Shaping of Hypermasculinity and Its Influences on Sexual Behaviour: A Study of Youth in Slum Communities of Mumbai, India

Hypermasculinity is a psychological term for the exaggeration of male stereotypical behaviour such as an emphasis on physical strength, aggression and sexuality while exhibiting emotional self-control as a sign of toughness as well as composure and impassiveness in times of great stress. "Alcohol Use, Sexual Health Risks and HIV Prevention among Young Men in Low Income Communities in Mumbai, India (ASHRA)" data have been analysed to find out the correlates of Hypermasculinity and its influence on sexual behaviour and sexual satisfaction among youth residing in low income settings of Mumbai. In the slums of Mumbai, a little over one-third of youth is having low masculinity, two-fifths is having moderate masculinity, and one-fourth is having hypermasculinity which shows that hypermasculinity is very much pervasive in the community. Standard of Living (SLI) and migratory status do not have a significant association with Hypermasculinity whereas, education, marital status (both models) religion (both models), occupation (both models), exposure to pornographic materials, exposure to sexual stimuli and leisure time activities are having a strong association with hypermasculinity of


Introduction
Every man is not the same. Their behaviour is often dictated by societal messages, gender norms and conducted by the level of masculinity which they adopt. Masculinity is a set of qualities, characteristics or roles generally considered typical of, or appropriate to, a boy or man. It can have degrees of comparison: "more masculine", "most masculine'". The opposite can be expressed by terms such as "unmanly" or epicene. It consists of the characteristics of the male sex and the traits of behaving in ways considered typical for men. Masculinity is made up of both socially defined and biologically created factors [1][2][3]. Sometimes, masculinity is also referred as manliness or manhood. Traits traditionally cited as masculine include courage, independence, and assertiveness [4,5], competition, logic and rational thinking, strength, boldness and aggressiveness [6]. These traits associated with masculinity vary depending on location and context and are influenced by a variety of social and cultural factors [7]. "Hypermasculinity" on the other hand, is a psychological term for the exaggeration of male stereotypical behaviour such as an emphasis on physical strength, aggression and sexuality. According to Zaitchik and Mosher [8], hypermasculinity is an extreme form of masculine gender ideology, often comprised of a cluster of beliefs that includes toughness, violence, dangerousness, and calloused attitudes toward women and sex. According to Dennehy et al. [9] hypermasculinity exhibits emotional self-control as a sign of toughness as well as composure and impassiveness in times of great stress or emotion and hypermasculine pattern leads to competition, rather than connection between persons [10].
One of the first studies of hypermasculinity was conducted by Donald L. Mosher and Mark Sirkin in 1984 [11]. They have operationally defined hypermasculinity or the "macho personality" as consisting of three variables: callous sexual attitudes toward women; the belief that violence is manly; the experience of danger as exciting. They developed the Hypermasculinity Inventory (HMI) designed to measure the three components.
Hypermasculine gender ideology is most likely to be enacted during adolescence and young adulthood, the developmental periods during which peer group support for hypermasculine behaviours is believed to be high [8,12]. During adolescence, boys start to identify more strongly with the masculine stereotypes than they did during childhood [13].
Researches from all over the world have found that hypermasculinity is associated with sexual and physical aggression towards women [14,15]. Prisoners and criminals often tend to have higher hypermasculinity scores than control groups [16] and the issue of masculinity and its link to criminal and delinquent behaviour have also been identified [17,18]. High masculinity or hypermasculinity can reinforce the risk in one's own behaviour as well as the persons connected to them. Jejeebhoy et al. [19] found that masculinity is an important factor shaping a man's behaviour and attitude towards alcohol, sexuality and risky behaviour.
Notions of masculinity can put men in danger of contracting HIV and spreading the disease since these notions often emphasise promiscuity and risk taking without considering their vulnerability to the risk and infection [20]. Masculine identity have been linked to sexual behaviour and associated risk taking in many researches [21][22][23][24]. Halkitis et al. [25] found that conceptions of masculinity were intimately linked to body image and sexual adventurism such that men defined their masculinity by their physical appearance and sexual behaviour. In many societies, masculinity is associated with being sexually active with lots of partners; this is the behaviour that often gives men a higher status among their peers. Furthermore, young adult males will often Abstract Hypermasculinity is a psychological term for the exaggeration of male stereotypical behaviour such as an emphasis on physical strength, aggression and sexuality while exhibiting emotional self-control as a sign of toughness as well as composure and impassiveness in times of great stress. "Alcohol Use, Sexual Health Risks and HIV Prevention among Young Men in Low Income Communities in Mumbai, India (ASHRA)" data have been analysed to find out the correlates of Hypermasculinity and its influence on sexual behaviour and sexual satisfaction among youth residing in low income settings of Mumbai. In the slums of Mumbai, a little over one-third of youth is having low masculinity, twofifths is having moderate masculinity, and one-fourth is having hypermasculinity which shows that hypermasculinity is very much pervasive in the community. Standard of Living (SLI) and migratory status do not have a significant association with Hypermasculinity whereas, education, marital status (both models) religion (both models), occupation (both models), exposure to pornographic materials, exposure to sexual stimuli and leisure time activities are having a strong association with hypermasculinity of the youth in Mumbai. As expected, high positive condom attitude is less and low condom attitude is more among the hypermasculine group than those having low masculinity. Exposure to mass media is negatively and leisure time activities, relational satisfaction with girlfriend/wife as well as sexual satisfaction are positively associated with hypermasculinity among the youth.
underestimate their risk of contracting the disease since they feel that if they look healthy and feel strong then nothing can harm them [20]. Findings indicate that traditional masculine gender role ideologies are linked with young men's unprotected vaginal sex and perpetration of violence towards intimate partners [26]. Researches also suggest that men have a tendency to lie about their height and number of sexual partners because they feel their masculinity is under threat [27]. This possible link between desire to demonstrate masculinity and its influence on sexual risk taking behaviour especially among youth needs an in-depth study. Such study assumes importance since risk of contracting HIV/AIDS is associated with their deviation towards risky sexual behaviour, often when the youth focus on hypermasculinity and sexual prowess.

