Unmarried Young People Research Articles

Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study.

BackgroundDelaying sexual initiation has been promoted as one of the methods of decreasing risks of HIV among young people. In traditional countries, such as Ethiopia, retaining virginity until marriage is the norm. However, no one has examined the impact of this traditional norm on sexual behaviour and risk of HIV in marriage. This study examined the effect of virginity norm on having sex before marriage and sexual behaviour after marriage among rural Ethiopian youth.MethodsWe did a cross-sectional survey in 9 rural and 1 urban area using a probabilistic sample of 3,743 youth, 15–24 years of age. Univariate analysis was used to assess associations between virginity norm and gender stratified by area, and between sexual behaviour and marital status. We applied Kaplan-Meier and Cox regression analysis to estimate age at sexual debut and assessed the predictors of premarital sex among the never-married using SPSS.ResultsWe found that maintaining virginity is still a way of securing marriage for girls, especially in rural areas; the odds of belief and intention to marry a virgin among boys was 3–4 times higher among rural young males. As age increased, the likelihood of remaining a virgin decreased. There was no significant difference between married and unmarried young people in terms of number of partners and visiting commercial sex workers. Married men were twice more likely to have multiple sexual partners than their female counterparts. A Cox regression show that those who did not believe in traditional values of preserving virginity (adjusted hazard ratio [AHR] = 2.91 [1.92–4.40]), alcohol drinkers (AHR = 2.91 [1.97–4.29]), Khat chewers (AHR = 2.36 [1.45–3.85]), literates (AHR = 18.01 [4.34–74.42]), and the older age group (AHR = 1.85 [1.19–2.91]) were more likely to have premarital sex than their counterparts.ConclusionAlthough virginity norms help delay age at sexual debut among rural Ethiopian youth, and thus reduces vulnerability to sexually transmitted infections and HIV infection, vulnerability among females may increase after marriage due to unprotected multiple risky sexual behaviours by spouses. The use of preventive services, such as VCT before marriage and condom use in marriage should be part of the HIV/AIDS prevention and control strategies.

Can the Internet Be Used Effectively to Provide Sex Education to Young People in China?

Purpose To assess the feasibility and effectiveness of sex education conducted through the Internet. Methods Two high schools and four colleges of a university in Shanghai were selected as the research sites. Half of these were assigned to the intervention group and the other half to the control group. The interventions consisted of offering sexual and reproductive health knowledge, service information, counseling and discussion to all grade one students in the intervention group. The intervention phase lasted for 10 months and was implemented through a special website, with web pages, online videos, Bulletin Board System (BBS) and expert mailbox. In total, 624 students from the intervention, and 713 from the control schools and colleges participated in the baseline survey, and about 97% of them were followed up in postintervention survey to assess changes that can be attributed to the sex education interventions provided through the Internet. Results The median scores of the overall knowledge and of each specific aspect of reproductive health such as reproduction, contraception, condom, sexually transmitted infections (STIs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) were significantly higher in the intervention group as compared with those in the control group at postintervention ( p < .0001), although no significant differences were found between these two groups in the baseline survey ( p > .05). Group by time interaction effects in ordinal logistic regression analysis were found on knowledge score ( p < .0001) and in attitude of high school students toward sex-related issues ( p < .05), suggesting that interventions increased subjects’ knowledge significantly and changed high school students’ attitudes to being less liberal toward sex. The intervention also had positive influence on students’ attitudes toward providing contraceptive service for unmarried people. Conclusions Providing sex education to students in Shanghai through the Internet was found feasible and effective. The Internet-based sex education program increased students’ reproductive health knowledge effectively and changed their attitudes toward sex-related issues in terms of being less liberal toward sex and more favorable to providing services to unmarried young people. The Internet thus offers an important and hitherto untapped potential for providing sex education to students and young people in China.

