MINISTRY OF HEALTH UNIVERSITY OF HEALTH SCIENCES, FACULTY OF PUBPLIC HEALTH and MINISTRY OF EDUCATION AND TRAINING - MINISTRY OF HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH SENGDALY XAYHONGKHAM PORNOGRAPHY WATCHING AND ASSOCIATED FACTORS AMONG UNIVERSITY STUDENTS AT UNIVERSITY OF HEALTH SCIENCES (UHS), LAO PDR DURING 2019 MASTER THESIS MASTER OF PUBLIC HEALTH CODE: MPH 8720701 HANOI, 2019 MINISTRY OF HEALTH UNIVERSITY OF HEALTH SCIENCES, FACULTY OF PUBPLIC HEALTH and MINISTRY OF EDUCATION AND TRAINING - MINISTRY OF HEALTH HANOI UNIVERSITY OF PUBLIC HEALTH SENGDALY XAYHONGKHAM PORNOGRAPHY WATCHING AND FACTORS ASSOCIATED AMONG UNIVERSITY STUDENTS AT UNIVERSITY OF HEALTH SCIENCES (UHS), LAO PDR DURING 2019 MASTER THESIS MASTER OF PUBLIC HEALTH CODE: MPH 8720701 Professor Bui Thi Thu Ha Dr. kongmany Chluenvong HANOI, 2019 i ACKNOWLEDGEMENTS I would like to express my special thanks and gratitude for the cooperation between the LEARN project and the two universities (The University of Health Sciences, Lao PDR and The Hanoi University of public Health, Vietnam) to build this project to develop the capacity of Lao staff in the public health field. This project gave me the golden opportunity to do this wonderful research on the pornographic watching and associated factors among university students at the UHS, Lao PDR. This also helped me in doing my master‟s study and I came to know so many new things and I am really thankful to them. Foremost, I would like to express my sincere gratitude to my advisors Professor Bui Thi Thu Ha and Dr. Kongmany Chaluenvong for their continuing support of my master‟s study and research, for their patience, motivation, enthusiasm, and immense knowledge. Their guidance helped me all the time when carrying out research and writing up this thesis. I could not have imagined having better advisors and mentors for my master‟s study. I would like to thank all of teachers on both sides, namely at the University of Health Sciences, Lao PDR and the Hanoi University of Public Health, Vietnam for giving me the chance to study for a master‟s degree and providing new knowledge and good experiences that I never attempted before. I would like to thank my extended family, friends, coworkers and classmates who always supported me throughout my master‟s study. Despite the hard work and long months, they have all been a source of laughter and fellowship. Finally, I would like to thank all of my anonymous participants for their time commitment and bravery to participate in such a vast and intimate study. I hope that this research will inspire others who have an interest in future research. ii ABSTRACT Background: Pornography watching has become an extensive social phenomenon worldwide and has contributed to changes in the terrain of human sexuality causing both positive and negative attitudes. Pornographic sources (Internet, smartphone, movies/videos, television, and magazines/books) have made the available of pornography faster and easier than ever before. Pornographic material provides sexual explicit content that is not filtered before publication and distribution into society, thus students often deliberately search for these materials due to curiosity. This paper has the aim of describing the proportion of watching pornography and associated factors among university students. Method: The PRECEDE–PROCEED Theory was used to guide this study. The study adopted a cross-sectional design. The study was conducted at the University of Health Sciences (UHS), Lao PDR from January to March 2019. A sample of 365 university students was selected for this study by cluster and multi-stage sampling. The data was collected by self-administered questionnaires and analyzed by using statistics software, namely SPSS version 13.1. In addition, descriptive and inferential statistics were applied. Results: The results showed that the frequency of erotic pornography detailing sexual intercourse was high at 40.9% (62.0% for males and 23.8% for females). Factors associated with watching pornography were sex, participants having partners, a positive attitude toward to pornography watching and having supportive friends. Males were 4.6 times more likely to watch erotic pornography than females participants (AOR=4.6, 95%CI=2.9-7.4, P<000). Participants who had partners were 1.9 times more likely to watch erotic pornography than those who were single (AOR=1.9, 95%CI=1.1-3.2, P<0.009). Participants who had positive attitudes were 1.8 times more likely to watch erotic pornography than those who had negative attitudes (AOR=1.8, 95%CI=1.1-2.9, P<0.014) and participants who had friends to support pornographic viewing were 1.8 times more likely to watch erotic iii pornography than those who did not have persuasive friends (AOR=1.8, 95%CI=1.6-2.9, P<0.010). Conclusion: The frequency of watching erotic pornography detailing sexual intercourse was high among university students. The factors such as males, having partners, maintaining a sympathetic attitude and having influential friends were also significant motivators associated with watching erotic pornography. Recommendations: Policy makers should develop programs and create barriers to reduce accessing to pornography, promote self-respecting social norms and take step to mitigate factors that put pressure on youth to watch pornography. Keywords: Pornography, Viewing, university students, UHS iv Contents ACKNOWLEDGEMENTS .................................................................................................................. i ABSTRACT ..................................................................................................................................... ii List of Tables ................................................................................................................................. vi List of Figures ............................................................................................................................... vii Abbreviation Template and Acronyms ........................................................................................ viii Introduction .................................................................................................................................. 1 Research objectives ...................................................................................................................... 3 Chapter 1: Literature Review......................................................................................................... 4 1.1. Definitions .......................................................................................................................... 4 1.1.1. Pornography ................................................................................................................ 4 1.1.2. Youth ........................................................................................................................... 6 1.2 Classification of Pornography .............................................................................................. 7 1.3 Measurements for Pornographic Watching ......................................................................... 8 1.4 Negative and Positive Effects of Pornographic Watching ..................................................... 9 1.4.1 Negative Effects of Pornographic Watching .................................................................. 9 1.4.2 Positive Effects of Pornographic Watching .................................................................. 10 1.5 Situation of Pornographic Watching Around the World and in the Lao PDR ....................... 11 1.5.1 Global Status of Pornography ..................................................................................... 11 1.5.2 Status of Pornographic Watching in Laos .................................................................... 12 1.6 Factors Affecting Pornographic Watching .......................................................................... 12 1.6.1. Predisposing Factors. ................................................................................................. 12 1.6.2. Reinforcing Factors .................................................................................................... 15 1.6.3. Enabling Factors ........................................................................................................ 16 1.7 Conceptual Frame Work .................................................................................................... 17 Chapter 2: Subject and Methodology .......................................................................................... 21 2.1. Study Area and Period ...................................................................................................... 21 2.2. Study Design: ................................................................................................................... 21 2.3. Sample Size: ..................................................................................................................... 21 2.4. Sampling Method: ............................................................................................................ 22 2.5. Data Collection Method.................................................................................................... 24 2.6. Variables and Definition ................................................................................................... 24 2.7 Measurements .................................................................................................................