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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 3  |  Page : 117-121

Adolescent sexual behaviour in Pokhara Submetropolitan Municipality, Nepal


Department of Public Health and Hospital Administration, Eternal University, Sirmaur, Himachal Pradesh, India

Date of Submission01-Oct-2016
Date of Acceptance10-May-2018
Date of Web Publication8-Mar-2019

Correspondence Address:
Bishwas Acharya
Department of Public Health and Hospital Administration, Eternal University, Baru Sahib, Sirmaur - 173 101, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/phmj.phmj_31_16

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  Abstract 


Background: Risky sexual behaviour among adolescents is an emerging problem in Nepal.
Aim: To assess the sexual behaviour and media influence and determine the association of watching porn movies and sexual activity with sociodemographic factors among adolescents in Pokhara submetropolitan municipality, Nepal.
Methods: An institution-based, cross-sectional study was conducted among 302 adolescents of higher secondary schools in Pokhara submetropolitan municipality, Nepal, using self-administered questionnaire technique. Data were collected and analysed using SPSS software version 21.
Results: Out of 302 respondents, 81 (27%) had sexual intercourse, whereas 221 (73%) did not have sexual intercourse. There was a statistical association between exposure to porn movies with age (P = 0.038), caste (P ≤ 0.05), gender (P < 0.001), monthly family income (P < 0.001), monthly pocket money (P < 0.001) and time spent on watching computer (P < 0.001). Presence of television in personal bedroom of the adolescents was significantly associated with the number of times they watched the porn movies (P = 0.013). Involvement in sexual intercourse was significantly associated with age (P < 0.001), type of family (P = 0.008), gender (P = 0.001), monthly family income (P = 0.014), monthly pocket money (P < 0.001), exposure to porn movies (P < 0.001) and presence of boyfriend/girlfriend (P < 0.001).
Conclusion: Sexual behaviour among adolescents was found to be high. Reproductive and sex education should be introduced into the school curriculum to minimise and control premarital and unsafe sex.

Keywords: Adolescents, mass media, porn movies, sexual behaviour, sociodemographic factors


How to cite this article:
Pahari S, Acharya B, Chauhan HS. Adolescent sexual behaviour in Pokhara Submetropolitan Municipality, Nepal. Port Harcourt Med J 2018;12:117-21

How to cite this URL:
Pahari S, Acharya B, Chauhan HS. Adolescent sexual behaviour in Pokhara Submetropolitan Municipality, Nepal. Port Harcourt Med J [serial online] 2018 [cited 2019 May 25];12:117-21. Available from: http://www.phmj.org/text.asp?2018/12/3/117/253715




  Introduction Top


Sexual behaviour among adolescents is a rising public health concern worldwide. Adolescence is regarded as the most vulnerable stage in human life that is characterised by tremendous physical and sexual changes that occur after childhood and before adulthood, from ages 10–19.[1] It is a critical period of sexuality and sexual development with initiation of sexual feelings and sexual desire. Media plays an influential role in adolescent sexual behaviour. On the one hand, it provides information about sexuality and safe sexual behaviour.[2] On the other hand, it promotes unsafe sexual behaviour including oral sex, casual sex, multiple partners, sexually aggressive behaviour and illegal activities such as rape and sexual violence.[3],[4],[5]

Media acts as a prime source for acquiring information about sexuality and sexual curiosity in developing countries like Nepal where parents and society take sexuality in a negative way. Premarital sex is at an escalating level in Nepal where it is not accepted at the social and cultural settings.[6],[7] Due to the absence of enough information and guidance, adolescents adopt risky sexual behaviour. Risky sexual behaviour makes them prone to various problems such as unwanted pregnancies, unsafe abortion and risk of sexually transmitted diseases (STDs) and HIV/AIDS.[7],[8],[9] Nationally, representative data showed that 20.7% of males and 20.9% of females had sexual intercourse, with condom use by 44% of males in the age group of 15–19 years. About 14% of males and 10% of females had been victim of STDs and infections.[10]

The study was conducted to assess the sexual behaviour and media influence and determine the association of watching porn movies and sexual activity with sociodemographic factors among adolescents in Pokhara submetropolitan municipality, Nepal.


