UNIVERSITY OF THE EAST Ramon Magsaysay Memorial Medical Center

College of Nursing

IN PARTIAL FULFILLMENT OF

RESEARCH
Perceptions of College Students in Engaging Premarital Sex
Submitted to: Wilhelmina Z. Atos, Ph.D, RN Submitted by: GROUP: A8 Mascareas, Aileen Motaghian, Mahdi Perseveranda, Mika Valbuena, Alynna Cherise Date: March 24, 2013

CHAPTER 1 INTRODUCTION

Premarital sex is sexual activity practiced by persons who are unmarried. Historically it has been considered taboo in some cultures and religions. In some cultures, the significance of premarital sex has traditionally been related to the concept of virginity. However, unlike virginity, premarital sex can refer to more than one occasion of sexual activity or more than one sex partner. There are cultural differences as to whether and in which circumstances premarital sex is socially acceptable or tolerated. Social attitudes to premarital sex have changed over time as has the prevalence of premarital sex in various societies. Social attitudes to premarital sex can include issues such as virginity, sexual morality, extramarital unplanned pregnancy, legitimacy besides other issues. Premarital sex may take place in a number of situations. For example, it may take place as casual sex, for example, with at least one participant seeking to experience sex; it may take place between a couple living together in a long-term relationship without marriage; for a betrothed couple engaging in sexual activity before their anticipated marriage; and many other situations are possible. Until the 1950s, the term "premarital sex" referred to sexual relations between two people prior to marrying each other. During that period, Western societies expected that men and women marry by the age of 21 or 22; as such, there were no considerations that one who had sex would not marry. The term was used instead of fornication, due to the negative connotations of the latter. The meaning has since shifted, referring to all sexual relations a person has prior to marriage; this removes emphasis on who the relations are with. The definition has a degree of ambiguity. It is not clear whether sex between individuals legally forbidden from marrying, or the sexual relations of one uninterested in marrying, could be considered premarital. Alternative terms for pre-marital sex have been suggested, including non-marital sex (which overlaps with adultery), youthful sex, adolescent sex, and young-adult sex. These terms also suffer from a degree of ambiguity, as the definition of having sex differs from person to person.

BACKGROUND OF THE STUDY The level of premarital sexual activity in Western nations is extraordinary. Establishing exact data can be elusive, but one report states that the "median age of first intercourse for American boys [is] 15.5" and "for American girls [it is] 16" (S.I. McMillen, M.D., and David Stern, M.D., None of These Diseases, 2000, p. 141). Circumstances are similar in Britain, where "the average age for both sexes to lose their virginity is 16" (The Observer, Dec. 2, 2001). Premarital sexual activity among French girls is also extremely high. "Whereas it used to be the case that for 50 per cent of French women their first sexual partner would be the man they would marry, by the 1990s it was only true for 10 per cent" (Angus McLaren, Twentieth-Century Sexuality: A History, 1999, p. 212). Although these figures are bad enough, even more shocking is the rampant promiscuity among so many. For example, among Britain's 16- to 24-year-olds, "19.7 percent of men and 14.6 percent of women have already had 10 or more partners" (The Guardian, Nov. 30, 2001). Adolescent Filipinos are also at Risk A study by the University of the Philippines Population Institute showed that in a study group of almost 20,000 young people 15 to 24 years old, 23 per cent have had premarital sex. It is like nne out of four Filipinos aged 15-24 are engaging in premarital sex. It also says that close to 4 million youngsters are engaging in premarital sex with 30% of the respondents doing it in their own homes while 18% were doing it inside motels and hotels. A study by the University of the Philippines Population Institute showed that in a study group of almost 20,000 young people 15 to 24 years old, 23 per cent have had premarital sex. Among respondents who ever had premarital sex, 35 per cent have had more than one premarital sex partner, 38 per cent used condoms during their last premarital sex, and 10 per cent have paid for sex. Among respondents who ever had premarital sex, 35 per cent have had more than one premarital sex partner, 38 per cent used condoms during their last premarital sex, and 10 per cent have paid for sex. The study also found that young people engage in other high-risk behaviours, such as drinking alcoholic beverages (70 per cent of respondents) and using prohibited drugs (11 per cent of respondents) at least once. The study also found that young people engage in other high-risk behaviors, such as drinking alcoholic beverages (70 per cent of respondents) and using prohibited drugs (11 per cent of respondents) at least once. The study further showed that young people are alarmingly lacking in correct information about HIV/AIDS: only 19 per cent of the study group could identify correct ways of preventing the sexual transmission of HIV; 28 per cent think that AIDS is curable; and 73 per cent believe they had no chance of contracting HIV. The study further showed that young people are alarmingly lacking in correct information about HIV / AIDS: only 19 per cent of the study group could identify correct ways of preventing the sexual transmission of HIV; 28 per cent think that AIDS is curable; and 73 per cent believe they had no chance of contracting HIV.

