Factors Influencing Premartial Sexual Intercourse

FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE AMONG ADOLESCENTS IN INDONESIA: A CASE STUDY OF IN-SCHOOL LATE ADOLESCENTS FROM INDONESIAN
YOUNG ADULT REPRODUCTIVE HEALTH SURVEY (IYARHS) 2007
RONNY A. P. SITUMORANG
A THESIS SUBMITED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS (POPULATION AND REPRODUCTIVE HEALTH RESEARCH) FACULTY OF GRADUATE STUDIES MAHIDOL UNIVERSITY 2011
COPYRIGHT OF MAHIDOL UNIVERSITY
Thesis entitled
FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE AMONG ADOLESCENTS IN INDONESIA: A CASE STUDY AMONG IN-SCHOOL LATE ADOLESCENTS FROM INDONESIAN YOUNG ADULT REPRODUCTIVE HEALTH SURVEY (IYARHS) 2007
Mr. Ronny A. P. Situmorang Candidate
Assoc. Prof. Sirinan Kittisuksathit, Ph. D. Major advisor
Lect. Charamporn Holumyong, Ph. D. Co-advisor
Prof. Banchong Mahaisavariya, M. D., Dip. Thai Board of Orthopedics Dean Faculty of Graduate Studies Mahidol University
Asst. Prof. Aree Jampaklay, Ph. D. Program Director Master of Arts Program in Population and Reproductive Health Research Institute for Population and Social Research Mahidol University
Thesis entitled
FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE AMONG ADOLESCENTS IN INDONESIA: A CASE STUDY AMONG IN-SCHOOL LATE ADOLESCENTS FROM INDONESIAN YOUNG ADULT REPRODUCTIVE HEALTH SURVEY (IYARHS) 2007
was submitted to the Faculty of Graduate Studies, Mahidol University for the degree of Master of Arts (Population and Reproductive Health Research) on August 17, 2011
Mr. Ronny A. P. Situmorang Candidate
Asst. Prof. Pimonpan Isarabhakdi, Ph. D. Chair
Assoc. Prof. Sirinan Kittisuksathit, Ph. D. Member
Prof. Surasak Taneepanichskul, M. D., Lect. Charamporn Holumyong, Ph. D. Ph. D. Member Member
Prof. Banchong Mahaisavariya, M. D., Dip. Thai Board of Orthopedics Dean Faculty of Graduate Studies Mahidol University
Assoc. Prof. Sureeporn Punpuing, Ph. D. Director Institute for Population and Social Research Mahidol University
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ACKNOWLEDGEMENTS
First of all, I would like to say thank you to Jesus Christ for His mercy and guidance in giving full strength to complete the master degree in Mahidol University. I am deeply indebted to my major advisor Assoc. Prof. Sirinan Kittisuksathit, Ph. D., and my co-advisor, Lect. Charamporn Holumyong, Ph. D., for their continuous guidance, valuable advices and useful suggestions in completion this thesis. I would like also to say thank you to the chair, Asst. Prof. Pimonpan Isarabhakdi, Ph. D., and the external examiner, Prof. Surasak Taneepanichskul, M. D., Ph. D. This thesis will not have been possible without their excellent support and effort. I would like to express my gratitude to all Ajarns of IPSR and guest lecturers for their valuable teaching in their expertise fields as well as their guidance to improve my knowledge. A special acknowledgement to Mrs. Luxana Nil-Ubol for her endless efforts. A lot of thanks to my office Badan Kependudukan dan Keluarga Berencana Nasional (BKKBN) for granting me this prestigious fellowship which made me possible to carry out this program. I would like to express special thanks to Mr. Eddy Hasmi, Mr. Dora, Mrs. Yuyun and all friends in BKKBN for their helpful supports. Then, I would like thanks to my parents bapak Donny S. M. Situmorang and ibu Theresia Lauretta Hutabarat, my brothers Freddy and Christian, and my girlfriend Henny Pakpahan for supporting me mentally and physically, and encourage me during the study period in Mahidol University. Finally, I would like to say a grateful acknowledgement to all my classmates, bang Christian Saragih, Mulyadi, Yunus Adhi Prasetyo, Veronica Meriam Angelina, Kak Ardhini Dwi Utari, Kak Veirine, Guntur Barden Sihombing, Generation for Christ in Bangkok, and all of my friends who never give up in giving their support to me in all aspects of life. Thank you very much my friends, I will never forget all of your kindness. Ronny A. P. Situmorang
Fac. of Grad. Studies, Mahidol Univ.
Thesis /iv
FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE AMONG ADOLESCENTS IN INDONESIA: A CASE STUDY OF IN-SCHOOL LATE ADOLESCENTS FROM INDONESIAN YOUNG ADULT REPRODUCTIVE HEALTH SURVEY (IYARHS) 2007 RONNY A. P. SITUMORANG 5338705 PRRH/M M.A. (POPULATION AND REPRODUCTIVE HEALTH RESEARCH) THESIS ADVISORY COMMITTEE: SIRINAN KITTISUKSATHIT, Ph. D.; CHARAMPORN HOLUMYONG, Ph. D. ABSTRACT The number of Indonesian adolescents practicing sex before marriage is relatively low compared to the rate in other countries (less than 6.5%). However, this issue should be given attention because the rate increased from 5% to 6.4% between 2002 and 2007. Therefore, the main aim of this study is to analyze factors influencing premarital sexual intercourse among in-school late adolescents in Indonesia. This study uses secondary data from the research of the Indonesian Young Adult Reproductive Health Survey (IYARHS) 2007. The study population of 6,792 in-school late adolescents aged 15-19 years was selected from a total of 19,311 unmarried Indonesian young adults that were interviewed. The findings illustrate that 2.4% of the in-school late adolescents have engaged in premarital sexual intercourse. Evidence indicated that sex, age, place of residence, knowledge of sexual reproductive health (SRH), knowledge of contraceptive methods, source of SRH information, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences have a significant association with in-school adolescents that have experienced premarital sexual intercourse. This study suggests that strengthening SRH education programs in every sector in the community for adolescents should be scaled up to increase their knowledge and make them less curious about practicing premarital sexual intercourse. KEY WORDS: INDONESIAN IN-SCHOOL LATE ADOLESCENTS / PREMARITAL SEXUAL INTERCOURSE / FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE 60 pages
CONTENTS
Page ACKNOWLEDGEMENTS ABSTRACT LIST OF TABLES LIST OF FIGURES LIST OF ABBREVIATIONS CHAPTER I 1.1 1.2 1.3 1.4 1.5 1.6 CHAPTER II 2.1 INTRODUCTION Background Problem identification Research question Scope of research Research objectives Definition of key words LITERATURE REVIEW General review 2.1.1 2.1.2 2.2 2.3 2.4 Social cognitive theory Planned Behavior theory iii iv vii x xi 1 1 2 4 5 5 5 6 6 6 7 8 8 10 10 11 11 12 12
Premarital sexual intercourse Socio demographic factors Knowledge on reproductive health issues 2.4.1 2.4.2 2.4.3 Knowledge of SRH Knowledge on contraceptive methods Source of SRH information
2.5 2.6
Attitude towards acceptance of premarital sexual intercourse Relationship status defined by having a boyfriend or girlfriend
2.7
Risky consumption behaviors
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CONTENTS (cont.)
Page 2.8 2.9 2.10 CHAPTER III 3.1 3.2 Peer influences Conceptual framework Research hypotheses RESEARCH METHODOLOGY Study population and sample Operational definitions 3.2.1 Dependent variable 3.2.2 Independent variables 3.3 3.4 CHAPTER IV 4.1 4.2 Method of analysis Limitation of the study RESULTS AND DISCUSSION Characteristics of in school late adolescents The relationship between premarital sexual intercourse and socio demographic factors, knowledge, attitude, relationship status, risky consumption behaviors, and peer influences 4.3 4.4 CHAPTER 5 5.1 5.2 Binary logistic analysis Discussion CONCLUSSION AND RECOMMENDATIONS Conclusion Recommendations 5.2.1 Recommendations 5.2.2 Need for future research BIBLIOGRAPHY BIOGRAPHY 36 41 48 48 50 50 51 52 60 13 13 15 16 16 17 17 17 21 21 22 22 28