What causes hypermasculinity?
Though there are different hypotheses on the causation of these masculinized traits, the most accepted idea is that hypermasculinity stems from hormonal irregularities (i.e., higher levels of prenatal testosterone). The effects of prenatal androgens can be seen on levels of sexual orientation and masculinity. Many studies claim that low levels of prenatal androgens can lead to male homosexuality while the opposite is true for those who exhibit hypermasculinized tendencies, often having a higher likelihood of committing crime, and having aggressive attitudes. High testosterone levels can also be linked to a lack of empathy and moral judgments [28] which could lead to the hypermasculanized tendencies identified by Mosher & Sirkin [11].
Hypermasculinity can often be adopted by young men due to their exposure to TV commercials or magazine advertisements showing man often having hypermasculinity. As Vokey et al. [13] pointed out, the widespread depiction of hypermasculinity in men' s magazine advertisements may be detrimental to both men and society at large. Currently, many men (especially those who are relatively younger, less educated, and less affluent) are exposed to advertisements showing that being a man means being tough, dangerous, violent, and callous toward women and sex.
Accumulated research evidence reveals that the concept and construct of masculinity or hypermasculinity is evolving, multifaceted and dynamic and its various ideas are constructed under differing social, economic and cultural contexts [29,30]. In India, caste, class and linguistic ethnicity have tremendous influence on how men construct their masculinities and define what is a 'real man' or what is expected of them [31][32][33].

Focus of the study
In south Asia, including India, young men grow up in a maledominated society with very low sex education and with limited contact with females in the post-pubertal period. Under these circumstances, masculinity is often characterized by male sexual dominance, unequal gender attitudes and behaviours, frequent use of harassment or teasing of young women by men, and lack of sexual knowledge [34][35][36]. Men's practices in the society and the structural factors that sanction, encourage and shape those practices of masculinity and sometimes hypermasculinity needs to be explored since in due course they have influence on youth behaviour. The present study is an attempt to find out the socio cultural correlates of hypermasculinity among youth residing in low income settings of Mumbai. This study also tries to focus on hypermasculinity as factor shaping sexual behaviour and sexual satisfaction of the youth.