  Methods Top


Study area and period

The study was carried out in higher secondary schools of Pokhara submetropolitan municipality, Nepal, from January to March 2015. Pokhara is one of the most popular tourist destinations in Nepal, which is located at 198 km west of Kathmandu, the capital of Nepal.

Study design and study population

Institution-based, cross-sectional study design was adopted. Higher secondary students of science and management streams up to the age of 19 were enrolled in the study. There were 69 higher secondary schools in total during the time of data collection in Pokhara submetropolitan municipality.

Sample size and techniques

A sample size of 302 was taken in the study. Initially, ten schools were randomly selected from the total of 69 higher secondary schools in Pokhara submetropolitan municipality in such a way that four were public and six were private by using proportionate sampling, and half of the schools were science related and half were management related. From each selected school, only a class was selected using simple random sampling technique.

Data collection tools and techniques

Pretested, structured and self-administered questionnaire was used for data collection.

Data processing and analysis

The collected data were entered and analysed using IBM SPSS version 21 (IBM Corporation, Armonko, NY, USA). Chi-square test was used to find out the association between watching porn movies and sexual activity with sociodemographic factors. P ≤ 0.05 was taken as statistically significant value at 95% level of confidence.

Ethical considerations

Approval for conducting the study was obtained from the Institutional Review Board of Eternal University. Informed consent was obtained from the students as well as from school administration. Privacy of the information was assured and maintained, and the data collected were used for research purpose only.


  Results Top


Basic background

Nearly two-thirds of the students (58.6%) were from science stream and the remaining 41.4% were from management stream. The mean age of the students was 17.2 years; around 60% of the respondents were male and about 40% were female. Majority (73.5%) were from nuclear family and 26.5% from joint family. Overall 53% of the respondents were currently in a love relationship as they were having girlfriend (GF)/boyfriend (BF), and 57% of those in the love relationship felt that the influence of TV programmes and movies inspired them to make BF/GF. TV sets were present in 35.8% of the adolescents' bedrooms. Nearly 73% of the respondents had ever noticed the advertisements of condoms in different mass media. Forty-two percent of the total respondents thought that watching porn movies and other influences from TV programmes had led to the early initiation of sexual activities in the adolescents.

Sexual behaviour of adolescents

Out of the 302 respondents, 81 (26.8%) had sexual intercourse and 221 (73.2%) did not have had sexual intercourse. Out of those 81 respondents that had sex, 24.7% were married and 75.3% were unmarried. The prevalence of premarital sex among males was found to be 32.36% and that of among girls was 4.71%. Discussing about the number of partners of sexual intercourse, 37% of adolescents stated that they had sexual contact with more than four persons, 27.2% had sexual contact with 2–4 partners and 35.8% with one partner. Most of the respondents (77.8%) had sexual intercourse with their BF/GF/husband/wife followed by sex workers (11.1%) and relatives (11.1%). More than half, 54.3%, had their first sexual intercourse when they were 14–16 years of age. One-third, 33.3%, had experienced their first sexual intercourse at the age of 17–19 years and 12.4% experienced at 10–13 years of age [Table 1].
Table 1: Sexual activity of adolescents

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Out of the total 81 adolescents who had sexual intercourse, 86% had used condoms. Of the total adolescents who had sexual intercourse, less than half (44.4%) had used condom for the purpose of preventing HIV and other STDs, followed by 28.4% to prevent pregnancy, 17.3% due to the pressure from their partners and 9.9% as a curiosity gained through media advertisements on condoms [Table 2].
Table 2: Condom use

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Association of exposure to porn movies with sociodemographic factors and presence of television in bedroom

There was a statistical association between the exposure to porn movies with age (χ2 = 4.308, P = 0.038), caste (χ2 = 10.54, P ≤ 0.05), gender (χ2 = 85.37, P < 0.001), monthly family income (χ2 = 19.49, P 0.001), monthly pocket money (χ2 = 16.175, P < 0.001) and time spent on watching computer (χ2 = 14.35, P < 0.001) [Table 3] and [Table 4]. The presence of TV in personal bedroom of the adolescents was significantly associated with the number of times they watched the porn movies (χ2 = 10.843, P = 0.013) [Table 5].
Table 3: Association between exposure to porn movies and sociodemographic factors