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LIST OF TABLES
Table 3.1 4.1 Summary of operational definition and measurement of variables Percentage of socio demographic factors among in-school late adolescents, Indonesia, 2007 4.2 Percentage of knowledge of SRH among in-school late adolescents, Indonesia, 2007 4.3 Percentage of knowledge of contraceptive methods among in-school late adolescents, Indonesia, 2007 4.4 Percentage of source of SRH information among in-school late adolescents, Indonesia, 2007 4.5 Percentage of attitude towards acceptance of premarital sexual intercourse among in-school late adolescents, Indonesia, 2007 4.6 Percentage of relationship status defined by having a boyfriend or girlfriend among in-school late adolescents, Indonesia, 2007 4.7 Percentage of smoking among in-school late adolescents, Indonesia, 2007 4.8 Percentage of drinking alcohol among in-school late adolescents, Indonesia, 2007 4.9 Percentage of using drugs among in-school late adolescents, Indonesia, 2007 4.10 Percentage of discuss about sexual matters with friends among inschool late adolescents, Indonesia, 2007 4.11 Percentage of friends have had sex before marriage among in-school late adolescents, Indonesia, 2007 4.12 Premarital sexual intercourse and sex among in-school late adolescents, Indonesia, 2007
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LIST OF TABLES (cont.)
Table 4.13 Premarital sexual intercourse and age among in-school late adolescents, Indonesia, 2007 4.14 Premarital sexual intercourse and place of residence among in-school late adolescents, Indonesia, 2007 4.15 Premarital sexual intercourse and puberty period among in-school late adolescents, Indonesia, 2007 4.16 Premarital sexual intercourse and knowledge of SRH among inschool late adolescents, Indonesia, 2007 4.17 Premarital sexual intercourse and knowledge of contraceptive methods among in-school late adolescents, Indonesia, 2007 4.18 Premarital sexual intercourse and source of SRH information among in-school late adolescents, Indonesia, 2007 4.19 Premarital sexual intercourse and attitude towards acceptance of premarital sexual intercourse among in-school late adolescents, Indonesia, 2007 4.20 Premarital sexual intercourse and relationship status defied by having a boyfriend or girlfriend among in-school late adolescents, Indonesia, 2007 4.21 Premarital sexual intercourse and smoking among in-school late adolescents, Indonesia, 2007 4.22 Premarital sexual intercourse and drinking alcohol among in-school late adolescents, Indonesia, 2007 4.23 Premarital sexual intercourse and using drugs among in-school late adolescents, Indonesia, 2007 4.24 Premarital sexual intercourse and discuss about sexual matters with friends among in-school late adolescents, Indonesia, 2007
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LIST OF TABLES (cont.)
Table 4.25 Premarital sexual intercourse and friends have had sex before marriage among in-school late adolescents, Indonesia, 2007 4.26 Binary logistic regression of factors influencing premarital sexual intercourse among in-school late adolescents, Indonesia, 2007
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LIST OF FIGURES
Figure 2.1 2.2 2.3 4.1 Social Cognitive Theory Planned Behavior Theory Components and Linkage Conceptual Framework Percentage of premarital sexual intercourse among in school late adolescents, Indonesia, 2007
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LIST OF ABBREVIATIONS
AIDS BKKBN BPS FSWs HIV LD-FEUI MOH PBT SCT SRH STDs STIs UNFPA UNICEF WHO
Acquired Immune Deficiency Syndrome Badan Kependudukan dan Keluarga Berencana Nasional Badan Pusat Statistik Female Sex Workers Human Immunodeficiency Virus Lembaga Demografi Fakultas Ekonomi Universitas Indonesia Ministry of Health Planned Behavior Theory Socio Cognitive Theory Sexual Reproductive Health Sexual Transmitted Diseases Sexual Transmitted Infections United Nations Fund for Population Activities United Nations International Childrens Emergency Fund World Health Organization
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LIST OF ABBREVIATIONS
AIDS BKKBN BPS FSWs HIV LD-FEUI MOH PBT SCT SRH STDs STIs UNFPA UNICEF WHO
Acquired Immune Deficiency Syndrome Badan Kependudukan dan Keluarga Berencana Nasional Badan Pusat Statistik Female Sex Workers Human Immunodeficiency Virus Lembaga Demografi Fakultas Ekonomi Universitas Indonesia Ministry of Health Planned Behavior Theory Socio Cognitive Theory Sexual Reproductive Health Sexual Transmitted Diseases Sexual Transmitted Infections United Nations Fund for Population Activities United Nations International Childrens Emergency Fund World Health Organization
M.A. (Pop. & Repro. H. Res.) / 1
CHAPTER I INTRODUCTION
1.1 Background
Adolescence is a part of human life phase with special characteristics that full of turbulent. The special characteristics that adolescents have such as unstable emotional development and life provision have made them more prone to social unrest (Muzayyanah, 2008). They influence a far more complex world in terms of globalization, the spread of mass media, increased international migration, economic and political crisis, global violence and war, and increasing access to drugs and alcohol (Utomo, 2003). According to the United Nations International Childrens Emergency Fund (UNICEF), adolescence can be categorized by three stages such as 10-13 years old as early adolescents, 14-16 years old as middle adolescents, and 17-19 years old as late adolescents. Moreover, around 3 billion people or almost half of the worlds population is under 25 years old in 2009 with 85% of them living in the developing countries with around 60% in Asia and 23% spread in Africa, Latin America and the Caribbean (UNICEF, 2009; United Nations, 2006). Nowadays, adolescents sexual and reproductive health (SRH) is complicated because of the sensitivity and controversial issues towards the subject. They tend to be marginalized in some societies. As a result of lack of knowledge of sexual and reproductive health (SRH) and access to services, less life experience and sexual exploitation, they are more vulnerable to sexual risk behavior than those who are more mature (Silva et al, 2009; Shaw, 2009). The United Nations Fund for Population Activities (UNFPA) has noted that the time between puberty and marriage is increasing in all regions of the world (UNFPA, 2009). Moreover, the World Health Organizations (WHO) has reported that young people aged 15-24 accounted for an estimated 45% of new HIV infections worldwide in 2007 and about 16 million adolescent girls give birth every year or roughly 11% of all births worldwide (WHO,
Ronny A. P. Situmorang
Introduction / 2
2007). Furthermore, at the lowest age range, adolescence consist of pre-teenage girls and boys, who are not yet sexually active while at the highest range, they consist of young women and men, virtually all of who have been sexually active for several years and in many cases have children of their own. Indeed, they are highly vulnerable to exposure to various risks and health risks in particular, especially those related to sex and reproduction (Utomo, 2003).
1.2 Problem Identification

