Home
|
Table of Content Volume 17 Issue 1 - January 2021
Knowledge, attitude, behaviours towards sex and sources of influences among youth in rural areas of northern Andhra Pradesh
Sai Lahari1, Abhinaya2*
1,2Assistant Professor of Psychiatry, Department of Psychiatry, Great Eastern Medical School and Hospital, Ragolu, Srikakulam, INDIA. Email: abhinayarvr@gmail.com
Abstract Background: The study was undertaken as there is very less literature related to sources of influence for sexual knowledge and attitude toward sex and sexual behaviors of youth in India. Aim: The objectives of the study were to explore sexual knowledge, attitudes, behaviors and the sources of influence. Method:The present study was carried out in the rural areas of Srikakulam district from February 2018 to March 2019. The sample was selected from colleges in rural areas of Srikakulam district in Andhra Pradesh. The tools used were sociodemographic data sheet, Sexual Knowledge and Attitude Questionnaire (SKAQ-II) and Sexual Behavior and Sources of Influence (SBSI) scale. Results: Descriptive statistics and correlation was done to analyze the data. The youth had poor sexual knowledge; there was positive relationship between sexual knowledge and attitudes. Sexual behaviors through media and with self or others were found to be low. Internet was found to be the major source for gathering information and was considered the most reliable source. Conclusion: Indian college youth continue to have poor sexual knowledge. Internet is a major source of information and is considered as the most reliable one among youth. More knowledge about sex is associated with liberal attitude toward sex. Key words: Media, Sexual Behavior, Sources of Influence, Rural college youth.
INTRODUCTION Currently, in many societies, unmarried, single youths are sexually more active than commonly realized. Adolescents also maintain sexual relationships, even though cultural values in countries like India do not permit this1 Sexual behaviors of adolescents depend on their knowledge about sex, attitudes and sources of influence. Sexual knowledge refers to the knowledge about sexuality, myths and misconceptions. The studies in this area cover knowledge about reproduction, pregnancy, masturbation, abortion, fertility, methods of contraceptive use and sexually transmitted diseases (STDs) and also gender differences in sexual knowledge.2,3 Sexual attitude refers to the attitude one has toward sexuality or sexual behaviors, which could be either liberal or conservative.4 Sexual knowledge and attitudes are often studied together. In a study exploring knowledge about reproductive health among 6549 married men in five districts of the northern state of Uttar Pradesh, India, it was reported that very few men had basic knowledge in areas pertaining to fertility, maternal health and STDs.5 Another study by Kumar and Tiwari1 assessed the knowledge, attitude and behavior toward premarital sex among 469 youths living in two city slums. It was observed that only 17% of the youth population was aware of safe sex and 22% had the prior knowledge that even first-time intercourse may lead to pregnancy. Joshi,2 in her study on sexual knowledge, attitudes and behaviors in urban youth (17-21 years), found that knowledge about physiology of sexual response, conception and pregnancy was less than that about other areas such as masturbation and contraception. Boys reported more liberal attitudes and more frequent sexual behaviors than girls. Social attitudes clearly favor cultural norms of premarital chastity, particularly for females, thereby leaving limited decision-making power in their sexual relationship.6 Studies on sexual behaviors have looked at the kind of practices young adults indulge in such as premarital sex, masturbation, watching pornography and sexual behaviors using mediums such as phone, social networking sites and chatting rooms.1,7,8 Sexually active adolescents engage in practices that pose a risk to sexual health. An earlier age of initiation of sexual activity has been associated with less frequent condom use, greater number of sexual partners, elevated rates of STDs and unplanned pregnancies.9,10 Often they do not take informed decisions about sexual practices and use of contraceptives, resulting in significant risk of experiencing negative consequences.11 Jeejeebhoy and Sebastian12 noted that a substantial proportion of young people who engage in risky or unwanted sexual activity do not receive prompt or appropriate care and therefore, experience adverse reproductive health outcomes. Contextual factors such as poverty, gender imbalances and lack of education or livelihood opportunities