Data
The study has used information from a community based survey as part of a National Institute on Alcohol Abuse and Alcoholism sponsored project entitled "Alcohol Use, Sexual Health Risks and HIV Prevention among Young Men in Low Income Communities in Mumbai, India (ASHRA)" conducted by International Institute of Population Sciences (IIPS), Mumbai with Institute for Community Research and University of Connecticut Health Center (UCHC), Connecticut, USA as partners. ASHRA survey was conducted from September 2005 to August 2009. The study was conducted in three low income urban communities in Greater Mumbai using a combination of quantitative and qualitative research methods. A mixed methods study, ASHRA included various forms of mapping, participant observation, key informant interviews, in-depth interviews with drinkers, and a questionnaire survey of 1239 men aged 18-29 years using randomized clustered sampling technique.
The purpose of the study has been to conduct formative research on the interaction of alcohol use and sexual risk-taking in targeted slum communities in Mumbai for use in formulating approaches to multi-level interventions to combat the combined risks of drinking and unsafe sexual practices that can lead to STI/HIV. Major issues and sub issues covered were background information, social life, alcohol, relationships, masculinity, sexuality and sexual health.

Why were these three communities chosen for the survey?
ASHRA project was designed to conduct formative research on the interaction of alcohol use and sexual risk-taking in targeted slum communities in Navi Mumbai such as Surendra Nagar, Chandra Nagar and Barsi Store. These designated slum communities share some of the characteristics of urban slums -they are densely packed. Urban infrastructure (water, lights, toilets, drainage, and paved streets) is lacking. Food and water are distributed under unsanitary conditions. Residents tend to be poor although there is a range in income among the residents of our study communities.
These areas have low income families, accommodate migrants and are in close proximity to a substantial industrial sector promoted by the Mumbai Industrial Development Corporation, justifying being included in study. Industrial development and construction are among the factors that have drawn migrants to the area over the past 40 years. The communities chosen for inclusion in the study are within walking distance of a very large wholesale market that serves the greater Mumbai area. Bearing in mind, the fact that presence of the commercial sex work sites adds a very conducive risk environment for alcohol and sexual risk for STI/HIV, one of the three localities has a red light area where more than 1500 Female Sex Workers (FSWs) have been operating. Despite the above commonalities, these communities occupy a separate niche and have a slightly different migration, occupation and political history of formation and development that depict different pictures operating within.

Methods
Bivariate and Multivariate techniques have been carried out for analysis of the data. Information about the dependent and independent variables are listed below. Binary Logistic regression has been employed to see the correlates of Hypermasculinity among the youth. For the analysis low and moderate masculinity have been coded as '0' and hypermasculinity as '1' which was the independent variable for the binary logistic regression. Two models were run to get the effect of the selected variables on hypermasculinity. In the first model the socio-demographic variables such as age, education, marital status, religion, Place of Birth (born in Mumbai), occupation, SLI and ever had sex were controlled. In the second model along with the above mentioned variables, exposure variables such as media exposure, exposure to pornography and leisure time activities were incorporated.

Correlates of Masculinity
Further a number of scales have been used in an attempt to capture covariates of hypermasculinity and its influence on sexual behaviour and sexual satisfaction. A brief description of these variables and scales is presented below. All these were computed by recoding a continuous Guttmann's scale created by merging statements concerning exposure to the variables of interest canvassed mostly on 5 point scale after testing of reliability and normalizing the scale.

Masculinity
This scale was constructed by merging eighteen statements (mentioned below) including items measuring male right to control over dimensions of household life, such as wife's activities, spending money and child's education and right to man's decision to engage in risky behaviours such as gambling, drinking and going out with friends. The continuous scale has also been classified into three categories: low, medium and high. In this study youth with high masculinity has been considered to be hypermasculine.

Statements used to create Masculinity Scale
You can demand sex and receive it whenever you want it You will play cards whenever you wish to You would never allow a woman to take the initiative for sex You would not allow your wife/lover to walk in the community without a burkha** / dupatta*** You alone would decide on children's schooling matters *Daaru: Alcohol **Burkha: A loose piece of clothing that covers the head and body completely except for the eyes. It is mainly worn in public by Muslim women. ***Dupatta: A length of material or a multi-purpose scarf worn, arranged in two folds over the chest and thrown back around the shoulders, typically by women from South Asia.

