An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices

Li Ping Wong, Li Ping Wong

Abstract

Background: The increasing trend of premarital sexual experience and unintended pregnancies in Malaysia warrants sustained and serious attention. The sensitivities of sex-related issues in a Muslim-majority country create various types of barriers to sexual and reproductive health information, support and practices. This study aims to gain understanding of knowledge, attitudes and behaviours of young women in Malaysia concerning reproductive, contraception and premarital sexual practices.

Methods: A cross-sectional study was performed, using an anonymous self-administered questionnaire carried out among 1695 female university students in a public university in Malaysia.

Results: Respondents had low scores for knowledge of reproduction and pregnancy (median=4, of maximum score 10), contraceptive uses (median=6, of maximum score 16) and contraceptive availability (median=3, of maximum score 13). The majority of women surveyed do not have liberal values in relation to premarital sexual behaviour (median=37, of maximum 40); higher scores on this scale corresponded to opposing premarital sex. The multivariate analyses showed that ethnic group was the strongest correlate of knowledge and attitude scores; being of Malay Muslim ethnicity was associated significantly with lower knowledge scores and premarital sex permissiveness. Other significant correlates were year of study, maternal occupational groups, level of religious faith, dating status and urban-rural localities. Level of premarital sex permissiveness was inversely correlated with reproduction and pregnancy knowledge score, and contraceptive knowledge scores.

Conclusion: Reproductive health knowledge and attitudes were intricately linked to religious values and cultural norms differences surrounding sexual issues.