Research Questions: 1. What are the perceptions of 1st and 2nd year college students in engaging Premarital Sex? 2. Is there a significant difference between the perceptions of males and females in Premarital Sex? Theory Used The theory of planned behavior (TPB) is one of the most cited and used theory to explain behavior. Its assumption centers on behavioral intentions as factor to performing the actual behavior. An intention is a function of attitudes towards the behavior, subjective norms and perceived behavioral control.

Particularly, health-related behaviors such as exercise, compliance to medication and even condom use have been explained in relation to the Theory of Planned Behavior. Although, there are few studies made specifically to investigate TPB in premarital sex intentions and behaviors, studies that involves Research Question: 1. 2. 3. 4. 5. 6. 7. Age Gender Marital Status of Parents No. of Siblings No. of dating partner you had so far Have you ever engaged in premarital sex? Age of first time engagement in premarital sex?

Rate the level of Agreement or Disagreement 8. Adolescents engaged in premarital sex out of curiosity 9. Adolescents engaged in premarital sex to search for excitement 10. Adolescents engaged in premarital sex due to sexual desire 11. Adolescents engaged in premarital sex for stress relief 12. Adolescents engaged in premarital sex to show that I am mature 13. Adolescents engaged in premarital sex in order to show off 14. Adolescents engaged in premarital sex to seek acceptance from peers 15. Adolescents engaged in premarital sex because it is common 16. Adolescents engaged in premarital sex in order to win peers

17. Adolescents engaged in premarital sex to seek love for the feeling of love 18. Adolescents engaged in premarital sex to satisfy my partners request 19. Love in a relationship should be established before practicing premarital sex? 20. Premarital sex in not morally wrong 21. Medical/Social networks affect people in premarital sex 22. Parents influenced opinions about premarital sex

Specific Design This study will examine the factors affecting premarital sex among college adolescents. The design of this study is non-experimental and cross-sectional, correlational design using an exploratory survey method.

CHAPTER 2 RELATED LITERATURE

General review

Accelerating social and economic change is posing new challenges to societies and families in preparing youth for productive social roles .Adolescents ability to make informed choices, to fulfill their individual potential and contribute to economic development, will be shaped by the way families, communities, nations and the world respond to their health, schooling and job needs. With puberty occurring earlier and average marriage age rising, young people today face a longer period of time during which they are sexually mature and, perhaps, sexually active. In many parts of the world, sexual relations begin during adolescence. It is a critical period that lays the foundation for reproductive health of the individuals lifetime, in relation to the individuals cultural and social context. Therefore, adolescent reproductive and sexual health involves a specific set of needs that differ from those of adults. A general sociological survey on adolescent sexuality is very difficult to conduct, since the topic is thought to be highly sensitive and personal, and information in this regard is also difficult to collect systematically. However, some broad patterns of adolescent sexual and reproductive healthrelated behavior have been identified. Pregnancy among school-age young girls can deprive them of their educational opportunity their employment opportunities, and their marital stability (UNFPA, 1998). Thus it can also increase their dependency on the family for financial assistance. Early sexual activity usually exposes adolescents to risks of pregnancy and disease. The large proportion of the young aged population and the increasing incidence of unsafe sex among them, in many developing countries, expose them to greater social, economic and healthrelated problems, as this increases the threats of HIV and other STD, which can cause serious morbidity and even mortality. Premarital Sexual Activity of Adolescents The level of premarital sexual activity in Western nations is extraordinary. Establishing exact data can be elusive, but one report states that the "median age of first intercourse for American boys [is] 15.5" and "for American girls [it is] 16" (S.I. McMillen, M.D., and David Stern, M.D., None of These Diseases, 2000, p. 141). Circumstances are similar in Britain, where "the average age for both sexes to lose their virginity is 16" (The Observer, Dec. 2, 2001). Premarital sexual activity among French girls is also extremely high. "Whereas it used to be the case that for 50 per cent of French women their first sexual partner would be the man they would marry, by the 1990s it was only true for 10 per cent" (Angus McLaren, Twentieth-Century Sexuality: A History, 1999, p. 212). Although these figures are bad enough, even more shocking is the rampant promiscuity among so many. For example, among Britain's 16- to 24-year-olds, "19.7 percent of men and 14.6 percent of women have already had 10 or more partners" (The Guardian, Nov. 30, 2001).

