South Asian sexual health: Scoping study
Summary of findings
Intermediary stakeholders interviewed confirmed that sex outside marriage is still largely forbidden within the South Asian culture and religion. Young men and women from the Bangladeshi, Pakistani and Indian communities are expected to remain chaste until they marry. It is still important that they do not dishonour their family or community by breaking these requirements. This is especially true for young women who are seen to be the key ‘upholders’ of their family’s honour. There can be serious repercussions if women do not adhere to the rules, with the risk of being ostracised by their family and community.
A majority of stakeholders believe that while young South Asians understand the expected behavioural norms, many wish to live their lives by their own personal values, even if only for a while before they have to conform to an arranged marriage. As a result, stakeholders unanimously reported that sex before marriage is rising amongst unmarried young South Asian men and women.
Stakeholders suggested that young Indian men and women are beginning to have greater freedom to socialise with members of the opposite sex and there is some loosening of parental controls. As a result, there are greater opportunities to meet people of the opposite sex, to date and to have sexual relationships. Some parents are becoming more open minded and are permitting their children to marry the partners they date.
Amongst the Bangladeshi and Pakistani communities, traditional gender roles and expectations are reported as still largely entrenched. Young Muslim men are becoming more westernised in their behaviour, although they are able to operate within the requirements of their own community. Whilst they are still expected to have arranged marriages, pre-marital sex is more acceptable as long as this is discreet. Feedback suggests that more young Muslim men are engaging in sex before marriage with white and South Asian partners.
A number of stakeholders suggested that they are seeing more Muslim women who are also engaging in less culturally acceptable behaviour. Some are seeking to follow their own desires (without their parents’ knowledge) as many feel they have a small ‘window of opportunity’ before they have an arranged marriage at a relatively young age. Thus, a number of stakeholders are aware of more young Muslim women engaging in pre-marital sex.
There is evidence of some gender differences in attitudes to sex and sexual behaviour. Stakeholders suggest that the first sexual encounter for many young South Asian men tends to be with white partners. In fact, those engaging in casual sex are almost invariably sleeping with white girls. It is suggested that this is because there is a commonly held view amongst these men that girls from the white community are more willing to engage in sex, there are fewer cultural consequences and they generally do not feel the need to take responsibility for contraception.
By contrast, sex with a South Asian woman is typically taken more seriously by young men and is more likely to take place within a more serious relationship. This is because there is perceived to be a higher risk if their partner becomes pregnant, as this would lead to shame for their parents and their partner’s parents if this were discovered. In this instance, men are more likely to take responsibility for contraception if their partner does not wish to use more planned forms such as the pill.
Stakeholders generally feel that for women from all three ethnic communities, sex outside marriage is taken seriously because of the social stigma attached to not being a virgin when they marry. However, it would appear that South Asian women are increasingly taking the risk as they often do not personally feel there is anything wrong in engaging in sex before marriage and sex usually takes place in the context of a relationship.
Most stakeholders reported that for some young men and women, their first sexual experiences can be at a relatively young age. For boys, this can be around the ages of 15 or 16, whilst some stakeholders had given advice on sexual health to young girls aged 16 and over.
Generally, stakeholders feel that there is an increasing confidence in discussing sex amongst this target audience, although this is not across the board. For example, younger girls often find it difficult to discuss their sexual experiences for fear of being judged if they admit to having sex.
It is reported that knowledge of contraception varies amongst this target group but knowledge of condoms is felt to be relatively high amongst men and women. However, unsurprisingly, women are generally felt to be more aware of the different forms of contraception as it is in their interests to be aware.
Despite knowledge of contraception, a number of stakeholders reported increasing numbers of young South Asian women seeking emergency contraception and advice about pregnancy and terminations.
It was difficult for stakeholders to comment definitively about condom usage amongst young men. However, many reported that they have been distributing more condoms to this group and more young South Asian men are asking for free condoms. However, the higher reported requests for the morning after pill and the cases of unplanned pregnancy suggests that there are incidences of unplanned sex.
Where condoms are used, this appears to be primarily for preventing unplanned pregnancies rather than as protection from STIs. Stakeholders generally felt that young South Asians do not see themselves as at risk from STIs. It was suggested that most young South Asians do not believe they are promiscuous. Therefore, many young men see little need to use condoms if they believe their partners are using other forms of contraception. This appears to be true even for those who are engaging in casual sex with a number of partners.
Lack of access to condoms was also perceived to be a possible reason for non usage. For some young South Asians, cost is thought to be prohibitive and access to free condoms varies depending on availability of grassroots organisations willing to distribute them. Additionally, it was assumed that many young men and women are uncomfortable going to their Asian GPs or local pharmacists for fear their parents might discover their sexual activities.
Most stakeholders reported a variety of local initiatives they have been involved in to raise awareness of contraception and sexual health amongst the target group. It was typically felt to be important that these take account of parental and community attitudes to sex before marriage but that they are targeted to the specific needs of young local South Asians.
The main objective for the scoping study amongst stakeholders was to provide insight into the attitudes and behaviour amongst young South Asians. More specifically, to gauge:
- general attitudes to sex, sexual health and condoms;
- current sexual behaviour amongst this target group and likely condom usage;
- what types of interventions could create behaviour change;
- whether further research is required to test hypotheses directly with the target group.
A need was identified for research to provide insight into the current attitudes and behaviours of young South Asians with regard to sex and sexual health. Given that sex outside marriage is considered taboo, it was felt that it may be difficult to get young South Asians to be truthful about admitting to behaviour which may go against cultural expectations. Given this, it was agreed that conducting a scoping study amongst intermediary stakeholders such as PCTs, doctors and community advisors could help to provide some initial insight into this audience and to ascertain if there is a need for specific and tailored interventions targeting young South Asians.
Stakeholder research to provide insight into the attitudes and behaviour amongst young South Asians around sex, sexual health and condoms
Individual interviews – 12 face-to-face, 3 by telephone
Data collection methodology