Reproductive Knowledge, Attitudes and Behavior among Adolescent Males in Tehran, Iran

Article excerpt

CONTEXT: Iran's culture and religion prohibit sexual contact prior to marriage. Due to the sensitivity of the topic, little is known about the sexual activity of unmarried adolescent males or about their knowledge of, and attitudes toward, sexuality and reproductive health.

METHODS: A population-based study of 1,385 males aged 15-18 in Tehran was conducted using a self-administered questionnaire. Participants were questioned about their beliefs and knowledge regarding reproductive health, and asked whether they had engaged in sexual activity. Bivariate and multivariate analyses were performed to identify factors associated with sexual knowledge, attitudes and behavior.

RESULTS: Twenty-eight percent of the sample reported having engaged in sexual activity. Sexual experience was associated with older age, access to satellite television, alcohol consumption and permissive attitudes toward sex. Substantial proportions of respondents held misconceptions regarding condoms, STIs and reproductive physiology. Attitudes toward premarital sex were more permissive among respondents who were older, were not in school, had work experience, had access to the Internet or satellite television, lived separately from their parents, or reported having used alcohol, cigarettes or drugs.

CONCLUSION: The relatively high prevalence of sexual activity and the lack of knowledge regarding STIs and contra ceptives pose a significant threat to the sexual and reproductive health of adolescent males in Iran. Programs are needed to provide adolescents with the information and skills to make safe sexual decisions.

International Family Planning Perspectives, 2006, 32(1):35-44

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Young people constitute a significant proportion of the Iranian population. In the most recent national census (1996), there were approximately 16 million adolescents aged 10-19, accounting for 25% of the Iranian population, and 21 million young people aged 10-24, accounting for more than one third of the population. (1)

Due to such factors as a rapid increase in age at first marriage, there has been a sharp decline in the proportion of postpubescent young people who are married. Between 1986 and 1996, mean age at first marriage rose from 19.8 to 22.4 among females and from 23.6 to 25.6 among males; (2) as a result, the proportion of adolescent females aged 15-19 who had ever been married fell from 33% to 19%, a 44% decline. (3) These data suggest a widening window during which young people may engage in potentially risky premarital sexual activities.

Despite this trend, little is known about the reproductive health needs of young people in Iran. Although some small- and large-scale investigations have been conducted, these studies, due to cultural sensitivities, have avoided sensitive topics such as attitudes about sexual relations, the prevalence of risky sexual behaviors, and rates of STIs. Instead, researchers have focused on topics such as puberty in girls and opinions on family planning. (4)

Cultural sensitivities may also be a factor in young people's poor knowledge about reproductive health. In Iran, few programs provide sexuality education to adolescents or enable youth to ask questions and correct misconceptions about reproductive health. Indeed, large numbers of young Iranians lack information about safe sex and about the skills necessary to negotiate and adopt safe sex practices.

Recently, the Iranian government has recognized the importance of addressing the reproductive health needs of adolescents and youth; it has undertaken a review of relevant policies and approaches, and efforts are under way to design programs that meet these needs in an acceptable and sensitive manner. (5) However, these efforts are hampered by the current lack of data regarding the reproductive health, attitudes, sexual behavior and related needs of unmarried young people.

This paper reports findings from a pioneering, population-based study that aimed to break the silence on adolescent reproductive health in Iran and to fill important information gaps regarding sexual behavior and associated factors among male adolescents in Tehran. …