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Indian Journal of Community Medicine

The Level of Awareness About the Consequences of Sex Act Among Adolescent Girls in Bankura, West Bengal

Author(s): A. Sinhababu, B. S. Mahapatra

Vol. 29, No. 3 (2004-07 - 2004-09)

Abstract

Objectives:

1. To find out the age at awareness of late adolescent girls about the risk of pregnancy and diseases associated with sex act.

2. To know their source of knowledge.

3. To ascertain their views and opinion towards getting reliable knowledge in this regard.

Study Design: Institution based cross-sectional study.

Setting: Classroom.

Participants: All the (a) first year female students admitted in MBBS Course at B.S. Medical College, (b) first year students admitted in GNM Course at Nursing Training Centre, Bankura and (c) Class XII and first year B.A. students at Saradamoni Women's College, Bankura. Study Period : March-May, 2001.

Result:

Four to five years gap was noticed between the age of menarche and awareness about the consequences of sex act. 42.5% had no prior knowledge of menarche. Friends formed the main source of knowledge about the risk from sex act and mothers about menarche. As for discussion of sex matters, taboo was highest with mother and least with friend. Majority opinion favours discussion with friends followed by doctors and teachers in that order.

Conclusion:

There is an imperative need to target middle adolescents for imparting sex education in order to reduce the gap between the age at menarche and awareness about the consequences of sex act. Since the taboo in discussing sex matters is minimum with friends, formation of peer group educators could be an effective and viable means to educate them.

Key words: Adolescence, Reproductive Health, Sexual behaviour

Introduction

Adolescents (10-19 years) constitute about 20% of total population in India1. The sexual behaviour of adolescents is rapidly changing in many parts of the world, the trend being towards more and earlier sexual activity2. A UNAIDS review of over 50 studies has shown that sexual health education programmes among young people do not encourage sexual experimentation. Such programmes actually help to delay the age of first intercourse. They also reduce sexually transmitted diseases and unwanted pregnancies in sexually active adolescents3. But in societies like India where talking sex is a taboo, the adolescents are really finding it difficult to acquire correct scientific knowledge in this regard both in formal and non-formal settings3.

Against this background the present study was undertaken among late adolescent girl students with the objectives to find out the age at awareness of late adolescent girls about risk of pregnancy and diseases associated with sexual act, to know their source of knowledge and to as certain their views and opinions towards getting reliable knowledge in this regard.

Material and Methods

An Institution based cross-sectional study was carried out among the (a) first year girl students admitted in the MBBS course at B.S. Medical college, (b) first year students admitted in GNM Course at Nursing Training centre, Bankura and (c) Class XII and first year B.A. course students of Saradamoni women's College, Bankura. All of these institutions are located in Bankura town within accessible distance from the Department of Community Medicine, B.S. Medical College. The study population was confined to students to ensure complete coverage. The age of the study population was found to vary in the range of 19-21 years. The relevant informations were collected by a pretested self-administered questionnaire put to the respondents in a classroom. Absentees were covered on subsequent dates. Anonymity was maintained by not including the names of the respondents in the proforma.

Results

A total of 348 girl students aged 18-21 years were studied. Majority of them (76.7%) started menstruation sometime between 12-14 years of age. The median age of menarche was 13 years. As for the risks from sex act, most of the girls (65.9%) became aware, for the first time, of the risk of pregnancy following sex act at the age of 16-18 years. The median age of such awareness was 17 years which happened to be 4 years higher than the median age of menarche. On the other hand, the earliest age of awareness about the risk of disease as a consequence of sex act was seen in slightly higher age. 62.2% of the girls became aware of this risk for the first time at the age of 17-19 years with the median age being 18 years. The difference from the median age of menarche in this case was 5 years.

Table I: Source of Knowledge Regarding Menstruation Before Menarche and About Risk of Pregnancy and Disease From Sex Act

Source of knowledge before menarche Knowledge Regarding
Menstruation Risk of Pregnancy Risk of disease
  No. % No. % No. %
No idea 148 42.5 8 2.3 52 14.9
Mother 74 21.3 9 2.6 5 1.5
Other family members # 56 16.1 13 3.7 6 1.7
Friends 70 20.1 274 78.7 72 20.7
Text books 0 0 28 8.1 177 50.9
News paper, TV 0 0 16 4.6 36 10.3
Total 348 100 348 100 348 100
# Other family members include aunt, sister, grandmother

42.5% of the girls had no prior knowledge of menstruation before menarche. Lack of awareness was relatively more pronounced with risk of disease (14.9%) and far less with pregnancy (2.3%). Mother and other family members formed the main source of knowledge regarding menarche whereas their contribution towards providing information about the risks from sex act was negligible. Friends and text books acted as the main source for the later. (Table I) Poor involvement of mothers here can be attributed to the taboo in discussing sex matters.