References

    1. Roseman MJ, Reichenbach L. International Conference on Population and Development at 15 years: achieving sexual and reproductive health and rights for all? Am J Public Health. 2010;100(3):403–406. doi: 10.2105/AJPH.2009.177873.
    1. Langhaug LF, Cowan FM, Nyamurera T, Power R. Improving young people's access to reproductive health care in rural Zimbabwe. AIDS Care. 2003;15(2):147–157. doi: 10.1080/0954012031000068290.
    1. Mturi AJ, Hennink MM. Perceptions of sex education for young people in Lesotho. Cult Health Sex. 2005;7(2):129–143. doi: 10.1080/13691050412331321285.
    1. Wamoyi J, Fenwick A, Urassa M, Zaba B, Stones W. Parent–child communication about sexual and reproductive health in rural Tanzania: Implications for young people's sexual health interventions. Reprod Health. 2010;7:6. doi: 10.1186/1742-4755-7-6.
    1. Ingham R, Mayhew S. In: Promoting young people’s sexual health: International perspectives. Ingham R, Aggleton P, editor. London: Routledge; 2006. Research and policy in young people’s sexual health.
    1. Schuster MA, Bell RM, Petersen LP, Kanouse DE. Communication between adolescents and physicians about sexual behavior and risk prevention. Arch Pediatr Adolesc Med. 1996;150(9):906–913. doi: 10.1001/archpedi.1996.02170340020004.
    1. Wight D, Plummer ML, Mshana G, Wamoyi J, Shigongo ZS, Ross DA. Contradictory sexual norms and expectations for young people in rural Northern Tanzania. Soc Sci Med. 2006;62(4):987–997. doi: 10.1016/j.socscimed.2005.06.052.
    1. Kirby D, DiClemente R. In: Preventing AIDS: Theories and methods of behavioral interventions. DiClemente RJ, Peterson JL, editor. New York: Plenum Press; 1994. School-based interventions to prevent unprotected sex and HIV among adolescents.
    1. St Lawrence J, Brasfield T, Jefferson K, Alleyene K. Social support as a factor in African American adolescents' sexual activity. J Adol Res. 1994;9:292–310. doi: 10.1177/074355489493002.
    1. Indralal De Silva W, Karunathilake K, Perera R. Patterns of sexual vulnerability among adolescents and youths in Sri Lanka. Asian Population Studies. 2009;5(1):41–59. doi: 10.1080/17441730902790099.
    1. Shaw D. Access to sexual and reproductive health for young people: bridging the disconnect between rights and reality. Int J Gynaecol Obstet. 2009;106(2):132–136. doi: 10.1016/j.ijgo.2009.03.025.
    1. Gao E, Zuo X, Wang L, Lou C, Cheng Y, Zabin LS. How Does Traditional Confucian Culture Influence Adolescents' Sexual Behavior in Three Asian Cities? J Adolesc Health. 2012;50(3):S12–S17. doi: 10.1016/j.jadohealth.2011.12.002.
    1. Trent K. Teenage childbearing: structural determinants in developing countries. J Biosoc Sci. 2008;22:281–292.
    1. Hanassaba S, Tidwella R. Change in the premarital behavior and sexual attitudes of young Iranian women: From Tehran to Los Angeles. Counselling Psychology Quarterly. 1993;6(4):281–289. doi: 10.1080/09515079308254122.
    1. Lee LK, Chen PCY, Lee KK, Jagmohni K. Premarital sexual intercourse among adolescents in Malaysia: a cross-sectional Malaysian school survey. Singapore Med J. 2006;7:476–481.
    1. WHO. Sexual and reproductive health of adolescents and youth in Malaysia: a review of literature and projects 2005. Retrieved 2 Dec 2011. 2011. Available at: . 2007.
    1. Mohd Jan J, Low WY, Awang H, Jani R, Wong LP. National study on reproductive rights, reproductive and sexual health of women in Malaysia. Unit Perundingan Universiti Malaya (UPUM); 2006.
    1. Ingham R, Mayhew S. Promoting Young People’s Sexual Health; International Perspectives (209-225) London: Routledge; 2006. Research and policy in young people’s sexual health.
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York: Academic; 1997.
    1. Regmi PR, van Teijlingen E, Simkhada P, Acharya DR. Barriers to sexual health services for young people in Nepal. J Health Popul Nutr. 2010;28(6):619–627.
    1. Williamson LM, Parkes A, Wight D, Petticrew M, Hart GJ. Limits to modern contraceptive use among young women in developing countries: a systematic review of qualitative research. Reprod Health. 2009;6:3. doi: 10.1186/1742-4755-6-3.
    1. Rani M, Lule E. Exploring the socioeconomic dimension of adolescent reproductive health: a multicountry analysis. Int Fam Plan Perspect. 2004;30(3):110–117.
    1. Kirby DB, Laris BA, Rolleri LA. Sex and HIV education programs: their impact on sexual behaviors of young people throughout the world. J Adolesc Health. 2007;40(3):206–217.
    1. Somers CL, Eaves MW. Is earlier sex education harmful?: an analysis of the timing of school-based sex education and adolescent sexual behaviours. Research in Education. 2002;67:23–32. doi: 10.1016/j.jadohealth.2006.11.143.