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Table 4: Association of exposure to porn movies with monthly pocket money and time spent in computer/television

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Table 5: Association between exposure to porn movies and presence of television in bedroom

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Association between involvements in sexual activity with sociodemographic factors

Involvement in sexual intercourse was significantly associated with age (χ2 = 14.936, P < 0.001), type of family (χ2 = 7.89, P = 0.008), gender (χ2 = 10.475, P = 0.001), monthly family income (χ2 = 10.669, P = 0.014), monthly pocket money (χ2 = 41.02, P < 0.001), exposure to porn movies (χ2 = 48.874, P < 0.001) and presence of BF/GF (χ2 = 72.99, P < 0.001) [Table 6] and [Table 7].
Table 6: Association between involvements in sexual activity with sociodemographic factors

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Table 7: Association between involvements in sexual activity with monthly pocket income, porn movie exposure and presence of girlfriend/boyfriend

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  Discussion Top


Nearly two-thirds of the male adolescents were in love relationships, which is supported by a study in India.[11] Regarding females, 42% were in love relationship, which is higher than the findings of a study in India.[11] Nowadays, due to the heavy influence of movies and TV serials, adolescents are more attracted towards being in love relationships. The presence of TV/computer in the bedroom is responsible for more exposure to TV programmes, computer usage and more indulgence in watching porn movies. Several studies[12],[13],[14] have reported that having a TV set in children's bedrooms is associated with higher levels of TV viewing. TV sets were present in 35.8% of the adolescents' bedrooms in the present study. A similar study in Canada[15] reported the presence of TV in 36% of the adolescents' bedroom. Various factors in the family environment, such as siblings and family viewing practices, may be the better indicators of adolescents at risk of exceeding national TV/video/DVD-viewing guidelines. More than one-third of the males (34%) had sexual intercourse, which is supported by a study in India[11] which found 34.2% involvement of males. Involvement in sexual intercourse was found to be high (26.8%). Premarital sex rate was 21.9%, with a rate of 32.36% for males and 4.71% for females. On the contrary, findings from a previous study in Nepal[6] found higher prevalence of premarital sex (39%) with a total prevalence of 47%. Whereas another study in Nepal[7] reported a prevalence of 13.5% premarital sex in the age group of 18–19 years. The increase in premarital sex among boys who were attending school/college might be due to the fact that they have greater independence (not living with family) from their families or due to increasing access to young women for sex and increasing number of prostitution business in Pokhara. Bi-variate analysis showed that some of the individual characteristics including the sociodemographic variables had significant association with the experience of premarital sex. Regarding the age at first sexual intercourse, in this study, 29.6% of the respondents had their first sexual intercourse when they were 16 years of age.

Most of the adolescents, 86%, had used condoms during their last sexual intercourse, which is higher than that reported from a previous study.[6] Higher condom use among adolescents might be the awareness created by different mass media on the risks of STDs. Mass media exposure is another important predictor for condom use at first sexual intercourse. Those students who were exposed to both electronic and print media were more likely to use condoms than those who had low exposure to these media. This finding is similar to that of other studies.[16],[17]

Age, type of family, sex of the student, monthly family income, monthly pocket money, exposure to social networking, exposure to porn movies and presence of GF/BF had significant statistical association with the involvement in sexual activity. A similar study in Nigeria[18] found significant association between being sexually active and the respondents' age (P = 0.001), sex (P = 0.004), marital status (P = 0.01), time spent daily in watching TV (P = 0.03), frequency of Internet use (P = 0.0003) and frequency of accessing sexually explicit materials on the Internet (P = 0.001). Adolescence is the age group with developing sexuality and sexual curiosity. This might be the cause for significant association with watching porn movies and involving in sexual activity with increase in age. Ultimately, having BF/GF provides easy access to meet the sexual desire and curiosity. Males and adolescents from joint family were significantly associated with involvement in sexual behaviour, which might be due to excessive freedom and lack of guidance. Patriarchal society where males are given more freedom and importance might be the cause for their huge involvement in sexual activities. With higher monthly income and pocket money, sexual involvement was found to be high, which provides a clue that adolescents buy sex by giving money in Pokhara where sex market is developing illegally and haphazardly.