Effects of a community-based sex education and reproductive health service program on contraceptive use of unmarried youths in Shanghai

Purpose To evaluate the effectiveness of a youth-friendly intervention in promoting one safe sex behavior—contraception and condom use among unmarried young people aged 15–24 years in Shanghai, China. Methods The study was conducted in two towns of a suburban area of Shanghai (one as the intervention and the other as the control), with comparable socio-cultural-economic and demographic characteristics. The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among unmarried youths, in addition to the routine program activities, which were exclusively provided in the control site. Baseline surveys were conducted in both sites before the implementation of the intervention, and similar surveys were conducted in both sites 20 months after the intervention had been initiated to test the feasibility and effectiveness of the intervention. In total, 1220 unmarried young people from the intervention site and 1007 from the control site, including 1304 out-of-school youths and 923 high school students, were recruited, and about 92% of them were successfully followed up. Four main measures were examined (i.e., ever contraceptive use, current regular contraceptive use, ever condom use, and contraceptive use at onset of sexual intercourse—if it occurred during the course of the intervention). The reasons for nonuse of contraceptives, the status of joint decision on contraception and the first method used were also assessed. Data were analyzed using Logistic regression models with dichotomous measures of contraceptive use and Generalized Estimating Equations (GEEs) with repeated measures. Results At baseline, there was no statistical difference in contraceptive use between the intervention and control groups. After intervention, the proportions reporting regular contraceptive use and condom use in the intervention group were much higher than that in the control group ( p < .001). A group × time interaction effect ( p < .0001) was found for regular contraceptive use and ever condom use. Logistic regression analysis with dichotomous measures of contraceptive use and GEEs with repeated measures showed similar results. The regular contraceptive use and ever condom use were correlated with subject's occupation and family economic status, respectively. After adjusting for demographic factors, the subjects from the intervention group were 14.58 (OR) times as likely to use contraceptives at onset of intercourse as those from the control group (95%CI: 8.55–24.87, p < .0001). Similar results were found for both females and males. Conclusions A multifaceted intervention program that provided information and skills, as well as counseling and services, appears to have positive influences on contraceptive practice and condom use among unmarried young females and males in suburban Shanghai.

Access to contraceptive services among unmarried young people in the north-east of China

Objective The concerns about the potential threats of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) have increased, since, in China, there is a lack of sexual education and condom use is rare. A community-based survey was conducted in September 2001 in Changchun city among 1227 unmarried young people aged 15-24 years (619 males and 608 females) to assess risky sexual practices and the obstacles to accessing appropriate contraceptive and other services. Method The study comprised a survey employing self-administered questionnaires, as well as key informant interviews, focus group discussions and in-depth interviews. This paper investigates the factors associated with young people's access to contraceptive services. Results Results showed that 16% of young people had experienced premarital sexual intercourse and, among them, only 48.2% used contraceptive methods during the first sexual intercourse; 29.9% used a condom. Drug stores were the main source of contraceptives. Conclusions While data are sparse, findings suggest that the hostile and judgmental attitudes of providers, as well as the lack of counseling and privacy, were the key obstacles that unmarried youth encountered in their search for contraceptive services. Findings suggest the need for a reorientation of the contraceptive services to focus on unmarried youth, and generally to make contraceptive services more accessible to young people.

Meeting the Contraceptive Needs of Unmarried Young People: Attitudes of Formal and Informal Sector Providers in Vientiane Municipality, Lao PDR

In Lao PDR, evidence is emerging of considerable sexual activity among unmarried youth, but contraceptive services remain inadequate to meet their needs. This study explored the attitudes of formal and informal sector providers in serving the contraceptive needs of unmarried youth in Vientiane Municipality, their perceptions of quality of care, confidentiality and privacy, level of comfort in discussing sexual matters, and any differences between providers in the two sectors. In-depth interviews were carried out with 56 key informants, followed by a quantitative survey of 150 formal sector and 100 informal sector providers. We found ambivalence and discomfort among providers in communicating with unmarried youth and providing contraceptives to them, and low priority placed on their right to privacy and confidentiality. Providers tended to attribute difficulties almost entirely to young people's inhibitions and unwillingness to listen. Less than 60% of formal sector providers would supply contraceptives to unmarried youth, compared to 80% of informal providers, but the latter were more likely to charge a fee for supplies. Both formal and informal sector providers need training in communication and counselling skills for serving unmarried youth. Programmes must ensure that unmarried youth have access to good quality contraceptive services and supplies.