While 38.2% of the girl students preferred not to discuss sex matters with anyone, those who discussed did so with friends. As for their opinion in this regard overwhelming majority were of the view that it should be discussed with others. But opinion differs widely as to the category of person with whom sex matters should be discussed. Majority opinion, however, favours discussion of sex matters with friends followed by doctors and teachers in that order.

Table II : Taboo in Discussing Sex Matters

Category of
person
Person with whom
sex matters were
discussed (n=348)
Persons with whom
respondants think sex
matters should be discussed
(Multiple response n=624)
  No. % No. %
No body 133 38.2 12 1.9
Mother 4 1.1 74 11.9
Other family members 14 4.1 51 8.2
Friends 197 56.6 198 31.7
Lady teacher 0 0 103 16.5
Doctor 0 0 186 29.8
Total 348 100 348 100

Discussion

The present study shows the median age of menarche as 13 years which is consistent with the finding of Srivastava et al4. A difference of 4-5 years was found between the median age of menarche and the median age of awareness about the risk of pregnancy and disease from sex act. This lack of awareness in early years of adolescence makes them vulnerable to the risks from sex act. Studies in India and abroad have reported occurrence of sexual activity at an early age. Study of Sonia Trikha4 on abortion among adolescent attending MTP centres in the Rohtak city of Haryana revealed that 43% of adolescent girls had the experience of sexual intercourse by the age of 16 years, another 40% by the age of 18 years, and the youngest age of first sex act was 14 years.The first sex act occurring at much earlier age was reported by studies conducted in other countries6. The findings of the present study together with these revealations present a strong case for imparting sex education targeted towards at least middle adolescents, if not early adolescents. Grover et al9 in their study among male adolescents also advocated the urgent need to target adolescents7.

The reason for this lack of awareness can be traced to the reliability of source of knowledge about menarche on the one hand and about the risk from sex act on the other. Most of the girls got to know about menarche in home setting from the mothers or other family members. By contrast, knowledge about risk of pregnancy and disease following sex act was obtained mainly from friends. Mothers contribution was very poor in this regard. The environment seems to be not conducive for involvement of mothers or because of the taboo in discussing sex matters. The taboo was most pronounced in case of discussion with mothers and least with friends.

Although friends constituted the chief source, they cannot be depended upon as reliable.This is because `in the absence of sex education in schools and colleges, they oscillate between the peers to gain scientific knowledge of sex8. Therefore, some mechanism to make them reliable should recieve priority attention.

Conclusion

Early years of adolescence is crucial for imparting education about the consequences of sex act since level of awareness was found to be minimal during this period. Because of taboo in discussing sex matters with parents, meaningful involvement of parents, particularly mothers, may not be possible in the immediate future. Since the taboo is least with friends, formation of peer group educators could be an effective and practical option.

References

  1. Paruthi R, Dutta PK. Adolescent Health- an emerging Priority. In : public Health in the new millenium. Joint National conference of Indian Public Health Association, Indian Association of Epidemiologist & Indian Society for Malaria and other communicable diseases. 2000. P-32.
  2. Mahajan BK, Gupta MC. Text Book of preventive and Social Medicine. 2nd ed. New Delhi. Jaypee Brothers. 1995. P-228.
  3. Children and young people in context of HIV/AIDS : Listen, Learn, Live! World AIDS compaign with children and Young people. ICMR Bulletin. 1999. 29(12). 125-134.
  4. Srivastava S, Pandey DN, Nandan D. A study of physical, psychological and behavioural changes among the Adolescent girls. In : public Health in the new millenium. Joint National conference of IPHA, IAOE & ISMOCD. 2000. P-21.
  5. Trikha Sonia. Abortion scenario of Adolescents in a North Indian City - evidence from a recent study. Indian Journal of community Medicine. 2001. 26(1) 48-55.
  6. UNAIDS : Force of change, world AIDS compaign briefing paper. 1998 cited in Ref. 4.
  7. Grover V. Kumar P, Agarwal OP. Awareness regarding STDs and HIV/AIDS amongst male adlescents in a resettlement colony of East Delhi - A community based study : In : Public Health in the new millenium. Joint National Conference of IPHA, IAOE & ISMOCD. 2000. P-11.
  8. Prakash V Foreward : A study on knowledge attitude and practice towards HIV / AIDS among the college students of West Bengal. Kolkata. Vasavan K. 1993-94.
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