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Sexual Behavior of Adolescents with an Emphasis on Use of Contraceptives / Risk of Sexually Transmitted Infections

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Sexual Behavior of Adolescents with an Emphasis on Use of Contraceptives / Risk of Sexually Transmitted Infections Cent Eur J Nurs Midw 2020;11(1):2–8 doi: 10.15452/CEJNM.2020.11.0002 ORIGINAL PAPER SEXUAL BEHAVIOR OF ADOLESCENTS WITH AN EMPHASIS ON USE OF CONTRACEPTIVES / RISK OF SEXUALLY TRANSMITTED INFECTIONS Simona Kelčíková1, Marcela Pydová1, Nora Malinovská2 1Department of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia 2Department of Foreign Languages, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia Received June 17, 2019; Accepted December 16, 2019. Copyright: This is an open access article under the CC BY-NC-ND license. Abstract Aim: The aim of the study was to survey adolescent sexual behavior, use of contraceptives, and sexually transmitted infections, and, in addition, to see how these factors correlated with selected individual characteristics of the respondents (e.g., age, gender). Design: A quantitative cross-sectional study. Methods: An exploratory method, using a specially designed questionnaire, was selected. The research sample consisted of 381 adolescents with an average age of 17.75 years (± 1.28). Data were analyzed using descriptive statistics and the Chi-squared (χ2) test (p < 0.05). Results: More than half of adolescents (61.35%; 2.49 ± 1.91) have had sexual intercourse. We found a variety of reasons for differences in the use of contraceptive methods. The most commonly used contraceptive methods during sexual intercourse were male condoms (50.13%), and hormonal pills (16.80%). However, most respondents (86.61%) reported they had not used condoms during their last sexual intercourse. Only 12.86% of respondents considered their sexual behavior safe. Statistically significant differences were found in adolescent sexual behavior relating to contraceptive use in terms of gender and age (p < 0.05). Male adolescents were more likely to use condoms during sexual intercourse, and to use contraceptive methods to prevent sexually transmitted infections. Conclusion: The study revealed that the level of adolescent sexual behavior deserves more attention. Evidence of significant differences should serve as an argument for efforts to increase awareness and education on issues related to sexual health, with an emphasis on the risk of sexually transmitted infections. Keywords: adolescence, contraceptives, prevention, sexual behaviour, sexually transmitted infections. Introduction in many representative studies of sexual behavior. The period of adolescence represents a transitional Sexual activity is influenced not only by degree phase of growth and development between childhood of sexual maturation, but also by surrounding cultural and adulthood. During this period, the development and social pressures. In recent times, adolescents of sexual maturation begins, and adolescents may have begun to mature at an earlier age than before, also experience their first sexual intercourse. with a number of negative consequences, particularly Compared to the past, the recent period can be on their reproductive capacity and sexual health characterized as more open and liberal, offering (Skrzeczkowska et al., 2015). Risky sexual behavior a variety of sexual opportunities that could generally automatically implies a greater incidence of sexually be viewed as risky. Adolescents begin to experiment transmitted infections (STIs), which are, and develop partnerships at a time when they are unfortunately, not uncommon in the period undergoing many changes, including physical of adolescent development and, according to data maturation, formation of identity, and self- released by the World Health Organization (WHO), development. Such early, often premature, their number is on the rise (World Health experience of sexual relationships might be Organization [WHO], 2004). Every day, more than 1 encouraged by the media, particularly the Internet, as million STIs are contracted worldwide. STIs are well as by the rapid pace of modern lifestyles, and the spread by contact with infected body fluids such as earlier onset of puberty. Research on adolescents’ blood, saliva, vaginal secretions, or semen during attitudes towards sexuality plays a significant role sexual contact, including vaginal, anal and oral sex (WHO, 2012). The main indicators for sexual Corresponding author: Simona Kelčíková, Department of behavior are lack of condom use, contraction of STIs, Midwifery, Jessenius Faculty of Medicine in Martin, Comenius and pregnancy in adolescents (Currie et al., 2008; University in Bratislava, Malá Hora 5, Martin, Slovakia; email: WHO, 2012). Adolescent sexual behavior has been [email protected] recognized as a significant health, social, and demographic problem