    1. Dawson DA. The effects of sex education on adolescent behavior. Fam Plann Perspect. 1986;18(4):162–170.
    1. Klein JD. Adolescent pregnancy: current trends and issues. Pediatrics. 2005;116(1):281–286. doi: 10.2307/2135325.
    1. Rodgers KB. Parenting processes related to sexual risk taking among adolescent males and females. J Marriage Fam. 1999;61(1):99–110. doi: 10.1542/peds.2005-0999.
    1. Mohammadi M, Mohammad K, Farahani F, Alikhani S, Zare M, Tehrani F. et al.Reproductive Knowledge, Attitudes and Behavior Among Adolescent Males in Tehran, Iran. Int Fam Plan Perspect. 2006;32(1):35–44. doi: 10.2307/353886.
    1. Cui N, Li M, Gao E. Views of Chinese parents on the provision of contraception to unmarried youth. Reprod Health Matters. 2001;9(17):137–145. doi: 10.1363/3203506.
    1. Bundy ML, White PN. Parents as Sexuality Educators: A Parent Training Program. J Counsel Dev. 1990;68(3):321–323. doi: 10.1016/S0968-8080(01)90017-5.
    1. DuRant RH, Sanders JM. Sexual Behavior and Contraceptive Risk Taking among Sexually Active Adolescent Females. J Adol Health Care. 1989;10:1–9. doi: 10.1002/j.1556-6676.1990.tb01382.x.
    1. Roebuck J, McGee MG. Attitudes toward premarital sex and sexual behavior among black high school girls. J Sex Res. 1977;13(2):104–114. doi: 10.1016/0197-0070(89)90039-9.
    1. Taris TW, Semin GR. Sexual Efficacy of Adolescents, Permissiveness, and the Transition Toward Nonvirginity: From Intention to Behavior. J Appl Soc Psychol. 2006;29(5):903–917. doi: 10.1080/00224497709550966.
    1. Chilman GS. Social and Psychological Research Concerning Adolescent Child-Bearing. J Marriage Fam. 1980;42:793–805.
    1. Wellings K, Nanchahal K, Macdowall W, McManus S, Erens B, Mercer CH. et al.Sexual behaviour in Britain: early heterosexual experience. Lancet. 2001;358(9296):1843–1850. doi: 10.2307/351825.
    1. Adhikari R. Are Nepali students at risk of HIV? A cross-sectional study of condom use at first sexual intercourse among college students in Kathmandu. J Intern AIDS Soc. 2010;13:7. doi: 10.1016/S0140-6736(01)06885-4.
    1. Adebiyi AO, Asuzu MC. Condom use amongst out of school youths in a local government area in Nigeria. Afr Health Sci. 2009;9(2):92–97. doi: 10.1186/1758-2652-13-7.
    1. Pedlow CT, Carey MP. Developmentally appropriate sexual risk reduction interventions for adolescents: rationale, review of interventions, and recommendations for research and practice. Ann Behav Med. 2004;27(3):172–184.
    1. Zelnik M, Kantner JF. Reasons for Nonuse of Contraception by Sexually Active Women Aged 15–19. Fam Plann Persp. 1979;11(5):289–296. doi: 10.1207/s15324796abm2703_5.
    1. Rasch V, Silberschmidt M, McHumvu Y, Mmary V. Adolescent girls with illegally induced abortion in Dar es Salaam: the discrepancy between sexual behaviour and lack of access to contraception. Reprod Health Matters. 2000;8(15):52–62. doi: 10.2307/2134461.
    1. Görgen R, Maier B, Diesfeld HJ. Problems related to schoolgirl pregnancies in Burkina Faso. Stud Fam Plann. 1993;24(5):283–294. doi: 10.1016/S0968-8080(00)90006-5.
    1. Harper CC, Minnis AM, Padian NS. Sexual partners and use of emergency contraception. Am J Obstet Gynecol. 2003;189(4):1093–1099. doi: 10.2307/2939222.
    1. Keele JJ, Forste R, Flake DF. Hearing Native Voices: Contraceptive Use in Matemwe Village, East Africa. African J Repr Health. 2005;9(1):32–41. doi: 10.1067/S0002-9378(03)00544-1.
    1. Adetunji J. Condom use in marital and nonmarital relationships in Zimbabwe. Int Fam Plann Persp. 2000;26(4):196–200. doi: 10.2307/3583158.
    1. Harper C, Callegari L, Raine T, Blum M, Darney P. Adolescent clinic visits for contraception: support from mothers, male partners and friends. Perspect Sex Reprod Health. 2004;36(1):20–26. doi: 10.2307/2648258.
    1. Blanc AK. The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Stud Fam Plann. 2001;32(3):189–213. doi: 10.1363/3602004.
    1. Chng CL. The male role in contraception: implications for health education. J Sch Health. 1983;53(3):197–201. doi: 10.1111/j.1728-4465.2001.00189.x.
    1. Williams SS, Kimble DL, Covell NH, Weiss LH, Newton KJ, Fisher JD. et al.College Students Use Implicit Personality Theory Instead of Safer Sex. J Appl Soc Psychol. 1992;22(12):921–933. doi: 10.1111/j.1746-1561.1983.tb07820.x.
    1. Beckwith J. Knowledge, attitudes, and practices in reproductive and sexual health: Valle de los Chillos, Rumiñahui County, Province of Pichincha, Ecuador. Mcgill J Med. 2006;9(2):119–125. doi: 10.1111/j.1559-1816.1992.tb00934.x.

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