Health Beliefs Health beliefs in this study include attitudes, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, normative beliefs, motivation to comply, and perceived self-efficacy. Attitude Some of the students said they had a positive attitude to having sex. Some of them believed that the premarital sexual intercourse is necessary. Others had a negative attitude towards premarital sexual intercourse. For example, one student stated: If you have premarital sexual intercourse you can understand things and get more mature.
If you do not try it before getting married you are confused. Perceived Susceptibility Perceived susceptibility refers to beliefs about the likelihood of getting a disease or condition. For instance, one of the students said that: Another participant stated that: If you have sex you may become infected as it is not known whether the person is healthy or not.
The students thought that having premarital sexual intercourse has bad consequences. Some students expressed that sexual activity can have negative social consequences.
For example, a student stated: Sometimes sex may lead to committing suicide or killing another person. Perceived Benefits Perceived benefits refer to belief in efficacy of the advised action to reduce risk or seriousness of impact. Benefits identified in this study include having physical and mental health, being aware of the disadvantages and complications of premarital sexual intercourse, perceived social benefits like keeping honor or dignity of themselves and their families, and psychological benefits such as mental and spiritual peace.
Perceived Barriers Perceived barriers are beliefs about the tangible and psychological costs of the advised action, such as being uncomfortable with preventive or therapeutic measures.
For example, a student said: This might lead to sexual stimulation. Normative Beliefs The normative beliefs are beliefs about whether each referent approves or disapproves of the behavior. Regarding sexual behavior, many of the students state that their friends considered this kind of sex as ordinary.
For example, one participant stated: Motivation to Comply Motivation to comply is belief about whether each referent approves or disapproves of the behavior.
Many of the students stated that they acted based on what their families accept as important. For example, one participant said: It is for their sake that I am not going to go have sex. However, some students said that they had high self-efficacy for overcoming barriers. For instance, one of students said: I cannot control myself against sexual stimulation and I am going to experience it if possible.
Religious and Spiritual Beliefs Religious and spiritual beliefs constitute the second main category of factors extracted from data and include subcategories of religion and spirituality cited frequently by the students in this study. Religion In this study, religion was repeatedly mentioned by participants as a shield to avoid premarital sexual intercourse.
Even students who had experienced sexual intercourse reported religion as a deterrent to sexual behavior before marriage. Sex before marriage was considered a sin based on religious beliefs of many students. For example, one student said: People who really adhere to Islamic religion will never experience premarital sexual intercourse, and if they have sex, it is adultery, sin and forbidden in Islam.
Spirituality Some students reported moral and humanitarian issues as factors affecting sexual intercourse. They deemed sex as inappropriate in their opinions. For example, one participant stated in this regard: Regarding having unpermitted affairs with a person, one should imagine oneself in her shoes. This is what I always do. This is related to ideological issues. Character Character is the third main category of factors extracted from the data.
They include self-esteem, instinct and sense of independence. Self-Esteem Some participants stated that they value themselves and respect their privacy. Instinct The sexual instinct is an internal desire for the opposite sex present in all people.
A large number of students reported the libido and sexual drive, inner passion and precocious puberty as the reasons for having sex. One of the participants stated in this regard: We have passion and sexual instinct. Therefore, we should have sex. Sense of Independence Some of the participants thought that feeling independent and grown up can encourage a person to have sex outside of marriage. In these cases, people are willing to make their own decisions.
At my age I should decide or think for myself and decide whether I should have sex or not. Discussion In this study, health beliefs, religious and spiritual beliefs and character were the main categories of individual factors affecting premarital sexual intercourse. Subcategories of health beliefs include attitude, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, normative beliefs and motivation to comply.
Since most health problems are closely related to human behavior, theories and models of behavior can provide insights into finding ways to prevent health problems Conceptual validity of the factors identified in this study was supported by numerous health behavior theories which used to understanding sexual behavior of adolescents and young people Various models and theories have been used to explain the attitudes and sexual behaviors in adolescents worldwide 1 , Attitude toward behavior and subjective norm are included in the theory of planned behavior The HBM is based on the assumption that individuals will take a specific health-related behavior if they have a positive expectation of avoiding the negative health condition Perceived barriers, perceived benefits, perceived susceptibility, and perceived severity are health belief model constructs In this model, behaviors to reduce health risks e.
AIDS and deaths and feel they are at risk and know the desired behavior avoiding sex can reduce their health risks. Also, when people decide to act, first they evaluate costs of a disease such as AIDS against the costs of preventing it by avoiding sex or using a condom In a study, self-efficacy in sexual abstinence was most strongly predicted by previous sexual activity.
In the study by Rijsdijk et al. It seems that in Iran, due to cultural norms which considered talking about sexual topics in public as taboo, formal education about such issues in schools, universities and community is nonexistent and communication with parents about them is rare.
Religious and spiritual beliefs are another major category of factors identified in this study. Another study has revealed that greater religious involvement was a protective factor to have unsafe sexual behavior, so that students who had higher religious scores were significantly more likely higher self-efficacy to refuse sex and their attitude were positive toward avoiding sex.
These students were more likely never to have had premarital sexual intercourse. It is consistent with social norms and religious values in Islamic societies that inhibit unmarried people from high-risk sexual behavior In a study by Mohammadi et al. Spirituality as an inherent image in humanity is experienced by all people with both the emotional and intellectual elements A number of studies has reported that a high level of spirituality was associated with lower levels of risk behaviors by youth.
In the studies by Weaver et al. Involvement and attendance in religious communities can provide opportunities for young people to be exposed to social and spiritual teachings and value for avoiding of risky behaviors in adolescents In this study, character was another category of individual factors affecting premarital sexual intercourse. In their study, Ma et al.
On the other hand, low self-esteem and high sexual maturity in adolescents were associated with early sex in adolescents Also, the increase in premarital sex among male students can be attributed to the fact that they were more independent from their families and had greater access to young women for sex 6.
In general, the use of multiple theories makes combining important variables possible and allows us to provide a holistic and comprehensive explanation In this study, there are certain limitations including first, we were unable to determine the number of people who had sex before marriage. Second, the fact that socially sensitive behavior is likely to be under-reported especially when face to face interviews are used instead of self-administered questionnaires Third, sampling strategy can be biased because people who speak more comfortably about sexual issues are more likely to be included in the study.
The strong points of the current study include maintaining strict privacy and observing rights of the participants. The study also successfully includes unmarried students in an in-depth qualitative study and obtains sensitive information associated with sexual issues.
Finally, the results of this study have both theoretical and empirical implications for future research. The current study identified premarital sexual intercourse-related individual factors among students. Also, areas where health professionals should assess and target for intervention were determined health beliefs, religious-spiritual beliefs.
This study also shows some characteristics and beliefs associated with sexual behavior which are related to behavior change models and theories. Therefore, the importance of using behavior change theories and models for designing interventions aimed at reducing sexual activity and controlling and preventing premarital sex is stressed.
Nonetheless, due to the nature of qualitative research, further research is required to explore the relationship between the identified variables, identify causal determinants and evaluate generalizability of the findings. Finally, this study is a form of shared experience that can help similar studies. Similar research is recommended to identify the determinants of having or not having sex in adolescents and young adults outside the campus.
Also, they warmly express their gratitude to the adolescents who participated closely in the present study. Qualitative inquiry into premarital sexual behaviours and contraceptive use among multiethnic young women: Aghajanian A, Mehryar AH.
Fertility transition in the Islamic Republic of Iran: Asia Pac Popul J.