In Indonesia, Ministry of Health (MOH) defines people who aged 10-19 years as the adolescents while National Family Planning and Population Board (Badan Kependudukan dan Keluarga Berencana Nasional/BKKBN) use aged 10-24 years old as the adolescents for their programs (Irdjiati, 1997). Therefore, in many researches in Indonesia, adolescents or young people or young adults or youth are used to define unmarried males or females who aged 15-24 years old or translated as remaja (Utomo, 1997; Situmorang, 2001; BPS, 2008). As we have mentioned earlier on that the forces of globalization may influence the adolescents lifestyle and behaviors. In all regions, lots of them have get involved with sexual activity where it is very risky to get sexually transmitted infections (STIs), HIV, or maybe unwanted pregnancy (Salgado & Cheetham, 2003). Moreover, following the worlds problems, Indonesia as one of the developing country may also have the same problems. Early sexual activities, which may be increasing in the world, also expose adolescents in Indonesia to unwanted pregnancy and sexually transmitted infections. Firstly, traditionally, in most Indonesian families, talking about puberty and sexuality are specifying only for married couple and active in sexual relationship. Moreover, information about these things is usually informed by a mother to her daughter only when she gets her menarche while for the boys, they learn from their peers and media (Situmorang, 2003). Regarding to this issue, study in Jakarta shows parents tend to refuse talking about sexual matters to their children (Iskandar, 1995; Utomo, 1997). According to Jameela, she says that the Indonesian in-school
adolescents are lack of SRH needs (2008). Moreover, health and educational issues has marginalized the SRH issues. Hence, inappropriate sex educations are being provided in educational level. Moreover, communication between parents and children on term of SRH information is something exceptional because of the cultural term, parents also never had the same experience of receiving this information from their parents as well or maybe parents have a little capacity to deal with sexual information while adolescents can solve by themselves (Utomo & McDonald, 2009; Utomo, 2003; Situmorang, 2003). Secondly, while they are lack of information from their parents and educational subject also cannot give them the SRH knowledge, Utomo claims, adolescents will adopt the knowledge from the people who are not the correct person or from the mass media such as television, films, movies, videos, magazines, books, pornographic materials, and computer networks which cannot be restrained (2003). Studies in Indonesia showed that in gaining knowledge of SRH, adolescents tries to seek reproductive health information from their peers (peer groups) who are the same adolescents and less healthy (Syafrudin, 2008). These groups can give them very great information through their peers better understanding comparing the knowledge from their parents (Tate, 2001). Beside from their peers, the exposure to mass media, both print (newspaper, magazines, porn books) and electronic (TV, DVD, the internet), have an influence directly or indirectly on teenagers to have premarital sex (Rohmawati et al, 2008). A research who was conducted in Indonesia shows that adolescents who have had premarital sex claimed, beside from friends, they get the idea of having sexual intercourse from the porn DVD, the internet, and magazine or newspaper (Yelda and Prasetyo, 2010). Thirdly, while they are provoked by the media about sex and sexuality, lack of accurate information about sex, reproduction, and reproductive health have influenced their behavior (Utomo, 2003). There are number of Female Sex Workers (FSWs) are adolescents aged under 19 years old in Jakarta (Utomo and Dharmaputra, 2001). Moreover, a research in Indonesia shows that teens tend to go outside to night entertainment venues to hanging out, clubbing, and other terms with some activities such as drinking alcohol, using drugs, dating, meeting new friend, kissing, petting, and one night stand (Pregiwatiningsih, 2008).
Introduction / 4
Furthermore, there is also a change in attitude towards virginity in Indonesia. Study in Yogyakarta and Bali among unmarried men aged 17-24 years old mentioned around 50% of the respondents said no to preserving womens virginity until they get married (Singarimbun, 1996). By having this attitude, it is not wondering why many adolescents are involved in practicing premarital sexual activity. A survey in Indonesia also shows only 5% of adolescents has had early sexual activity in 1980s but in 2000 the percentage is increasing to 20% (BKKBN, 2001). Moreover, in 2006 shows that there were 43 million adolescents in Indonesia and almost one million adolescent boys (5%) and 200 thousands of adolescent girls (1%) have had sexual intercourse (MOH, 2006). However, even though the number of them practicing sex before marriage was relatively low (less than 6.5%) compared with other countries, Thailand (51%), Cambodia (36%), and Vietnam (65%) (BPS, 2008; Bergenstrom & Isarabkahdi, 2009; GSO, 2005). The issue should be given an attention because the number tends to increase from 1% to 3% for females and from 5% to 6.4% for males between 2002 and 2007 (Hidayat, 2005; BPS, 2004; BPS, 2008). Finally, following previous studies, the lack of knowledge of SRH manners, the peers and media influence, and changing of their attitude and behavior are the factors that can make adolescents to engage early sexual activity. Therefore, this thesis tries to examine the factors that can influence having premarital sexual intercourse among adolescents in Indonesia, specifically examining in-school late adolescents aged 15-19 years old in Indonesia.
1.3 Research Question