Adolescent Filipinos are also at Risk A study by the University of the Philippines Population Institute showed that in a study group of almost 20,000 young people 15 to 24 years old, 23 per cent have had premarital sex. It is like one out of four Filipinos aged 15-24 are engaging in premarital sex. It also says that close to 4 million youngsters are engaging in premarital sex with 30% of the respondents doing it in their own homes while 18% were doing it inside motels and hotels. A study by the University of the Philippines Population Institute showed that in a study group of almost 20,000 young people 15 to 24 years old, 23 per cent have had premarital sex. Among respondents who ever had premarital sex, 35 per cent have had more than one premarital sex partner, 38 per cent used condoms during their last premarital sex, and 10 per cent have paid for sex. Among respondents who ever had premarital sex, 35 per cent have had more than one premarital sex partner, 38 per cent used condoms during their last premarital sex, and 10 per cent have paid for sex. The study also found that young people engage in other high-risk behaviours, such as drinking alcoholic beverages (70 per cent of respondents) and using prohibited drugs (11 per cent of respondents) at least once. The study also found that young people engage in other high-risk behaviors, such as drinking alcoholic beverages (70 per cent of respondents) and using prohibited drugs (11 per cent of respondents) at least once. The study further showed that young people are alarmingly lacking in correct information about HIV/AIDS: only 19 per cent of the study group could identify correct ways of preventing the sexual transmission of HIV; 28 per cent think that AIDS is curable; and 73 per cent believe they had no chance of contracting HIV. The study further showed that young people are alarmingly lacking in correct information about HIV / AIDS: only 19 per cent of the study group could identify correct ways of preventing the sexual transmission of HIV; 28 per cent think that AIDS is curable; and 73 per cent believe they had no chance of contracting HIV. Factors Affecting Adolescents Sexual Behavior Studies in some Asian and African countries found that many diverse factors influence adolescents' level of risky sexual behavior ethnicity, religiosity, peer relations, school performance, involvement in risk taking behaviors like drinking alcohol and taking drugs, and family composition and relationships have all been identified as determinants of adolescent sexual behavior. Usually, an individual does not perform most sexual activity alone or in the absence of others. Sexual activity is only partly determined by factors originating within the individual. In some societies, adolescents behavior may be influenced by family characteristics, like parents education and occupation, family income, living. In other societies, children are more responsive to institutions such as the school and peers (Gorgen et al, 1998; Abraham and Kumar, 1999; Barker and Rich, 1992; Isarabhakdi, 1997). Age Adolescents all over the world are sexually active, but the age at which they start having intercourse varies between regions and, within a country, between urban and rural settings