Knowledge of sexual health issues among unmarried young people in Nepal

Early and universal marriage has traditionally been the norm in Nepalese culture, although the practise of delayed marriage appears to be on the increase. In 1961, nearly 75 per cent of young women aged 15 to 19 years were married; this figure declined to just under 50 per cent by 1991 and to a low of 40 per cent in 2001 (Mehta 1998; Khanal 1999; NDHS 1996 and 2001). This, along with the advent of reducing age at first menarche due to improved nutritional status, has led to an increase in the window of opportunity for premarital sexual activity to occur.

Determinants of condom use among young people in urban Cameroon.

To reduce the prevalence of reproductive health problems among adolescents, governmental and nongovernmental organizations in Cameroon are implementing youth-oriented reproductive health programs. To facilitate the design of effective programs to increase condom use, this study examines survey data on the determinants of having ever used condoms and on current condom use with regular and casual partners among unmarried young people in urban Cameroon. While most adolescents have tried condoms at least once, use remains inconsistent. Parental support, personal risk perception, and self-efficacy are found to be associated with higher levels of condom use. Youth-oriented programs seeking to increase the number of new condom users among the young should promote parental support for condom use and enhance young people's perceptions of personal risk. Programs that work to convince the young that their sexual history can put them at risk of HIV infection and that dispel the myth that HIV risk with regular partners is low may serve to increase personal risk perception. Finally, communications programs should aim to increase adolescents' self-efficacy, particularly in terms of their perceived ability to convince partners to use condoms and to use them correctly.

Timing of Alcohol and Other Drug Use and Sexual Risk Behaviors among Unmarried Adolescents and Young Adults

Although alcohol and drug use by young people has been associated with sexual risk behavior in some research, detailed data are lacking on the timing of substance use in relationship to sexual risk-taking. Cross-sectional data on 7,441 unmarried young people aged 14-22 from the 1992 Youth Risk Behavior Survey (household supplement) were used in the analysis. Alcohol and other drug use at last sexual intercourse, substance use in the past 30 days (recent use), the number of different substances ever used (lifetime use) and age at initiation of alcohol use are examined here. The outcome variables assessed through multivariate regression analyses were condom use at last intercourse and more than one sexual partner in the past three months. Failure to use a condom was strongly associated with the lifetime substance-use scale or, alternatively, with age at initiation of alcohol. Once the number of substances ever used was controlled for, neither substance use at last sexual intercourse nor recent use was associated with the likelihood of using a condom at last coitus. Among young men and women, recent substance use and use of either alcohol or drugs at last intercourse were both strongly associated with having had more than one sexual partner in the past three months. For females only, lifetime use also increased the probability of recent multiple partners. The relationships between alcohol and other drug use and two sexual behaviors--condom use and multiple partners-suggest distinct mechanisms of influence and the need for different prevention strategies.

Sexual Experiences and Their Correlates Among College Students in Mumbai City, India

Sexual behavior among unmarried young people and its correlates among college students were examined in the metropolitan city of Mumbai India. Data from a 1997 survey of 966 low-income college students were analyzed in order to identify levels of sexual behavior. Multivariate analysis was used for behavior correlation. Findings showed that 47% of males and 13% of females had had any sexual experience; 26% and 3% respectively had had intercourse. In the analysis of factors affecting the odds of any sexual behavior between males and females that reached a marginal level of statistical significance (p < 0.10) individual and intermediate variables were found to have had significant effects on students sexual behavior but most familial factors were not significant. Degree of knowledge degree of exposure attitudes and amount of social interaction concerning sex-related issues were foundational in predicting sexual behavior of the students. The outcomes of the study differed between male and female students. The relationship between knowledge about sexual issues and sexual behavior was found to be an inconsistent one. Thus in spite of the opposition of Indian parents school-based sexuality programs are needed in order to provide students with accurate information about pregnancy contraception and sexually transmitted diseases.

