Qualitative Inquiry into Premarital Sexual Behaviours and Contraceptive Use among Multiethnic Young Women: Implications for Education and Future Research

Li Ping Wong,Kathleen A. O’Connor

doi:10.1371/journal.pone.0051745

Abstract

BackgroundThis study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory.MethodsA total of 34 focus group discussions with 185 participants were conducted among the Malay (35%), Chinese (34%), and Indian (31%) young females between November, 2010 and April, 2011. The participants were secondary school students and university undergraduates from Selangor and the Federal Territory of Kuala Lumpur.ResultsThe study found a lack of knowledge about sexual issues and contraception among the participants. Many engaged in unprotected sexual intercourse and relied on periodic abstinence, natural methods, and traditional folk pregnancy preventive practices. The findings also revealed numerous categories of factors influencing sexual attitudes and behaviours: ethnic group and religion, level of religiosity, peer pressure and norms, and parental monitoring. With regard to condom use, factors such as embarrassment about condom acquisition, low perceived susceptibility to sexually transmitted infections (STIs), and perceived efficacy of traditional and folk methods of contraception, were uncovered from the discussions.ConclusionThis study underscores the importance of development of culturally specific interventions that address the identified promoting factors of premarital sex. Behavioral interventions to promote condom use should increase awareness about condom effectiveness against not only unwanted pregnancies but also STIs.

Highlights

Premarital sexual behaviour has been a critically important area of research and the literature concerning this issue is abundant, the understanding of premarital sexual behaviour in Eastern countries, Islamic societies, is relatively scarce as sexuality remains a sensitive issue for many Muslims
A national study, conducted in 1995 by the National Population and Family Development Board (NPFDB) surveying Malaysian households, found that about 1% (13 of 1379) adolescents admitted that they had engaged in sexual intercourse and that most sexual encounters were unsafe, with no protection against sexually transmitted infections (STIs) and unwanted pregnancy [3]
Mean age (SD) Range Ethnicity Malay Chinese Indian Others Religiosity Very religious Somewhat religious Not at all religious Family background Average household monthly income a .MYR4000 MYR1000–4000,MYR1000 Parent’s discipline Permissive Moderate Strict Locality Urban Suburban Rural Sexual intimacy Dating status Currently dating Ever dated Never dated Non-sexual physical affecting during dating b, c Holding hands Kissing on face Kissing on lips Hugging Ever had sexual intercourse Yes Age of first sexual intercourse, years (SD) Mean (SD) d a1 US Dollar = 3.0 Malaysian Ringgit (MYR). bResponded by participants who have ever had dating relationship. cNumber of respondents do not sum up to 185 due to multiple-responses. dResponded by participants who have ever had sexual intercourse. doi:10.1371/journal.pone.0051745.t001

Summary

Introduction

Premarital sexual behaviour has been a critically important area of research and the literature concerning this issue is abundant, the understanding of premarital sexual behaviour in Eastern countries, Islamic societies, is relatively scarce as sexuality remains a sensitive issue for many Muslims. Being a moderate Muslim-majority nation, sex and related issues are sensitive and considered taboo for many in the three main ethnic groups. Little is known about the sexual attitudes and behaviours of young unmarried women in Malaysia. There were national reports regarding adolescent sexual reproductive health knowledge and attitudes [2,3], empirical evidence or published research in academic journals related to this issue is relatively scarce. A more recent nationwide survey, conducted in 2005, found that nearly 1.3% (25 of 1901) of young people aged between 15 and 24 years who were unmarried reported being sexually active [2]. This study was a qualitative investigation into sexual attitudes and behaviours, and contraceptive use among Malaysian youth, based on constructs from the health belief model, theory of reasoned action, and problem behaviour theory

Objectives

Methods

Results

Discussion

Conclusion