(UNESCO and UNFPA, 1999; Mehta et al., 1999; UNFPA, 1998). Many authors have documented the strong correlation between age and sexual experience (Abraham and Kumar, 1999; Kiragu and Zabin, 1993); as age increases, the likelihood of participation in sexual activity increases. Age can also increase opportunities for independence and decision making for adolescents. Studies in Kenya (Kiragu and Zabin, 1993) and Tanzania (Soori and Pool1997) have shown that psychological and biological variables are closely related toadolescents sexual and contraceptive behavior. In their examination of biological influence, Udry et al., (1986) demonstrated that the sexual behavior of young adolescents is positively related to hormonal levels, which in turn are related to age of the individual. Similarly, Kiragu and Zabin (1993) found that early puberty development is associated with early commencement of coitus. However, in many African traditions, sexual initiation of girls often occurs even before menarche; more than half of the 300 female adolescents in a study conducted in Malawi had had sex before menarche, as stated by UNFPA (1997). However, according to Mensch et al. (1999), sexual activity before age 16 may have also declined or remained stable in some other parts of Sub-Saharan Africa, such as Kenya, Ghana and Zimbabwe. Academic performance and education Some studies stressed on a relationship between the qualities of the academic program or performance and adolescents sexual behavior. The findings of a survey in Jamaica (Eggleston et al., 1999) found that school attendance as well as academic performance may be related to early sexual activity and unintended pregnancy. Also, in their study conducted on Indian college students, Abraham and Kumar (1999). Observed that the academic programs like arts, science or commerce, and number of years in school significantly influences the likelihood of having had premarital sex. A cohort analysis study in Costa Rica (Luis, 1991) documented a considerable increase in girls' education and the concurrent beginning of a decline in the incidence of age at first intercourse. This could be related to the fact that most of the pre-maritalsex in Costa Rican society occurs during the period between engagement and marriage. With increasing education, more young women are delaying marriage, thereby reducing the length of the period of engagement, which in turn decreases premarital sex. As mentioned earlier the situation in Mongolia is different, with increasing consensual union and to some extent, sexual experimentation. Exposure to mass media The explosion of telecommunications across cultural boundaries is influencing the sexual behavior of young people by providing so called role models. In many countries in the west, it is socially accepted, indeed encouraged that teenagers experiment with adult patterns of language, dress and sexual behavior. In the developing world, where opportunities are limited and health care availability inadequate, emulating western patterns of behavior has disastrous consequences (UNESCO and UNFPA, 1998). While in the developed countries of the west teenagers are granted certain attitudes pertaining to adult behavior in the context of sexuality, they are also given the resources with which to practice those behaviors safely. During the period of market economy transition in Mongolia, easy access to various forms of mass media, both printed and electronic, and improved communication technology influenced adolescents sexual

behavior to a great extent. While there are no research results in this regard, it is generally felt that the western influence has been very strong in the present generation of Mongolian adolescents. They like to follow the western concepts presented in the media without going deeper into the underlying issues, like culture, personal values and family norms, as well as pregnancy and the other consequences of unsafe sex.

Knowledge on sexuality and reproductive health issues According to a UNFPA (1999) survey of sex education studies in developed countries, there was no increase in sexual activity among adolescents and clear evidence of higher level abstinence, a later start to sexual activity, higher contraceptive use, fewer sexual partners and/or reduced rates of unplanned pregnancy and STD. The report also noted that sexual health programs do not encourage sexual experimentation. However, it has been reported that adolescents sexual behavior also depends on the content of the reproductive and sexual health program. Instruction on biological topics or contraception was found to be significantly associated with earlier initiation of intercourse, while instruction on AIDS or resistance skills. However, this study did not measure the timing of instrumentation and initiation of intercourse. There continues to be controversy regarding the relationship between reproductive health knowledge and sexual activity, in part because of the varying definitions of "knowledge" in this context and in part because of the unclear direction of causality. Therefore in this context, Marsiglio and Mott (1986) suggested that while sex education does not promote or deter sexual activity, it increases the likelihood of contraceptive use. Numerous studies in developing countries have shown that young people lack adequate knowledge about contraception and disease prevention and many have misconceptions about reproductive health issues and sexuality (Gorgen et al., 1998; UNFPA, 1999, Mensch et al., 1999; Mehta et al, 1999). Equally inconclusive are the effects of attitudes toward sex or sexual behavior (Zabin, 1984). Most adolescents are found to have high knowledge about the existence of contraceptives and almost all of them have heard of HIV/AIDS/STD (Mehta et al., 1999; SCF, 1998a). However, many lack knowledge of the mode of transmission and consequences of STD/HIV/AIDS (UNFPA, 1998; MHSW, 1999; Mehta al., 1999). Besides, due to their lack of knowledge in this regard, very few report to health personnel for treatment, some because they cannot identify their problem and others because they do not want to disclose about their infection. Therefore the small number of cases that report to doctors, and lack of information about their sexual partners present a high risk in the context of society. For each individual that reports to a doctor, there are many more that do not and thus they continue to spread their infection. It appears that most young boys and girls do not have the appropriate knowledge regarding puberty and menstruation (Nahar et al., 1999; Ajayi et al., 1991). Therefore increased knowledge about contraception and condoms alone may not be sufficient to reduce sexual risks. The appropriate knowledge about reproductive health leads to awareness about the consequences of unsafe sex, as shown by studies conducted in several parts of the world, including Mongolia (MHSW, 1999; Mensch et al., 1999; Eggleston et al., 1999; Barker and Rich, 1992). Those who become sexually active early and change partners frequently are at greater risk. Thus, while adolescents require the appropriate sexual and reproductive health education to prepare them for a better and healthier future, the content of the sexual and reproductive health education program also need to be studied carefully.