Condom attitude
By merging a series of statements (If you have extra-marital sex, you will always use a condom, You have used a condom, You know where to get condoms, Condoms can prevent sexually transmitted diseases, Condoms can prevent conception, Condoms can tear, Condoms are only for use with sex workers, Condoms reduce the pleasure of sex, When a man drinks, it is hard to remember to use a condom) concerning different attitude towards condom use, this scale was constructed. The index was then classified into three groups -low, moderate and high.

Exposure to pornographic materials
This scale was created by merging two sentences (How often does the following activity make you think about having sex-Blue films? How often does the following activity make you think about having sex -Other porno materials?) concerning exposure to different forms of pornographic materials canvassed on 5 point scale after testing of reliability and normalizing. The index has also been categorized as low, medium and high.

Exposure to sexual stimuli
The scale was constructed by merging six statements (How often do the following activities make you think about having sex-Romantic movies? Blue films? Other porno materials? Watching women? Watching women dance? Drinking alcohol?) concerning exposure to different forms of sexual stimuli. The continuous scale has also been converted in three categories: low, medium and high.

Leisure time activities
This was computed by merging eight statements (Do you play cards with your friends? Do you roam with your friends? Do you gamble with your friends? Do you drink alcohol with friends? Do you visit beer bars/ drinking place with your friends? Do you watch blue films with your friends? Do you visit CSW with your friends? Do you meet girls and women with your friends? ) concerning known risk related activities men do with friends including roaming, drinking, playing cards, gambling, seeking women etc. transformed by hand into a Guttman Scale and divided into one, two, and three or more activities.

Relationship satisfaction with wife
This scale was created by merging three statements (How true the following statements are about your marital relationship?-You feel happy about your marital relationship, You feel discouraged about your marital relationship, You are very satisfied with your marital relationship) concerning relationship with wife. The continuous scale has also been grouped into two categories: satisfied and not satisfied.

Who are these youth?
This section presents the demographic and socioeconomic characteristics of the young men included in the study.
As presented in Table 1, overall, half of the respondents belonged to 25-29 age group and one-third of them were in the age group 21-24. Two-fifths respondents were never married and a little over one fifth of married respondents were not living with their wives at the time of the survey. The distribution of the respondents by duration of their stay in the present community revels that almost one-third of respondents (30 percent) were living in these communities since birth and 28 percent had been living there for last ten years or more. Overall, 15 percent of men aged 18-29, have no education and an additional 19 percent of men have completed only primary school. Only 12 percent of young men age 18 to 29 in low income communities have 10 or more years of education. A large majority of men (overall 80 percent) in these communities are Hindu followed by Muslim (11 percent). Despite relatively lower levels of education, majority of young men in these low income areas had high level of media exposure. In total, almost one-third of the respondents included in the study were factory workers and one-fifth were drivers (mainly auto-rickshaw drivers). Low income communities are often characterised by sub standard and crowded housing which is again reconfirmed by the fact that nearly one-third of the respondents in the study communities lived in houses where the number of persons per room was more than four. Table 2 and 3 present the levels of masculinity and its relationship with various socio-demographic, economic factors and other key factors such as media exposure, exposure to pornographic materials, sexual stimuli, and leisure time activities.

Dimensions and determinants of hypermasculinity among the youth in slum communities
It is apparent from results that a little over one-third of youth in the slums of Mumbai demonstrates low masculinity, two-fifths a moderate masculinity and one-fourth hypermasculinity. This shows that hypermasculinity is very much pervasive in the community.
This study found that age and educational attainment is having an inverse relationship with hypermasculinity. A little more than one-fifth youth in the age group of 25 and above had hypermasculinity compared to 29% youth in age group 20 and below. Among youth having above high school education, 40% have low masculinity compared to 30% among the illiterate young men. Migration also plays an important role in determining the levels of masculinity among the youth of Mumbai. Low masculinity is found more among the youth who were born in Mumbai than those who have migrated from any other place to Mumbai. Close to one-fourth of the Buddhists and Hindus as compared to two-fifths of the Muslim men in the community had hypermasculinity. When the extent of hypermasculinity was explored with respect to different occupational groups, it was observed that it is high among contractors and self home workers (35 percent) followed by factory workers and others (27 percent). It was the lowest among Government workers.
Nearly three-fifths young men from the low SLI group exhibited the traits of moderate to hyper masculinity as compared to those from higher SLI groups.
Hypermasculinity is more prominent among unmarried men (29 percent) compared to married men (22%). It was also found that exposure to mass media is negatively and leisure time activities are positively associated with hypermasculinity.