What factors are influencing premarital sexual intercourse among inschool late adolescents in Indonesia?
1.4 Scope of Research

This research focuses on the Indonesian in-school late adolescents who are currently studying or at educational level aged 15 to 19 years old. The respondents are both males and females living in urban and rural areas from 33 provinces in Indonesia.
1.5 Research Objectives

1.5.1 General Objective This study analyzes factors influencing premarital sexual intercourse among in-school late adolescents in Indonesia. 1.5.2 Specific Objective 1. To describe independent and dependent variable of premarital sexual intercourse among in-school late adolescents in Indonesia 2. To examine the relationship between factors influencing premarital sexual intercourse among in-school late adolescents in Indonesia.
1.6 Definition of Key Words

1. Indonesian In-school Late Adolescents This term refers to the adolescents who are currently studying or at education level aged 15-19 years old in Indonesia. 2. Premarital Sexual Intercourse This term refers to the final step for adolescents in expressing their sexual desire with their opposite sex without any binding rules such as by law and religion. In this thesis, it refers to have had premarital sexual intercourse. 3. Factors influencing Premarital Sexual Intercourse This term refers to the factors that can influence adolescents in having premarital sexual intercourse.
Literature Review / 6
CHAPTER II LITERATURE REVIEW
2.1 General Review

The main focus of this study is to analyze what factors influencing premarital sexual intercourse among in-school late adolescents aged 15 to 19 years old by describing the way of knowledge, attitude, relationship status, and behaviors. Moreover, there are social demographic factors as the individual characteristics that can also influence their behavior. According to previous research, there are two theories that can explain the linkage among those components, Social Cognitive Theory (SCT) and Planned Behavior Theory (PBT). These two theories thus can be applied in this study on the relationship of in-school late adolescents sexual practice. 2.1.1 Social Cognitive Theory On SCT, there is a framework with three components, personal factors, environments, and behavior, which can affect one to another. In addition, personal factors that have been influenced by environments will affect someones behavior or vice versa (Baranowski et al, 2006). The interventions of personal factors of cognitive, affective and biological events in behavior influence someone thinking and practicing. The stage of selfcontrol, observational learning, reinforcement, self-efficacy and emotional coping responses of person lead them to outcomes of behavior. Environmental factors, such as family members, friends and mass media, can affect individual behavior and create person perceptions (Baranowski et al, 2006).
Behavior
Personal Factors
Environmental Factors
Figure 2.1 Social Cognitive Theory
On this thesis, we define personal factors as in-school late adolescents knowledge, attitude, relationship status, and behaviors that can influence them on having premarital sexual intercourse while individual characteristics as the environment factors that control them. 2.1.2 Planned Behavior Theory According to this theory, someones behavior is guided by three considerations, beliefs about outcomes of behavior and evaluation of outcomes (behavioral beliefs), beliefs of others about the expectations of behavior and motivation to follow these expectations (normative beliefs), and beliefs about the factors that encourage or inhibit the emergence of behavior and perception about the strength of each of these factors (control beliefs) (Ajzen, 2006). Overall, behavioral beliefs produce attitude toward the behavior (attitude toward behavior) which may be positive or negative nature; normative beliefs produce the perception of social pressure or subjective norms; and control beliefs to produce the perception of behavioral control (perceived behavioral control). If we combined attitude toward the behavior, subjective norms, and perceived behavioral control, it will lead to the formation of behavioral intentions (intentions behavior). General, the more positive these three, the stronger someone intend to perform the behavior (Ajzen, 2006).
Believe about outcomes Evaluation of these outcomes
Attitudes towards the behavior
- Believe about important others attitudes to the behavior - Motivation to comply with important others
Subjective norms
Behavior intention
Behavior
Control beliefs
Perceived behavioral control
Figure 2.2 Planned Behavior Theory Components and Linkage
2.2 Premarital Sexual Intercourse

In Asia, although national-level surveys shows that premarital sex is less frequent, researches on adolescent sexual and reproductive health in some countries in Asia have discovered the increasing number on early marriage age and childbearing (Brown et al, 2001). These trends may occur because of the degradation pattern in age at menarche that influences them to be early adolescent, sexual maturity and ready to reproduce. For example, adolescent girls are biologically enough to engage in sexual activity and get pregnant early although in emotional and psychological level they are not ready enough to get the effects (United Nation, 2001; Gubhaju, 2002). Moreover, this problem increases the possibility for young people to have had premarital sexual activity. The initiation of sexual activity is a major milestone for many adolescents on the road to adulthood. Early sexual activity happens more often in the developing world (excluding China) and continuing high levels of child marriage, especially in Africa and South Asia (UNFPA, 2010). A study conducted in Vietnam in 2005 reported that many adolescents who are sexually active have had premarital sexual intercourse. Moreover, study in 1993 from 12 cities in Indonesia found that many young people who are still school students are reported to have had sex before marriage and compared to females, males are more likely to approve of premarital sex and more likely to report having had sex. However, fun is the main reason for female adolescents to have had premarital sex (Duong et al, 2007; Situmorang, 2003).
2.3 Socio Demographic Factors