Socioeconomic Status of Parents It is generally accepted that the earliest social influence on an individual comes from the family. An important social correlate of adolescent sexual behavior is the family environment. Studies in Thailand, Philippines, Kenya and Uganda found several relevant family characteristics that could affect adolescents sexual behavior, like parents socioeconomic status, family structure, parents conflict, family relationships and interactions, and attitudes, values and norms of family members (Isarabhakdi, 1997; Lacson et al., 1997; Kiragu and Zabin, 1993; Twa-Twa, 1997). Their role as care givers and breadwinners changes to more of breadwinner. These changes were reported to have increased opportunities for young people to indulge in sexual activity and new moral values are interchanged with old values regarding sexual behavior (Soori and Pool, 1997). Though there exist no studies in this regard, it is generally believed that a similar situation existed in Mongolia during the period of market economic transition in the early 1990s. Neither parental socioeconomic status nor religious participation seemed to be significantly related to age at first sexual relations in a study of Kenyan adolescents (Oloko and Omoboye, 1993). However, in a similar study in Philippines, adolescents whose families had higher socioeconomic status were found to be less likely to be sexually active, perhaps as a result of the social environment and perceived opportunities and role models available to them (Lacson et al, 1997). Kiragu and Zabin (1993) reported similar findings. However, a study conducted in India found that family socioeconomic status had no significant associations with sexual behavior (Abraham and Kumar, 1999). Furthermore, some studies (Twa-Twa, 1997; Gorgen et al, 1998) observed that in case of parents with a low income, their daughters had some type of sexual relationship which involved money. Living environment It is commonly seen that family structure has an important influence on sexual behavior (Twa-Twa, 1997; Kiragu and Zabin, 1993; Owuamanam, 1995). Parental conflict was found to have a major influence on sexual behavior of female adolescents in Kenya (Kiragu and Zabin, 1993), as is assumed to exist elsewhere in the world. The absence of a congenial atmosphere in the home leads young people to seek entertainment and pleasure outside the home, often in the wrong company, as they are still too young to understand or differentiate between the good and the bad among themselves. Good parental care with correct upbringing and assertiveness are recommended to have a positive value in reducing adolescent sexual activity (TwaTwa, 1997). This study of school-going youth in Uganda also found that children who grow up with responsible parents are less likely to manifest excesses in sexual behavior

Conceptual Framework

Individual characteristics: Age Academic performance Exposure to media Knowledge on sexual and reproductive health issues

Family characteristics: Educational level of parents Both parents living together at home Living arrangement Relationship with parents Parent-child communication on sexual & reproductive health issues

Premarital sex: Males Females

Peer communication: Communication with friends Have girl/boyfriend over time Risk taking behavior Sexual behavior of friends

Conceptual Model The following conceptual framework has been developed based on the above review of literature, showing the causal model for this analysis. The framework consists of one dependent variable, which is adolescents ever having had premarital sex. The independent variables are categorized into three groups: individual characteristics, family characteristics and peer influences. These three groups of independent variables are expected to have a direct effect in the model of adolescents premarital sex tested in this study.