Multivariate analysis results
Two models of Binary logistic regression analysis were run to check the effect of several socio-demographic and exposure variables on hypermasculinity of the youth in Mumbai. It was found that compared to illiterates, youth having high school and above high school education were 35-40% less likely (p≤ 0.10) to show hypermasculinity. Muslim young men were 2 times more likely (p≤ 0.01) to have hypermasculinity than the Hindus. With reference to rock breakers/loaders/construction workers, youth who worked on their own and at home were 3 times (p≤ 0.01) more likely to have hypermasculinity. Whereas factory workers as well as 'other' group of workers were 1.8 times more likely (p≤ 0.05) to have hypermasculinity than having low or moderate masculinity. Married men are 30-35% less likely (p≤ 0.01) to have hypermasculinity than the unmarried men. Youth who never had sex in their lifetime are 50% less likely (p≤ 0.01) to have hypermasculinity compared to those youth who ever had penetrative sex. Results also show that youth with high media exposure were 76% less likely (p≤ 0.01) and   Whereas, young men having "three or more" leisure time activities compared to those with no activity, are 2 times (p≤ 0.01) more likely to demonstrate hypermasculinity. Those who had medium exposure to pornographic materials were almost 3 times (p≤ 0.01) more likely to have hypermasculinity compared to youth with low exposure to pornographic materials.
Overall it was found from the logistic regression that SLI and migratory status do not have significant association with hypermasculinity whereas, education, marital status (both models) religion (both models), occupation (both models), exposure to pornographic materials, exposure to sexual stimuli and leisure time activities are having strong association with hypermasculinity of the youth in Mumbai.

Influence of Hypermasculinity on youth risk behaviour
Influence of hypermasculinity on sexual debut, patterns of drinking, condom attitude, condom use, relational and sexual satisfaction, multiple partnerships has been established in this section to better understand hypermasculinity as a core construct underlying sexual risk behaviour of youth. This segment specifically looks at intrinsic relationship between hypermasculinity and risk behaviours among the youth of Mumbai.
From Table no. 4, it is evident that, there is not much difference in patterns of drinking of the youth with hyper, moderate and low masculinity. As expected, high positive condom attitude is less and low condom attitude is more common among the hypermasculine group than those youth having low masculinity. Though more condom use at sexual debut is found to be high among youth with hypermasculinity, use of condom in last sex is lower than other two masculine groups of youth.
Almost 94% youth coming under hypermasculine group are having high relational satisfaction with their wife as compared to only three-fifths with their girlfriends. But it has been observed that with increasing masculinity low relational satisfaction is decreasing and high satisfaction is increasing. Alike relational satisfaction, sexual satisfaction is also more among the married youth than the unmarried youth of the hypermasculine group. But it should be noticed that with increasing masculinity, sexual satisfaction is increasing among the youth irrespective of their marital status.
"I do sexual intercourse almost every alternate day with my wife. I am sexually satisfied with her. I expect my wife to fully cooperate with me and whenever I wish for sexual intercourse. I am getting full cooperation from my wife for sex. " (Age-34, Education-7th, Occupation-Commission Agent).
Not much difference was observed in the three groups of low masculine, moderate masculine and hypermasculine men when number of unprotected sex with non spousal partner in the last one year was considered. Most of them reported no unprotected sex while 3-4% informed to have had it less than 5 times and 1-2 % 5-10 times on a whole. The same situation can be seen when number of non spousal partners in the last on year was taken into account. Around 5% youth with hypermasculinity informed of having two or more non spousal partner and 6-8% of youth irrespective of level of masculinity had one non spousal partner in the last one year.
" Currently I am enjoying vaginal sexual intercourse with my wife in the house and in addition to that I have sexual relations with the sex workers at store. " (Age-25, Education-8 th , Occupation-Auto Driver).
Interestingly, communication with girlfriend as well as wife is increasing with increasing hypermasculinity.