1. Sex Various studies has documented that males are more likely to have sexual experience than females. Findings a study in India found that young boys tend to have premarital sexual activity than young girls and the similar patterns happened in Malaysia and China. Furthermore, the boys began earlier sexual intercourse than girls. However, there are more females adolescents believed in possibilities of having a relationship without sex than male adolescents. Hence, compare with males, females
show a low tendency to engage in premarital sex (Abraham and Kumar, 1999; Anwar et al, 2009; Ma et al, 2009). In Indonesia, research found that male adolescents are two times more likely to approve early sexual activity than female adolescents (Iswarati and Prihyugiarto, 2008). 2. Age Several studies have noticed that there is a strong correlation between age and sexual experience (Nikula, 2009; Bangkole et al., 2009); as age raises, the participation in sexual experience increases. The raise of age can also increase opportunities for independence and decision making for adolescents (Leena and Kumar, 1999). Moreover, age has relation with condom use, while the younger adolescents are less likely to use a condom at the first sexual intercourse (Ma et al, 2009). In the contrary, the older young men documented are rather to use a condom as their most first contraceptive method when they had first sex or with new or casual partners than women (Nikula, 2009). A lot of studies also explained that young adults have knowledge and experiences better than early adolescents. Although there are different information needs between the older and younger age (Khan, 2009). In Indonesia it self, research found that in-school adolescents aged 15-17 years old, as the early stage of late adolescent, are more danger comparing to the final step of late adolescentns aged 18-19 years old. This condition happens because age 1517 years old is the time where they are in a dillema situation; they slowly leave the attitude and behavior that say only fit for small child but also dabble in attitude and behavior that they have considered as an adult (Suwarti, 2010). 3. Place of Residence Derived from some studies, there are significant effects of residence on knowledge and awareness towards SRH practices. In some part of the world, research found that people who live in urban area have more levels of knowledge in HIV/AIDS preventions and are more likely to practice a condom use than the rural. It is explained that people in urban area commonly have a higher social status, a better education and an easier SRH access comparing with the rural people (Chanthavong, 2009).
However, regarding to sexual practice, research in Indonesia found that adolescents who live in rural area are less likely to say agree to have early sexual activity than those who live is urban (Iswarati and Prihyugiarto, 2008). 4. Age of the First Puberty Period A research in developed countries have identified about the decline of age at menarche among women over time (Wysack and Fish, 1982 cited in Bongaarts and Vohen, 1998). This trend could be accepted as well in developing countries like Indonesia due to the improvement of nutrition level comparing nowadays than in the past (Situmorang, 2003). Study in India have mentioned that young women were knowledgeable than young men regarding menarche period and pregnancy while male better in male contraceptive method only (Abraham and Kumar, 1999). Therefore, many of them evidently miss information on puberty and sexuality; some of them said menstrual blood is a dirty blood and better to keep it hidden while the boys believe that having wet dreams experience is a sin (Situmorang, 2003). Finally, early puberty period in adolescence will increase their skeletal maturation and short adult height, and lead them to have an early sexual activity, likely to get sexual abuse and psychosocial problems (Golub et al, 2008).
2.4 Knowledge of Reproductive Health Issues

2.4.1 Knowledge of SRH Several researches in developing countries found that adolescents who are students know more about SRH than non students. In-school adolescents also know more about sex and are more realistic in discussing it while out of school adolescents, especially females, are having more sex and more RH problems (WHO, 2005). A study in Philippine and Indonesia showed that many of adolescent do not know when they are fertile during their monthly cycle and believed a woman cannot get pregnant from a single act of sexual intercourse. Moreover, the misperception that happens on the issues of puberty, fertile period, premarital sexual
intercourse, and even the abortion, STDs, and HIV/AIDS, have forced them to do risky sexual behavior and get such as unwanted pregnancy, abortion, STI including HVI/AIDS (WHO, 2005; Situmorang, 2003; Hidayat, 2005). Therefore, consistent with the problem that may happen with adolescents, a study in Mongolia among inschool adolescents shows that the lower their knowledge of SRH, the more likely they have had sex than others (Algaa, 2002). 2.4.2 Knowledge of Contraceptive Methods A study from Indonesia, the unmarried young people seldom use contraception because their limitation of knowledge of contraception (LD-FEUI, 1999). Even they have ability to mention the name of contraceptive methods; it does not mean they know details about those function or even the source where they can get them (Situmorang, 2003). On the other hand, although sex has become more familiar, many of adolescents do not know how to keep themselves from those disease or even unwanted pregnancy and abortion (Duong et al, 2007). A study in Philippine have noticed that many adolescents claimed that they had heard about the contraceptive methods but they did not know how to use those particular contraceptive methods (WHO, 2005). 2.4.3 Source of SRH Information A Study in Pakistan found that after receiving information, people will have a positive effect on their knowledge, toward awareness, attitudes, and sexual practices. However, the mass media is the major source of information that people get if comparing with any other source of information such as family and friends or neighbors (Chanthavong, 2009). A study in Sub-Sahara Africa also showed that regularly exposure of television program was a reason for condom use at the last intercourse among young men Bangkole et al., 2009). Moreover, a study in Uganda and Thailand observed that the positive outcome on the knowledge towards awareness and attitudes after watching weekly TV programs, reading the newspapers, magazine articles, and surfing in the internet (Chanthavong, 2009). Morover, the same study from Pakistan found that sources of knowledge of HIV prevention are parents, siblings and other family members (Muhammad, 2007
cited in Chanthavong, 2009) while in Indonesia a lot of studies reported that adolescent are more comfortable to discuss the sexual behavior and sensitive daily topics with friends than their parents and adults (Moeliono, 2003; Hidayat, 2005; Chanthavong, 2009). Therefore, peer education should become an important approaches addressing SRH context (UNFPA, 2007). A number of studies also have shown that sex education programs in the schools increase students knowledge of SRH and contraception methods. It showed significant improvement in knowledge and attittude after the education programs. The information about the relationship with the partner and on sexuality also produced increases in contraceptive use and delayed initiation of sex about equally. (Dawson, 1986; Jaiswal et al, 2005; McKeon, 2006)
2.5 Attitude towards Acceptance of Premarital Sexual Intercourse

A study in Vietnam showed that the acceptance of premarital sex was consistently higher if it was a man who had premarital sex as opposed to a woman. Furthermore, people who were daily exposed to the media were less accepting of premarital sex than those who had less frequent media exposure and there is western culture influence has motivated increasing trends in premarital sex. Furthermore, students perception sexual activity showed that premarital sex is common, acceptable, and fashionable for young people (Do, 2009; Sabaiying, 2009).
2.6 Relationship Status defined by Having a Boyfriend or Girlfriend

Many studies have found that having boyfriend/girlfriend will lead to have a potential of dating violence (Wingood et al, 2001; Kreiter, 1999). Dating violence itself is related to negative outcomes and behavior such as premarital sexual activities. Moreover, girls were more likely reported to get violence and psychological aggression perpetration within relationship (Swhan et al, 2008).
2.7 Risky Consumption Behaviors

Smoking, drinking alcohol, and using drugs are factors that have been found to have a bearing on sexual activity and more boys than girls have been identified as smokers, consumers of alcohol, and drugs users (WHO, 2005). A study in Finland showed that frequent alcohol use and drunkenness and having used drugs increased the likelihood of engagement in unprotected intercourse (Nikula, 2009). Adolescents usually engage in sex after drinking alcohol (reasons for drinking vary from endless birthdays to camping). Such behaviors have been closely linked to increased vulnerability to unprotected sexual activity (Algaa, 2002).
2.8 Peer Influences