Premarital Sex Among Young People in Langjun District, Yingcheng County

In June 1986 we conducted an investigation into premarital sex among young people in Langjun District, Yingcheng County, Hubei. Taking into account the secrecy and sensitivity of this problem and the mental frame of young people in the rural areas at present, we adopted an indirect survey approach. By dividing those investigated into three groups—unmarried youth, married young and middle-aged people, and old people (over 50) in the ratio of 1:1:0.5—we made a random sample survey of 250 persons.

Survey of Abortions among a Portion of Single Young Women in Beijing

In recent years, there has been strong reaction from gynecology and obstetrics as well as family planning departments of many Beijing hospitals on the question of unmarried young women who had come to them to perform abortions. They suggest that relevant quarters reinforce moral and ideological education among unmarried young people to reduce such incidents. From June to August 1984, the Beijing Family Planning Association, with the assistance of city public health departments, surveyed the situation in six city hospitals. The method was that of natural sampling, that is, interviews with applicants who had come for such operations during the above period, who had voluntarily stated that they were not married. A total of 275 cases were studied, 150 at the Municipal Gynecology and Obstetrics Hospital, 73 at Chaoyang District Hospital, 16 at West City Chinese Medicine Hospital, 16 at Erlonglu Hospital, and 10 each at Fuxing and Zhanlanlu Hospitals.

Development of a scale to measure attitude toward the condom as a method of birth control

The Attitude Toward Condoms Scale (ATC) was developed as an assessment instrument for use in research directed toward promotion of barrier methods of contraception. The resulting 40-item, Likert-type scale was found to have an internal consistency reliability coefficient of .93, with an average inter-item correlation of .24. It is comprised of five major factors, accounting for 45No of the total variance. The scale has been shown to be sensitive to a positive attitude change manipulation, giving some evidence of its construct validity. It has been estimated that, on the average, at least half of sexually active, unmarried young people fail to use contraception consistently (Anderson, McPherson, Beeching, Weinberg, & Vessey, 1978; Brown & Pollack, 1983; Fisher, et al., 1979; Pollack & Brown, 1982). Among the young and unmarried who do use contraception, the method most used at first intercourse appears to be the condom (Brown & Pollack, 1983; Parcel, 1975b; Sorensen, Drusin, Ley, Deuschle, & Yano, 1978). As sexual activity continues, oral contraception (the pill) gains

Effectively Strengthen Party Leadership Over the Work of Family Planning

This article tells of the steps taken by the party committee of T'ai-hu Fishery Commune in Wu-hsi municipality, Kiangsu, to strengthen the Party's leadership over family planning. The key lies in realizing how important family planning is to the state, the collective, and the individual. It is important to the state and the collective because, with fewer children, women's hands are freed to help men increase productivity. It is important to the individual becuase, with fewer people to look after, each family will have more to spend to raise their standard of living. Next the committee tried to change thought patterns. They encouraged late marriage and family planning. They tried to convince people to give up outmoded ideas such as it being preferable to have sons rather than daughters; that the more children one has, the greater the support; and that giving birth is a private matter of minor importance. The committee then enlisted the aid of the medical personnel in the commune. At first reluctant to regard family planning as part of their job, they later worked constantly to publicize to the masses the significance of family planning and hygiene. Some members of the commune were sterilized. After a few years the effects of the family planning programs began to show. Of 383 couples with reproductive potential, 345 practice family planning. Over 95% of the unmarried young people plan to marry late. It is estimated that this year's birthrate may drop to 10 or less per 1000.