Sexual practices, knowledge and usage of contraceptives among adolescents and young adults

Abstract

INTRODUCTION: Adolescence is a critical period of development, as important behaviour patterns are learnt during this period. The sexual debut in Sri Lankan schooling adolescents has been reported as 15.3 years for males and 14.4 for females. Furthermore a significant difference in the prevalence of heterosexual experience among the two sexes have been reported(14% among boys Vs 2% among girls). In 2001, of the pregnant women who received antenatal care from public health midwives, 7.8% were teenagers. Interestingly 22.2% of maternal deaths due to illegal abortions were in this age group during 1996. Thus the situation demands research into sexual practices and strategies to increase the contraceptive uptake by teenagers. OBJECTIVES: To describe and compare the sexual practices. knowledge and usage of contraceptives by the adolescents and young adults with different educational backgrounds. METHOD: Study was a cross sectional descriptive study done involving subjects of three different educational levels i.e. students of universities and technical colleges and employees of garment factories. Data were collected with a pretested self administered questionnaire. RESULTS: Data of 1258 subjects were analyzed. Of them 23% were garment factory workers, 38.2% were technical college students and 38.8% were university students. Females consisted 58.9% of the population. The mean age for males and females were 20.5 years and 20.7 years respectively. The mean age of first sexual relationship of males and females were at 17.65 and 19.44 years respectively (p<.001). Out of the total population 17% of females and 33.5% of males were sexually active. Sexual relationships were reported by 51.7% of garment factory employees, 19.4% technical college students and 12.3% of university students. Majority of male garment factory workers ("90 %) were sexually active. Of the 166 sexually active males 19.3% had sexual relationship with commercial sex workers. Out of the 172 people who have not used modern contraceptives during heterosexual relationships, 32% has used natural family planning. Significantly larger proportion (21.7%) of garment factory workers compared to other settings believed that IUCD would protect them from HIV infection. Of the study population 24.9% of females and 71.2% of males knew barrier methods would minimize the risk of development of HIV. With regard to primary source of information regarding contraceptive methods, 24.2 % and 23.4% of subjects reported school and news papers, while 28.4% felt that information from parents as the least important source. Of the people who selected school as their main source of information, only 41.4% knew barrier methods could protect them from HIV. Majority preferred instructions from school and special health clinics on contraceptive usage. CONCLUSIONS: Teenage and young adult males have their first sexual relationship at an earlier age than female counterparts. A larger proportion of garment factory employees are sexually active compared to students of technical colleges and universities. Significant proportion of males of the age group had their first relationship with commercial sex workers. The knowledge about different contraceptive methods among this population is inadequate. More emphasis should be given to the preferred media by the adolescents and young adults in educating them on contraceptive methods.