Adolescent reproductive health and premarital sex in Medan

Abstract

Young people of today face demands, expectations, risks and temptations that are more numerous and complex than any facing youth in the previous generation. They are more mobile, more educated, reach menarche earlier and tend to marry later. These massive changes, including the explosion of information across international frontiers, have increased the exposure of young people to a variety of risks related to reproductive health such as unwanted pregnancy, abortion, and SIDs including HIV. However, because of socio-cultural and political concerns, unmarried young people in many developing countries, including Indonesia, receive limited parental guidance and community, and government support. This study concerns single young Indonesians' attitudes and behaviour regarding reproductive health and premarital sex including puberty, unwanted pregnancy, abortion and sexually transmitted diseases including HIV/ AIDS. Data used in this thesis were mainly obtained from the 1997 /1998 Medan Adolescent Reproductive Health Study, which I conducted over a period of seven months. The study included a survey of 875 unmarried young people aged 15-24 in the city of Medan. The respondents came from various ethnic and social groups including those in high school and university and those working and unemployed. Data obtained from the survey were analyzed through descriptive statistics, including frequency and percentage distribution, bivariate analysis including cross-tabulation and the chi-square test and logistic multivariate regression analysis. In addition to the survey, qualitative data were collected. Methods included in qualitative approach are in-depth interviews and focus group discussions. A total of 48 in-depth interviews were conducted involving married and unmarried young people, parents, experts, NGOs representatives and policy makers. Eight focus group discussions were conducted among high school students, university students, working youth, street youth and married young people. Young people in Medan are increasingly tolerant of premarital sex. Although for most of them a woman's virginity is a great concern, it is no longer seen as the most important factor in choosing a future spouse. The demise of parental arrangement of marriage and the growing opportunity to know the future spouse long before marriage means that the potential wife's personality is now of more significance than her virginity. Losing virginity does not necessarily mean losing respectability. Of 875 unmarried young people studied, nine per cent of women and 27 per cent of men reported having had sex; these figures doubled for those who approved of premarital sex. Men had more positive reactions to their first sexual intercourse than women. More than half of men who reported having had sex did not feel guilty or sinful the first time they did so, compared to only 20 per cent of girls. Religious affiliation significantly influences adolescents' attitudes for both sexes, but it was insignificant as a determinant of differences in respondents' reported sexual experiences. On the other hand age appeared to be important factors in predicting the likelihood of reporting sexual experience among male respondents, but they were not significant in predicting attitudes. Respondents' main activities, whether they are studying, working or unemployed was the most important predictor of the likelihood of approving of premarital sex as well as the likelihood of reporting experience of premarital sex. Out-of-school young people are more likely to approve of premarital sex and more likely to report having had sex. Many young people engage in risky sexual behaviour out of ignorance. Misconceptions about the onset of puberty, human reproduction, STDs including HN /AIDS and contraception among young people are evident. Many young people believe that a woman cannot become pregnant from a single act of sexual intercourse; therefore, to avoid causing a pregnancy, some young men prefer to have sex in a casual relationship or have sex only once in a month with the same girl. Although the majority of Medan young people have known about STDs and AIDS, misinformation still abounds. The most common errors are the belief that STDs including HN can be avoided by maintaining physical stamina and the belief that someone who is 'clean' and comes from a better-off family cannot possibly have STDs. Misconception about the side-effects of using condoms are also found. Fears that condoms may cause 'weakness' (lemas) and discomfort are evident. Young people urgently need comprehensive sex education as well as access to safe and effective reproductive health services if they are to achieve better reproductive health. Most young people in this study suggested that adolescents, regardless marital status should be given such services. For some adolescents, especially street youth, the issue is no longer on how to prevent premarital sex, but on reducing risks attached to unprotected sex.