"My wife is very open to me and we share all our feelings. I am satisfied by my wife and she is also satisfied by me. "(Age-25, Education-7th, Occupation-Factory Worker).
Hypermasculinity did not show any significant relationship with sexual debut of the youth in the communities.

Discussion
Findings from many countries show that older men had more equitable gender attitudes than men in the middle-age groupings affirming the importance of men gaining experience in cohabitation and its influence on men's attitudes [33,37]. In this study, it has also been observed that hypermasculinity has an opposite relationship with current age of the respondents. It may be due to the fact that in young adolescent ages men tend to have lesser experiences and knowledge about relationships and also fail to understand the line demarcated  between masculinity and hypermasculinity. In young ages, they tend to get influenced by their peer groups. Relatively, lesser percentage of youth from Hindu religion are having hypermasculinity than the Muslims, which can be attributed to more inequitable traditional gender norms found among the Muslims. Another study done in Mumbai also found that Muslims are more likely to hold inequitable views about gender. Religious leaders like Imams and Aalimas within the religious sector, in particular, were found to have the highest levels of internal agreement in less equitable norms, and thus may send a strong and more consistent message to others in the community endorsing inequitable gender roles [38].
Other than age and religion, education and employment also have impact on the extent of masculine perceptions a youth upholds. External factors such as education, work stress, job security and poverty contribute to men's likelihood to hold rigid notions about masculinity, which can result in harmful behaviour [39]. Results have revealed that hypermasculinity is having an inverse relationship with educational attainment. Educational attainment in any society can be considered as crucial indicator, which enhances the ability of a person to perceive the gender norms more liberally. Literatures also suggest that youth employment is not only crucial to the lives of young men but also to society. Youth employment is critical for social and economic stability and growth, apart from all the other good reasons why it is important for society to give it the greatest attention [40]. Young men themselves perceive that employment helps them to develop a wide range of beneficial attributes such as the capacity to take responsibility, develop time-management skills, overcome shyness with adults, and handle money and employment makes them feel more like an adult. Critics also report that adolescents engage in a wide range of problem behaviours like drinking and smoking more, with increased hours of work [42,43]. So employment is a fundamental part of the transition to adulthood and plays a vital role in providing them with economic security and expediting their participation in society at multiple levels and it is necessary to see the effect of employment and types of jobs on the perception of the youth about masculinity. Our study demonstrates that very few government workers in the study sample had hypermasculine traits as compared to more number of self employed men and contractors. This can be attributed to the fact that government jobs are generally perceived as less stressful as compared to self employed jobs or private sector jobs. A study by Crompton [44] among Canadian workers established that being self employed increased the likelihood of being highly stressed.
Like employment, marriage is a vital event in the life of a person which mainly needs sharing of life with a partner, respect and commitment in relationship. The present study found that married men are less likely to have hypermasculinity which may be attributed to the fact that after marriage, the perception, attitude and gender norms of youth may get reshaped due to sharing and gradual understanding of marital relationship. This is also reconfirmed by a study of Barker et al. [37] that married men may learn to "soften" or modify their attitudes as they acquire experience in co-habiting relationships with women.
Education, employment, religion and marital status may not always determine a youth's thinking process and thus the extent of masculinity among youth may get influenced by their exposure to the outer world. Dewan [41] found that by gradually shaping public opinion on personal beliefs, and even people's self-perceptions, media influences the process of socialization and shapes ideology and thinking. This study observed that more youth with low media exposure are having hypermasculinity indicating that they tend to accumulate ideas about more gender equitable norms and behaviour from their exposure to various forms of mass media. Thus, exposure to outer world based on interaction and networking with several places and people may act as an important tool revealing the contexts and environments in which people are living and hence influencing their masculinity.
Till now, the discussions have lead to a relevant conclusion that socio-demographic and exposure variables do determine a youth's hypermasculinity in the slums of Mumbai. On the other hand, hypermasculinity also have effects on youth behaviour and more specifically on risky sexual behaviour. The study found that communication with girlfriend and wife is more among the hypermasculine youth and these youth who are standing high on masculinity scale were more likely to fulfil their sexual desire and ensure pleasant sex performances, resulting in having sexual as well as relational satisfaction. In a study done in Mozambique, men revealed that multiple sexual partnerships are viewed as an expression of manhood thus increasing the risk of HIV infection [45]. Faxelid et al. [46] also found that engaging in sex with many partners and practising unsafe sexual practices, which could result in STIs, appears to add status to men. But contrary to these literatures the present study did not find any significant relation between hypermasculinity and number of non spousal partners in last one year and unprotected sex with non spousal partners in last one year. This may be due to the fact that, context and environment in which these young men in slums are living, a substantial proportion is engaged in unprotected sex irrespective of extent of masculinity.
Researchers have long observed that negative consequences of expression of masculinity include gender-based violence, sexual abuse of women, and homophobia [31]. Hypermasculinity has been found to be directly related to increased violence against women [15,[47][48][49], dangerous driving and accidents [14,50,51], and drug and alcohol abuse [11,14]. Specifically, young men may feel pressure to prove their sexual prowess by having unprotected sexual relationships, may feel hindered from seeking information about sexual and reproductive health (SRH) and HIV issues, and face peer pressure to prove their dominance over girls [37,52]. Likewise, our study too discerned that positive condom attitude is low among the hypermasculine youth. This study also affirms the fact that in Mumbai, youth who are having more leisure time activities are more likely to have hypermasculinity. This suggests that notions and perceptions about masculinity may be influenced when youth meet friends, spend time, discuss and have open communication with them.