Interaction with peers often exposes young people to norms and values that are more likely to facilitate sexual behavior. The young may be more likely to perceive peer attitudes as desirable and behave according to their values (Isarabhakdi, 1997). Research on sexual experience of Thai adolescents in rural area found that the peers pressure has motivated them to have premarital sexual intercourse (Isarabhakdi, 2000). Moreover, peers play important role in making someones personality, attitudes and behavior. Further research has shown that individual behavior get influence from peer behavior and it commonly happens in adolescents and adolescents (Cernada et al, 1986). On the other hand, a study in Thailand found that peers are of a minor influence as far as sexual behavior is concerned. Furthermore, if peers influence doubled with lack of control over entertainment places and easy access to porn media, adolescent may feel encouraged involving in sex at an early age (Podhisita, 2009).
2.9 Conceptual Framework

The following conceptual framework has been developed based on the above review of literature, showing the causal model for this analysis. The framework
consists of one dependent variable which is in-school late adolescents having premarital sexual intercourse. The independent variables are categorized into 6 groups such as knowledge of reproductive health issues, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, peer influences, and socio demographic factors. These groups of independent variables are expected to have a direct effect in the model of in-school late adolescents ever having premarital sexual intercourse.
Independent Variable Socio Demographic Factors - Sex - Age - Place of Residence - Age of the First Puberty Period Knowledge of Reproductive Health Issues - Knowledge of SRH - Knowledge of Contraceptive Methods - Source of Information Attitude towards Acceptance of Premarital Sexual Intercourse Relationship Status defined by Having a Boyfriend or Girlfriend Risky Consumption Behaviors - Smoking - Drinking Alcohol - Using Drugs Peer Influences - Discuss about Sexual Matters with Friends - Friends Have Had Sex Before Marriage Dependent Variable
Premarital Sexual Intercourse
Figure 2.3 Conceptual Framework
2.10 Research Hypotheses

1. Male in-school adolescents in Indonesia are more likely to have premarital sexual intercourse. 2. In-school late adolescents in Indonesia who are at the beginning age of late adolescents are more likely to have premarital sexual intercourse. 3. In-school late adolescents in Indonesia who live in urban are more likely to have premarital sexual intercourse. 4. In-school late adolescents in Indonesia who get puberty period at the early age are more likely to have premarital sexual intercourse. 5. In-school late adolescents in Indonesia who have worse knowledge of SRH are more likely to have premarital sexual intercourse. 6. In-school late adolescents in Indonesia who have worse knowledge of contraceptive methods are more likely to have premarital sexual intercourse. 7. In-school late adolescents who get the information of SRH from family are less likely to have premarital sexual intercourse. 8. In-school late adolescents in Indonesia who accept premarital sexual intercourse are more likely to have premarital sexual intercourse. 9. In-school late adolescents in Indonesia who have a boyfriend or girlfriend are more likely to have premarital sexual intercourse. 10. In-school late adolescents in Indonesia who are smoking are more likely to have premarital sexual intercourse. 11. In-school late adolescents in Indonesia who are drinking alcohol are more likely to have premarital sexual intercourse. 12. In-school late adolescents in Indonesia who are using drugs are more likely to have premarital sexual intercourse. 13. In-school late adolescents in Indonesia who discuss about sex with their friends are more likely to have premarital sexual intercourse. 14. In-school late adolescents in Indonesia who have friends have had sex before marriage are more likely to have premarital sexual intercourse.
Research Methodology / 16
CHAPTER III RESEARCH METHODOLOGY
3.1 Study Population and Sample

The secondary data from quantitative research of Indonesian Young Adult Reproductive Health Survey (IYARHS) 2007 is used for this study. This was carried out by Indonesia Statistic Bureau (BPS) and Macro International Inc at the request of the National Family Planning Coordinating Board (BKKBN). The 2007 IYARHS sample was aimed to provide the reliable estimation of key characteristics for nevermarried Indonesian males and females young adult aged 15-24 in 33 provinces (BPS, IYARHS 2007, 2008). There were 1,694 selected census blocks (CBs) from the list of CBs Indonesias National Labor Force Survey (Sakernas), 676 in urban areas and 1,018 in rural areas. The number of selected CBs was proportional to the number of households in each district. For each selected CB, a complete household listing and mapping was used for the second-stage sampling. There were on average 25 households systematically selected from each CB. Moreover, the data collection involved many interviewing teams, and was conducted between June 25 and December 31, 2007 (BPS, IYARHS 2007, 2008). By using the Individual Questionnaire that was updated from the 20022003 IYARHS, there were 19,311 unmarried Indonesian young adults interviewed, 8,481 females and 10,830 males, and divided into 2 age groups; 15-19 and 20-24. However, for respondents aged less than 18 years old, it required parental approval. Although the survey exercised private face to face interview, in fact the respondents parents may have introduced bias due to influence of parent approval or attendance (BPS, IYARHS 2007, 2008). The subgroup for this study selects in-school adolescents aged of 15-19. The respondents were both males and females living in urban and rural areas. Therefore, there are 6,792 adolescents selected for the analysis.
3.2 Operational Definitions