clearly increase the vulnerability of youth. Although young people's knowledge and awareness about sexual and reproductive health is increasing, much of this knowledge remains superficial and ridden with myths, misperceptions and a sense of invulnerability. Many factors that influence the early onset and increase in sexual activities of adolescents in developing countries include early age of sexual maturation, lack of knowledge about sex, declining cultural and religious influences and urbanization.13 Gender discrimination coupled with the stigma about discussing sex and sexuality issues with young people further contributes to risk-taking behaviors amongst youth, thus influencing their sexual and reproductive health.14,15 Although peers, books and magazines were the most frequently used sources of information on sex,2 Internet is gradually taking over all these sources. The Internet and other new media technologies such as digital cameras and cell phones have made sexually explicit materials more accessible to young people than ever before. Media plays a major role in determining whether certain teenagers become sexually active earlier rather than later.16 Much of the concern over increasing accessibility of explicit sexual content is that young people may develop unrealistic ideas about and/ or undesirable patterns of sexual behavior because of the exposure.17
METHODS The ethical clearance for the study was obtained from Institute Ethics Committee. The study was carried out in the rural areas of Srikakulam from February 2018 to March 2019. Sample consisted of 742 unmarried young adults from colleges in rural areas of Srikakulam District. The inclusion criterion for the study was young adults who could understand English language, were in the age range of 18-25 years and consenting to participate in the study. The tools used were sociodemographic data sheet, Sexual Knowledge and Attitude Questionnaire (SKAQ-II) and Sexual Behavior and Sources of Influence (SBSI) scale. Sociodemographic data sheet was used to collect details such as age, gender, education, occupation and socioeconomic status. A self-administered Sexual Knowledge and Attitude Questionnaire-II (SKAQ-II)4 was used to assess knowledge and attitudes. Sexual Behavior and Sources of Influence scale was divided into two sections: one for assessing sexual behavior and other for assessing sources of influence. Sample from the colleges was obtained after getting permission from college authorities. The study tools were administered in group format after the informed obtaining consent from the participants. Ethical considerations such as confidentiality, anonymity, right to participate and right to withdraw at any point of the study were ensured.
RESULTS The sample comprised of more number of females (n =374, 50.4%) than males (n = 368, 49.6%). Average age was 19.6 years. With respect to the courses that they were pursuing, 166 were doing business management, 206 commerce, 42 arts and 328 science. All of them were from Middle and Lower middle class socioeconomic status. Sexual knowledge and sexual attitude The mean score for sexual knowledge was 18.52 (±4.76), which indicates that the participants had poor knowledge regarding sexuality. The item analysis for most frequently agreed and disagreed items are given in Table 1. The mean score for sexual attitude was 36.79 (±7.32), indicating that the participants had a liberal attitude toward sexuality. The item analysis showed that 78% of them agreed that it is always bad to engage in extramarital sex; 82% agreed that abortion should always be with permission; 65% agreed that virginity should be encouraged in our society and 43% of them disagreed on abortion is not a crime. Sources of influence The youth gathered information about sexuality largely from Internet, friends, movies, newspapers, magazines and books compared with getting knowledge from parents and family members. With respect to clarifying doubts, most of them relied on friends, and the least preferred source was parents. They trusted Internet as the most reliable source of information followed by friends and printed material compared with other sources.
Sexual behaviors of the youth The mean for sexual behaviors through media was 9.83 (±4.76), indicating low level of indulgence in sexual behaviors using media. The mean for sexual behaviors with self and others was 27.97 (±12.46), indicating low level of indulgence. The mean for not interested in sexual behaviors was 6.34 (±1.98), indicating low level of aversion to sexuality. The percentage of youth reporting indulgence in sexual behaviors across various subsections is presented in Table 2.