Hypothesis H1: Is there a significant difference in the perception of male and female in premarital sex?

CHAPTER 3 RESEARCH METHODOLOGY I. Research Design This study will examine the factors affecting pre-marital sex among in- school adolescents. The design of this study is descriptive and correlational. II. Population/Sampling Procedure:

In this study we will be using the data that will be gathered from the survey regarding our topic that will be conducted during our field research on the summer of 2013 at the university/ties that we will be visiting for our research survey. The main objective of the survey is to provide information on the students levels of knowledge about factors predisposing female students to be involved in premarital sexual activities, students aware of the health consequences of engaging in premarital sex, peer groups could be an influential in premarital sex. The sample will cover the universities 1st and 2nd year college students. The sample design adopted for the survey will be clustered and random sample of individuals. Self-administered questionnaires will be used for collection of data.

III.

Data Treatment Classical estimation techniques have the characteristic of taking all of the data and mapping the data into a few numbers ("estimates"). This is both a virtue and a vice. The virtue is that these few numbers focus on important characteristics (location, variation, etc.) of the population. The vice is that concentrating on these few characteristics can filter out other characteristics (skewness, tail length, autocorrelation, etc.) of the same population. In this sense there is a loss of information due to this "filtering" process. The EDA approach, on the other hand, often makes use of (and shows) all of the available data. In this sense there is no corresponding loss of information.

Classical

Exploratory

Questions asked to gather data: Date: ______________ Age: ______________ Gender: ______________ A. Marital status of parents Number of siblings Are your parents both living together? Are you close with your parents? Do you communicate with your parents about sexual and reproductive health issues? Do you communicate with your friends about sexual and reproductive health issues? Number of dating partner you had so far, if none leave blank Have you ever engaged in premarital sex? If no, leave blank If yes, age of first-time engagement in premarital sex

1. 2. 3. 4. 5. 6. 7. 8. 9.

_________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________

B. Rate the level of agreement or disagreement Instructions: please put a check the response category which best identifies your personal belief about the item (response category: SA strongly agree; A agree; U uncertain; D disagree; SD- strongly disagree). 10. In your opinion, do adolescents engaged in premarital sex out of curiosity. SA____ A____ U____ D____ SD____ 11. In your opinion, do adolescents engaged in premarital to search for excitement. SA____ A____ U____ D____ SD____ 12. In your opinion, do adolescents engaged in premarital due to sexual desires. SA____ A____ U____ D____ SD____ 13. In your opinion, do adolescents engaged in premarital for stress relief. SA____ A____ U____ D____ SD____ 14. In your opinion, do adolescents engaged in premarital to show that Im mature. SA____ A____ U____ D____ SD____ 15. In your opinion, do adolescents engaged in premarital in order to show off. SA____ A____ U____ D____ SD____ 16. In your opinion, do adolescents engaged in premarital to seek acceptance from peers. SA____ A____ U____ D____ SD____ 17. In your opinion, do adolescents engaged in premarital because it is common. SA____ A____ U____ D____ SD____ 18. In your opinion, do adolescents engaged in premarital in order to win peers. SA____ A____ U____ D____ SD____

19. In your opinion, do adolescents engaged in premarital to seek for the feeling of belonging. SA____ A____ U____ D____ SD____ 20. In your opinion, do adolescents engaged in premarital to safety my partners request. SA____ A____ U____ D____ SD____ 21. Love in a relationship should be established before practicing premarital sex. SA____ A____ U____ D____ SD____ 22. Premarital sex is not morally wrong. SA____ A____ U____ D____ SD____ 23. Medial social networks affect people in premarital sex. SA____ A____ U____ D____ SD____ 24. Parents influenced opinions about premarital sex. SA____ A____ U____ D____ SD____