3.2.1 Dependent Variable The dependent variable in this study is the adolescents aged 15-19 years old who are currently in-school and experience on premarital sex. It is a dichotomous variable comprising two categories, yes for ever had sex and no for never had sex or on nominal scale should be 0=No and 1=Yes. 3.2.2 Independent Variables The independent variables are divided into: 1. Socio Demographic Factors a. Sex Sex (Q. 11) is defined as 2 categories in a nominal scale; 0 = Female and 1 = Male. b. Age Age (Q.103) is defined as how old the respondent at his/her last birthday when the survey was held in 2007 and measured by a ratio scale from 15-19 years old. Then, we will group it into two groups such as the beginning age (aged 15-17 years old) and the final age of late adolescents (aged 18-19 years old). c. Place of Residence Place of residence refers to the geographical area where the respondent lives at the time of survey in 2007 (Q.5) and is divided into 2 groups in a nominal scale; 0 = Urban and 1 = Rural. d. Age of the First Puberty Period Age of the first puberty period (based on two questions: Q.205 and Q.208A) is defined as how old the female and male respondent had their first puberty period and measured by a ratio scale from 10-19. Then, we will group it into two groups such as early (10-13 years of age) and late (14-19) age of the first puberty period.
2. Knowledge of Reproductive Health Issues a. Knowledge of SRH Knowledge of SRH (based on 10 questions: Q.201, Q.202, Q.209, Q.211, Q.211A, Q.605C, Q. 607, Q.615, Q.618, and Q.618A) refers to whether a respondent have knowledge. Knowledge on each question will be made into dummy variable; 0=No and 1=Yes. Then, knowledge score is constructed by grouping up from 0 to 10 and divided into 5 categories such as those who get 0 score as unsatisfied, 1-3 as poor, 4-6 as fair, 7-9 as good, 10 as excellent knowledge of SRH. b. Knowledge of Contraceptive Methods Knowledge towards Contraceptive Methods (Q.212) refers to whether a respondent knows contraceptive methods or not. Knowledge on each method will be made into dummy variable; 0=No and 1=Yes. Then knowledge score of each method is constructed by adding up from 0 to 8 and divided into 5 categories such as those who get 0 score as unsatisfied, 1-2 as poor, 3-5 as fair, 6-7 as good, 8 as excellent knowledge of contraceptive methods c. Source of SRH Information It defines where the respondent has learned about SRH matters (Q.203). 3. Attitude towards Acceptance of Premarital Sexual Intercourse Acceptance of premarital sexual intercourse (Q.720) refers to whether a respondent accept premarital sexual intercourse or not. It is categorized into 2 groups in a nominal scale; 0 = No, disagree and 1 = Yes, I agree. 4. Relationship Status defined by Having a Boyfriend or Girlfriend Having a boyfriend or girlfriend (Q.701) refers to whether a respondent ever having/currently having a boy friend or not. It is categorized into 2 groups in a nominal scale; 0 = No and 1 = Yes.
5. Risky Consumption Behaviors a. Smoking Smoking (Q.504) is categorized into 3 groups in a nominal scale; 0 = No, 1 = Yes, currently, and 2 = Yes, ever. b. Drinking Alcohol Drinking (Q.508) is categorized into 3 groups in a nominal scale; 0 = No, 1 = Yes, currently, and 2 = Yes, ever. c. Using Drugs Using drugs (Q.511) is categorized into 2 groups in a nominal scale; 0 = Never and 1 = Ever. 6. Peer Influences a. Discuss about Sexual Matters with Friends It (Q.401) refers to whether a respondent have talked about sexual matters with his/her friends or not. It will be made into dummy variable; 0 = No and 1 = Yes. b. Friends Have Had Sex Before Marriage Friends have had sex (Q.715) is categorized into two groups in a nominal scale; 0 = No and 1 = Yes. Dependent and independent variables, summary of the operational definition and measurement are shown in Table. 3.1. Table 3.1 Summary of operational definition and measurement of variables Measurement Variable Operational Definition Categories Scale Dependent Variable Premarital Sexual Respondent ever had 0 = No Nominal Intercourse premarital sexual 1 = Yes intercourse Independent Variables Socio Demographic Factors Sex Respondents sex: female 0 = Male Nominal or male 1 = Female Age Respondents age in 15-17 = Beginning Ordinal completed years. It is 18-19 = Final divided into two groups: beginning and final stage of late adolescent
Variable Place of Residence Age of the First Puberty Period
Operational Definition
Categories
Respondents place of 0 = Urban residence: urban or rural 1 = Rural Respondents age when 10-13 = Early get the first puberty period. 14-19 = Late It is divided into two groups: early and late age at the first puberty period. Knowledge of Reproductive Health Issues Knowledge of Respondents score on 0 = Unsatisfied SRH knowledge of SRH from 1-3 = Poor 10 questions related to 4-6 = Fair SRH. The score comprises 7-9 = Good 0-10. It is categorized into 10 = Excellent five levels: unsatisfied (0), poor (1-3), fair (4-6), good (7-9), and excellent (10). Knowledge of Respondents score on 0 = Unsatisfied Contraceptive knowledge of 1-2 = Poor Methods contraceptive methods 3-5 = Fair from 8 questions about 6-7 = Good contraceptive methods. 8 = Excellent The score comprises 0-8. It is categorized into five levels: unsatisfied (0), poor (1-2), fair (3-5), good (6-7), and excellent (8). Source of SRH The main source where the 0 = Do not know Information respondent get the 1 = Friends information. 2 = Family 3 = School 4 = Mass media 5 = Other Attitude Attitude towards Respondents opinion on 0 = No, I disagree Acceptance of acceptance of premarital 1 = Yes, I agree Premarital Sexual sexual intercourse Intercourse Relationship Status Having a Respondents relationship 0 = No, do not have Boyfriend or status whether they are in a 1 = Yes, I have Girlfriend relationship status or not Risky Consumption Behaviors Smoking Respondents behavior on 0 = Never smoking: never, ever, and 1 = Yes, currently currently 2 = Yes, ever
Measurement Scale Nominal Ordinal
Ordinal
Ordinal
Nominal
Nominal
Nominal
Nominal
Variables Drinking Alcohol
Operational Definition
Categories
Using Drugs
Discuss about Sexual Matters with Friends Friends Have Had Sex Before Marriage
Respondents behavior on 0 = Never drinking alcohol: never, 1 = Yes, currently ever, and currently 2 = Yes, ever Respondents behavior on 0 = Never using drugs: never and 1 = Ever ever Peer Influences Respondent has discussed 0 = No about sexual matters with 1 = Yes friends Respondent has friends 0 = No have had sex 1 = Yes
Measurement Scale Nominal
Nominal
Nominal
Nominal
3.3 Method of Analysis

The data will be analyzed using Statistic Package for the Social Sciences (SPSS) version 11.5. There will be three steps of analyzing such as characteristics of in-school late adolescents in Indonesia as univariate, the relationship between premarital sexual intercourse and socio demographic factors, knowledge of reproductive health issues, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences as bivariate, and binary logistic regression as multivariate analysis.
3.4 Limitation of the Study

This study is using secondary data from IYARHS 2007. Therefore, it is difficult to find the reliability since this data is based on interviewing the respondents face to face that may make some bias.
Results and Discussion / 22
CHAPTER IV RESULTS AND DISCUSSION
This chapter presents research findings of the study. It is organized into four sections. The characteristics of in-school late adolescents are presented as the first section. The second section shows the relationship between premarital sexual intercourse and socio demographic factors, knowledge of reproductive health issues, attitude towards premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences. The third section shows the investigation of factors influencing premarital sexual intercourse by using binary logistic regression. However, the third section itself is divided into 3 models. Finally, the discussion will be presented as the fourth section.
4.1 Characteristics of In-school Late Adolescents

