Multiple sexual partnership (MSP) and its distribution, determinants, gender differences, socio-economic inequalities and regional patterns: a nested multilevel regression analysis of a nationally representative survey among Indian youth (15–24 years)

Abstract Introduction The youth age group (15–24 years) is a crucial transition period between adolescence and adulthood, which shapes the sexual behaviour of humans as an adult. Unsafe sexual behaviours, such as Multiple Sexual Partnerships (MSP), can increase the risk of sexually transmitted diseases among Indian males and females. Hence, to prevent MSP early, an assessment of MSP is needed among Indian youth along with its determinants for targeted interventions. Methods This is a secondary data analysis of the National Family Health Survey (NFHS-5, 2019–2021) dataset. It included 4,669 Indian men (15–24 years) and 8,817 Indian women (15–24 years). MSP was defined as having more than one lifetime sexual partner. Nested multilevel logistic regression was used to estimate Odds Ratio, denoting the associations between MSP and explanatory variables (Socio-demographic, health-related, and behavioural factors). Results The prevalence of Multiple Sexual Partnerships (MSP) among Indian youth males (15–24 years) was 19.04%, and among Indian youth females (15–24 years) was 3.49%. Comprehensive knowledge regarding HIV/AIDS made a difference only among youth females (Odds Ratio (OR) 0.58), but this was not observed among males. Tobacco use (OR 1.87), alcohol use (OR 1.70), unmarried status (OR 2.17), domestic violence history (OR 1.26), and employment status (OR 1.40) increased the odds of MSP among Indian youth males (p < 0.05). Conclusion Around one in five Indian youth males and 3.49% of Indian youth females had Multiple Sexual Partnerships (MSP). Comprehensive knowledge about HIV influences the MSP of youth females, but not youth males. Broadening sexuality education, reducing substance abuse, combatting domestic violence, changing gender norms, and studying the emerging socio-cultural determinants of MSP are needed to reduce risky sexual behaviours among Indian males and females.