  Conclusion Top


Sexual behaviour among adolescents was found to be high (26.8%), with 13.6% adopting a risky sexual behaviour. Media plays an influential role for promoting sexual behaviour as well as for safe sex. Age, caste, gender, monthly family income, monthly pocket money, time spent in TV/computer and presence of TV/computer in bedroom were significantly associated with watching porn movies. Involvement in sexual behaviour was significantly associated with age, type of family, gender, monthly family income, monthly pocket money, watching porn movies and presence of BF/GF. Parents, society and school administration should provide regular guidance through proper care and support and supervision for preventing premarital and unsafe sexual behaviour and promoting safe sexual behaviour. Reproductive and sex education should be introduced into the school curriculum to minimise and control premarital and unsafe sex.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
World Health Organization. Maternal, Newborn, Child and Adolescent Health; June 2016. Available from: http://www.who.int/maternal_child_adolescent/topics/adolescence/dev/en/. [Last accessed on 2016 Jun 20].  Back to cited text no. 1
    
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Committee on Communications, American Academy of Pediatrics. Sexuality, contraception and the media. Pediatrics 1995;95:298-300.  Back to cited text no. 3
    
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Ybarra ML, Strasburger VC, Mitchell KJ. Sexual media exposure, sexual behavior, and sexual violence victimization in adolescence. Clin Pediatr 2014;1:1-9.  Back to cited text no. 4
    
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Strasburger VC. Adolescents, sex, and the media. Adolesc Med State Art Rev 2012;23:15-33, ix.  Back to cited text no. 5
    
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Adhikari R, Tamang J. Premarital sexual behavior among male college students of Kathmandu, Nepal. BMC Public Health 2009;9:241.  Back to cited text no. 6
    
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Regmi P, Simkhada P, Van Teijlingen ER. Sexual and reproductive health status among young peoples in Nepal: Opportunities and barriers for sexual health education and services utilization. Kathmandu Univ Med J (KUMJ) 2008;6:248-56.  Back to cited text no. 8
    
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Dave VR, Makwana NR, Yadav BS, Yadav S. A study on high-risk premarital sexual behavior of college going male students in Jamnagar city of Gujarat, India. Int J High Risk Behav Addict 2013;2:112-6.  Back to cited text no. 9
    
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Ministry of Health and Population. Nepal Demographic and Health Survey 2011. Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc., 2012.  Back to cited text no. 10
    
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Vasan A. Films and TV: Viewing Patterns and Influence on Behaviours of College Students. Health and Population Innovation Fellowship Programme Working Paper. New Delhi: Population Council, 2010.  Back to cited text no. 11
    
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Wiecha JL, Sobol AM, Peterson KE, Gortmaker SL. Household television access: Associations with screen time, reading, and homework among youth. Ambul Pediatr 2001;1:244-51.  Back to cited text no. 12
    
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Saelens BE, Sallis JF, Nader PR, Broyles SL, Berry CC, Taras HL. Home environmental influences on children's television watching from early to middle childhood. J Dev Behav Pediatr 2002;23:127-32.  Back to cited text no. 13
    
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Woodard EH, Grindina N. Media in the Home 2000. Report No: 7. University of Pennsylvania, 2000.  Back to cited text no. 14
    
15.
Hardy LL, Baur LA, Garnett SP, Crawford D, Campbell KJ, Shrewsbury VA, et al. Family and home correlates of television viewing in 12-13 year old adolescents: The Nepean study. Int J Behav Nutr Phys Act 2006;3:24.  Back to cited text no. 15
    
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Foreit KG, Castro MP, Franco FD. The impact of mass media advertising on a voluntary sterilization program in Brazil. Family Planning Operations Research: A Book of Readings. New York: Population Council, 1998; 141-56.  Back to cited text no. 16
    
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Sharan M, Valente TW. Spousal communication and family planning adoption: Effects of a radio drama serial in Nepal. Int Fam Plann Pers 2002;28:16-25.  Back to cited text no. 17
    
18.
Asekun-Olarinmoye OS, Asekun-Olarinmoye EO, Adebimpe WO, Omisore AG. Effect of mass media and internet on sexual behavior of undergraduates in Osogbo metropolis, Southwestern Nigeria. Adolesc Health Med Ther 2014;5:15-23.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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