Table 1: The most frequently agreed and disagreed items on sexual knowledge and attitude questionnaire (n = 742)
Table 2: Sources of influence and sexual behaviors as reported by participants (n = 742)
DISCUSSION The participants in the study had poor knowledge regarding sexuality such as masturbation, sexuality in females and children and effects of increased sexual activity. This is inconsistent with the study done by Choi and Ha,18 who found that although sexual knowledge was low with college students, knowledge with regard to masturbation, induced abortion and contraception was high in their sample. The item analysis indicated that they tend to have good knowledge regarding STDs and condom usage for prevention of STDs [Table 1]. This finding was inconsistent with studies by Bloom et al.,5 who explored the knowledge about reproductive health among males, and a study by Kumar and Tiwari,1 who reported that only 17% of college students knew about safe sex practices, STDs and maternal health. The reason for the present sample to have better knowledge may be that the youth in the present study were better educated or gathered more knowledge about safe sex practices. It can also be noted that many of them had relied on the Internet and social networking sites to obtain information would have contributed to clarifying the doubts or attaining knowledge easily without hesitation and feelings of stigma [Table 2]. The participants showed liberal attitude toward sexuality, this could be because of the participants’ education level.7 Item analysis of the scale showed that the participants expressed conservative attitude toward premarital and extra marital sexual practices, which could be because of sociocultural factors and family values where there is strict ideology regarding these issues.20 They expressed liberal attitude over usage of contraceptives and abortion. The finding may be understood in the background of major campaign on prevention of AIDS in recent times, which encourage usage of contraceptives. The campaign majorly happens through mass media to which everybody is exposed often.21 With respect to sources of information regarding sexual matters, majority of the participants gathered information from Internet; this could be because of easy access to information through Internet. This result is in accordance with the study done by M’Imaita,22 who found that information accessed through the media by adolescents included pornographic pictures and text, dressing and fashion, sex styles and contraceptive use. The Internet has become an abundant source of both sexual information and pornography which is difficult to regulate.23 A large percentage of the youth in the study get the knowledge from friends. This could be because discussing sexual matters openly is a taboo and parents or family members are often hesitant in initiating or discussing about it, youth choose to discuss with friends.24 This is further corroborated by the fact that very low percentage of them get information from parents and family members (Table 2). Further, half of the participants get information about sexual matters from the movies. While movies are considered as one of the important sources of information,25 it can also foster misconceptions, since the content in the movies can be distorted in terms of views on romance and normal adolescent sexuality, sexual performance and stereotypes of male and female sexuality.26 Similarly, less than half of the participants get information from newspaper, magazine and books. However, Joshi2 found that peers, books and magazines were the most frequently used source of sex information. Now that the electronic media is available in various forms, access to Internet is replacing the print media in gathering information. With regards to sources for clarifying doubts or experiences regarding sexuality, participants found discussing or clarifying among friends as comfortable. This could be because the youth might feel that their peers might also have had similar doubts/experiences, since they are also of the same age and also that they tend to spend lot of time together, thus may be comfortable discussing personal issues.24 A lower percentage of them found discussing sexual matters with doctors or medical professionals comfortable. This hesitation could be because the professionals often themselves find it uncomfortable and they do not ask about these issues.27 A very less percentage of them discussed these matters with parents, teachers and other family members, which may be because of taboo associated with talking about sexual matters in our country.7,28 Some of them indicated that they feel comfortable discussing with siblings, which may again be because of the same age range. The sources which the youth consider reliable to provide information about sexuality were Internet, followed by friends, and newspaper, magazines and books, movies, parents and family members. The findings on sexual behavior of the youth show that the indulgence in sexual behaviors was low. However, the percentages on various kinds of indulgence [Table 2] show that majority of them used Internet, television and reading material to fulfill their sexual desires.
CONCLUSION Youth have poor sexual knowledge but have more liberal attitude toward sexuality. The major source for gathering information was the Internet, which is also considered the most reliable source. Youth are more likely to clarify doubts about sexuality through discussions with friends. Having more sexual knowledge was likely to influence a liberal attitude toward sexuality. Individuals who are likely to indulge in sexual behaviors through media are more likely to indulge in sexual behaviors with self and others, indicating the link between influence of media and sexual behaviors.
REFERENCES
Policy for Articles with Open Access: Authors who publish with MedPulse International Journal of Community Medicine (Print ISSN: 2579-0862) (Online ISSN: 2636-4743) agree to the following terms: Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
|
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.