in the developing world, © 2020 Central European Journal of Nursing and Midwifery 2 Kelčíková, S. et al. Cent Eur J Nurs Midw 2020;11(1):2–8 particularly with regard to unintended pregnancies items, three of which were demographical. (Osaikhuwuomwan & Osemwenkha, 2013; Somba et The respondents selected options from al., 2014). One of the most significant trends a predetermined list of responses, using an ordinal influencing the sexual behavior of adolescents in the scale from 1 – “disagree” to 5 – “agree”. Data 21st century has been the constantly decreasing age collection was conducted from February 2018 to of sexual initiation in teenagers, and the tendency October 2018. A combined method of personal and among younger adolescents to delay use electronic questionnaire administration was chosen. of contraception (Osaikhuwuomwan & Osemwenkha, A total of 300 paper questionnaires were distributed 2013). Hence, prevention is a more important and by hand in grammar schools and secondary beneficial tool in fighting this global challenge than vocational schools (with a final graduation therapeutic or remedial interventions, which are both examination) in the Prešov District, which had agreed associated with difficulties (Mazúchová, 2012). to take part in the research and had provided signed Control strategies and key principles of prevention informed consent. The completed questionnaires centre on comprehensive sex education, which should were put into a marked drop box, located in the be available and accessible to adolescents. It should school building. The response rate for the paper begin before their sexual initiation, and should questionnaires was 93% (n = 280). A total of 120 include new methods of family planning and electronic questionnaires were received via social contraception that have been developed in recent networks (Facebook, Twitter) and e-mail. From the decades (Maskálová, 2010; Mazúchová & Kulová, total of 400 questionnaires distributed physically and 2014). electronically, 19 were excluded due to non- compliance with the inclusion criteria. As a result, Aim a total of 381 questionnaires were used for the research study, a response rate of 95%. The aim of the study was to survey adolescent sexual behavior, use of contraceptives, and STIs, and, Data analysis in addition, to see how these factors correlated with The received data were analyzed in SPSS 22.0 and selected individual characteristics of the respondents Microsoft Office Excel 2007 programs, using (e.g., age, gender). descriptive statistics and a Chi-squared test (χ2) to determine differences among the selected groups. Methods A test result with a p-value below 0.05 (p < 0.05) was considered statistically significant. Design A quantitative cross-sectional study. Results Sample The average scale response and standard deviation The cohort consisted of participants who had fulfilled (d ± SD), representing interpretation of descriptive the following inclusion criteria: aged 15–21 years, characteristics of individual questionnaire statements, attending a secondary school with a final graduation are shown in parentheses. examination, and signed informed consent prior to The results of the quantitative study revealed that participation. The research sample consisted of 381 the most popular contraceptive methods among adolescents, with an average age of 17.75 years adolescents was the male condom at 50.13% (SD ± 1.28). The largest group (141 respondents) (3.67 ± 1.64), followed by hormonal contraceptive were 18-year-olds. From the total sample of 381 pills at 16.80% (2.32 ± 1.57), the calendar rhythm respondents, 275 were female and 106 were male. In method at 13.65% (2.48 ± 1.52), and the withdrawal terms of age, 142 respondents were aged 15–17 method at 12.86% (2.39 ± 1.49) (see Table 1). years, and 239 were aged 18–21 years. Most adolescents (86.61%) did not use condoms Data collection during their most recent sexual intercourse. A non-standardized specially-constructed For adolescents, the major reasons for contraceptive questionnaire was used to collect the data. The clarity use are the following: a) to prevent pregnancy of the questionnaire was verified by a pilot study with (39.37%; 3.19 ± 1.74); b) non-contraceptive health ten respondents. Based on the piloting, problematic benefits (7.63%; 1.89 ± 1.31); c) to prevent STIs formulations of a formal and/or stylistic character (18.64%; 2.65 ± 1.59). In addition, 50.92% were modified. The questionnaire was designed to (2.25 ± 1.53) of adolescents use at least one form identify how aspects of sexual behavior related to of contraceptive method during sexual intercourse, knowledge and contraceptive use. It contained 26 while 16.27% use none. The most common reasons © 2020 Central European Journal of Nursing and Midwifery 3 Kelčíková, S. et al. Cent Eur J Nurs Midw 2020;11(1):2–8 Table 1 Contraceptive
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