response 6 (3.1) 7 (10.0) 13 (4.9)

p>0.05

Regarding anal sex, 24% of the respondents experienced it and more than half of them (13.5% of total respondents) found it bad. More females (16%) had bad experience than males (13%). Responses between the sexes, however, did not differ significantly (p>0.05).

Discussion:

Present study shows that although only about one-fourth of the respondents knew that masturbation is a normal activity, more than half of the respondents had experienced it and over 70% of them experienced it first before 15 years of age. Savara and Sridhar3 in their 'Debonair' questionnaire survey found that 96% of their respondents had experienced masturbation and 63% of them had their first experience before 16 years of age. In the survey of Basu4, 74% and 82% males in 'in-home' and 'in-hall' surveys, respectively, accepted having experience of masturbation, while, corresponding figures for females were 22% and 23%. These figures nearly correspond to our results.

Regarding homosexuality, only about one-third respondents of present survey felt that some homosexual behaviour is a normal part of growing up but more than half of the respondents had experience of homosexual relations and more than three-fourth of them had their first homosexual experience between 13-18 years of age. Savara and Sridhar3 reported that 37% of their respondents had homosexual experience and most of them had it first before 20 years of age. Savara and Sridhar5 in another study reported that incidence of homosexual experience ranged from 1-6% amongst different groups. In present survey, the incidence of homosexual relations is high which may be because of two reasons. First, because of rise in the age of marriage, may be more persons are moving towards their easily available and familiar partners of same sex, or second, due to change in social values and more openness in the society, more and more people are coming forward to accept their homosexual relations.
In our study, nearly half of the respondents had experience of oral sex and 24% of anal sex. Close to these findings, Savara and Sridhar3 found that 59% and 16.3% married respondents had experience of oral and anal sex, respectively. In another study experience of anal sex was found in 2-5% of the subjects of different working groups5. Practice of oral sex is higher, which may be due to decrease in the age old inhibitory forces against it. The low incidence of anal sex may be due to its painful nature.

The difference in homosexual experience and anal sex in above mentioned two studies of Savara and Sridhar is large, however, no explanation is given for this in later study. The difference, however, may be due to methodology. First study was through questionnaire published in an adult magazine. Whereas, second study was through interviews and also it was among different working groups.

In conclusion, it can be said that although most of the people had incorrect knowledge and perceptions about masturbation and homosexuality, they practice these very often. Oral sex was also experienced by a good proportion of persons. Practice of anal sex was low in comparison to masturbation, homosexual relations and oral sex. Males and females differ significantly on masturbation and homosexuality but not on practices and perceptions about oral and anal sex.

References:

  1. Raizada A. AIDS and Sexuality: A study in the urban area of Jhansi city, MD thesis, Department of S.P.M., M.L.B. Medical College, Jhansi.
  2. Kumar P. Social classification - Need for constant updating. Indian Journal of Community Medicine 1993; 18: 60-1.
  3. Savara M, Sridhar CR. Sexual behaviour of urban educated Indian men: Results of a survey. The Journal of Family Welfare 1992; 38(1): 30-43.
  4. Basu DP. Appropriate methodologies for studying sexual behaviour in India. Indian Journal of Social Work 1994; LV: 573-88.
  5. Savara M, Sridhar CR. Sexual behaviour amongst different occupational groups in Maharashtra. India and the implications for AIDS education. Indian Journal of Social Work 1994; LV: 617-32.
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