'If your husband calls, you have to go': understanding sexual agency among young married women in urban South India.

BACKGROUND: Early marriage is common in many developing countries, including India. Women who marry early have little power within their marriage, particularly in the sexual domain. Research is limited on women's ability to control their marital sexual experiences. METHODS: We identified factors affecting sexual communication among married women aged 16-25, in Bangalore, India, and how factors associated with sexual communication differed from those influencing non-sexual agency. We ran ordered logit regression models for one outcome of sexual agency (sexual communication, n = 735) and two outcomes of non-sexual agency (fertility control, n = 735, and financial decision-making, n = 728). RESULTS: Sexual communication was more restricted (83 women (11.3%) with high sexual communication) than financial decision-making (183 women (25.1%) with high financial decision-making agency) and fertility control (238 women (32.4%) with high fertility control). Feeling prepared before the first sexual experience was significantly associated with sexual communication (odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.13-2.89). Longer marriage duration (OR 2.13; 95% CI = 1.42-3.20) and having worked pre-marriage (OR 1.38; 95% CI = 1.02-1.86) were also significant. Few other measures of women's resources increased their odds of sexual communication. Education, having children, pre-marital vocational training and marital intimacy were significant for non-sexual outcomes but not sexual communication. CONCLUSIONS: Policy-makers seeking to enhance young married women's sexual communication need to consider providing sex education to young women before they marry. More broadly, interventions designed to increase women's agency need to be tailored to the type of agency being examined.