Conclusions and Recommendations
The study points at the crux of the issue of hypermasculinity and its connectedness with youth's risk taking behaviour. Traditional norms about sexuality and the gender roles attributed to both the sexes in the family and society mostly effectuate hypermasculinity. Other reasons behind this could be the misconceptions, unawareness, unavailability of sex education and less guidance at the adolescent age of these youth living in the slums of Navi Mumbai. As Verma et al. [53] found, most significant changes occur in the adolescent age, which sometimes bring tremendous amount of curiosity about sex and sexuality among both boys and girls and if they are not properly supported by adequate information and understanding, these curiosities are likely to result in several misconceptions, a sense of shame and guilt and in the long run this may result in poor self-esteem. Therefore, implementation of sex education as part of curricula under framework of family life education in schools is an exigent task. School dropouts should be targeted by clubs/organisations in the slums which may be achieved by organising curriculum based educational sessions on relationship dynamics and addressing masculine behaviour of young men in low income communities of metropolis. These sessions should encompass imparting correct knowledge and information about the sexuality, safe sexual practices, addictions and HIV, especially for youth at early ages. It has been noticed that young men with more leisure time activities tend to have hypermasculinity in these low income communities of Mumbai. Use of leisure time, peer based social networks and networking locations can be effectively utilised for implementation of intervention sessions which will be accessible, appropriate and acceptable to the youth. Exposure to pornographic materials and surfeit of opportunities have resulted in hypermasculine perception in these areas resulting in multi partner, premarital and extra marital sexual activities, which are mostly unprotected putting a higher proportion of men and women at the pedestal of contracting STDs including HIV. This calls for an immediate attention of policy makers and programme planners to deal with the dual challenge of liberalised sexual norms and practices and increased burden of unprotected sex amplifying susceptibility of STI/HIV through innovative approaches of interventions. Promoting equalised gender norms among the youth in the slums and discouraging control over their partner's sexuality is imperative. Awareness about gender equality and equity in sexual relationships minimising sexual dominance in relationships should be promoted. Services like counselling and psychological support centres designed to help couples to work towards healthy relationship based on respect and breaking the predetermined role and behaviour assigned to men and women is needed. Above all women should not be looked as sexual objects and should get a feasible environment to seek control over their own sexuality specially when their husbands/boyfriends are revealing high extent of masculinity.

Limitations
As it was presupposed that the respondents had correctly answered all the questions of masculinity, some bias might have been incorporated into the study since to uphold their masculine personality the respondents might have exaggerated or compressed the answers. Another limitation is that the data used in this paper is only cross-sectional data. Also, this study was not focused explicitly on hypermasculinity; better and more direct measures of masculinity and risk behaviour will improve potential study outcomes. Finally the study population was aged 18-29 years; hence, coverage of broader age group would have given much more prominent results.