4.1.1 Socio Demographic Factors As mentioned earlier on chapter 3 of this study, the sample size is 6,792 in-school late adolescents. Among the sample size, Table 4.1 shows approximately the same proportion between selected female and male respondents (49.7% and 50.3 % respectively). Moreover, regarding to the age of the respondents, 80.1% of respondents are in the beginning age of late adolescents while the rest are in the final age of late adolescents. For the place of residence, 50.8% of the in-school late adolescents are living in urban area while 49.2% are in rural area. Therefore, age of the first puberty period is another socio demographic factor considered in this study. Among selected respondents, 68.0% of them get their first puberty period at the late age of puberty period while the rest (32.0%) get it at the early age of the puberty period. The puberty period indicates that the age of the first puberty period among respondents is in the late age of puberty period.
Table 4.1 Percentage of socio demographic factors among in-school adolescents, Indonesia, 2007 Total (N = 6,792) Socio Demographic Factors N Sex Female 3,374 Male 3,418 Age Beginning age of late adolescents 5,440 Final age of late adolescents 1,352 Mean = 16.37, Min = 15, Max = 19 Place of Residence Rural 3,343 Urban 3,449 Age of the First Puberty Period Early age 2,175 Late age 4,617 Mean = 12.60, Min = 10, Max = 19
late
% 49.7 50.3 80.1 19.9
49.2 50.8 32.0 68.0
4.1.2 Knowledge of Reproductive Health Issues The knowledge describes about the knowledge of Sexual Reproductive Health (SRH), knowledge of contraceptive methods, and source of information among in-school late adolescents in Indonesia. 4.1.2.1. Knowledge of Sexual Reproductive Health (SRH) Table 4.2 shows the knowledge of SRH among in-school late adolescents. The most of in-school late adolescents (45.3%) are having fair knowledge of SRH. However, only 4.8% out of 6,792 in-school adolescents have excellent knowledge related to SRH while there are 2.8% have unsatisfied knowledge. Table 4.2 Percentage of knowledge of SRH among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Knowledge of SRH N % Unsatisfied 191 2.8 Poor 1,243 18.3 Fair 3,074 45.3 Good 1,959 28.8 Excellent 325 4.8 Total 6,792 100.0
4.1.2.2. Knowledge of Contraceptive Methods Knowledge of contraceptive methods is shown in Table 4.3. Most of the in-school late adolescents can have fair knowledge of contraceptive methods (45.3%). However, there are 191 respondents out of 6,792 in-school late adolescents have unsatisfied knowledge (2.8%) while only 171 respondents have excellent knowledge of contraceptive methods (2.5%). Table 4.3 Percentage of knowledge of contraceptive methods among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Knowledge of Contraceptive Methods N % Unsatisfied 401 5.9 Poor 1,198 17.6 Fair 3,801 56.0 Good 1,221 18.0 Excellent 171 2.5 Total 6,792 100.0 4.1.2.3. Source of SRH Information When source of information on SRH among the respondents is considered, descriptive analysis (Table 4.4) indicates that around a half of the respondents (48.7%) reported that their main source of SRH information is from their friends, whereas 21.4%, 8.6%, 8.4%, and 7.5% reported that they received the information from school, other sources (religious leader or health personal), family, and mass media respectively. Table 4.4 Percentage of source of SRH information among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Source of SRH Information N % Do not know 365 5.4 Friends 3,306 48.7 Family 571 8.4 School 1,455 21.4 Mass media 512 7.5 Other 583 8.6 Total 6,792 100.0
Interestingly, 5.4% of respondents have never received SRH information from any sources.
4.1.3 Attitude towards Acceptance of Premarital Sexual Intercourse Table 4.5 describes about the attitude of in-school late adolescents regarding to their opinion on having premarital sexual intercourse. From the 6,792 selected respondents, three quarter of them say disagree of having premarital sexual intercourse while one quarter agree (74.3% and 25.7% respectively). Table 4.5 Percentage of attitude towards acceptance of premarital sexual intercourse among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Attitude towards Acceptance of Premarital Sexual Intercourse N % No, I disagree 5,047 74.3 Yes, I agree 1,745 25.7 Total 6,792 100.0
4.1.4 Relationship Status defined by Having a Boyfriend or Girlfriend Table 4.6 shows the respondents relationship status defined by having a boyfriend or girlfriend. It indicates that there are two third of respondents having or ever having a boyfriend or girlfriend (66.1%) and one third of them not (33.9%). Table 4.6 Percentage of relationship status defined by having a boyfriend or girlfriend among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Relationship Status defined by Having a Boyfriend or Girlfriend N % No, do not have 2,303 33.9 Yes, I have 4,489 66.1 Total 6,792 100.0
4.1.5 Risky Consumption Behaviors Risky consumption behaviors describe in-school late adolescents life style such as smoking, drinking alcohol, and using drugs.
4.1.5.1. Smoking In smoking behavior, Table 4.7 shows that 14.6% of the selected in-school late adolescents are currently doing smoking, 24.7% just stopping it, while the rest are never having that behavior (60.7%). Table 4.7 Percentage of smoking among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Smoking N % Never 4,123 60.7 Yes, currently 989 14.6 Yes, ever 1,680 24.7 Total 6,792 100.0 4.1.5.2. Drinking Alcohol Regarding to drinking alcohol behavior, it is asking them about whether they have tried drinking alcohol or not, Table 4.8 shows that 83.9% of the respondents have never tried drinking alcohol while the rest have tried it currently and in the past (5.5% and 10.5% respectively). Table 4.8 Percentage of drinking alcohol among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Drinking Alcohol N % Never 5,700 83.9 Yes, currently 376 5.5 Yes, ever 716 10.5 Total 6,792 100.0 4.1.5.3. Using Drugs Table 4.9 shows the percentage of using drugs among inschool late adolescents in Indonesia. Table 4.9 Percentage of using drugs among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Using Drugs N % Never 6,703 98.7 Ever 89 1.3 Total 6,792 100.0
It reveals that almost all of the respondents interviewed are never using drugs compare to ever using drugs (98.7% and 1.3% respectively). It means using drugs are not popular among in-school late adolescents.
4.1.6 Peer Influences On this section, peer influences are divided into whether in-school late adolescents have discussed about sexual matters with their friends or not and have friends have had sex before marriage. 4.1.6.1. Discuss about Sexual Matters with Friends Table 4.10 illustrates the peer influence on whether the respondents discuss about sexual matters with their friends. Regarding to that issue, there are almost two third out of 6,892 in-school late adolescents has discussed about sexual matters with their friends (65.5%) while 34.5% have not discussed. Table 4.10 Percentage of discuss about sexual matters with friends among inschool late adolescents, Indonesia, 2007 Total (N = 6,792) Discuss about Sexual Matters with Friends N % No 2,345 34.5 Yes 4,447 65.5 Total 6,792 100.0 4.1.6.2. Friends Have Had Sex Before Marriage Table 4.11 illustrates the peer influence on whether the respondents have friends have had sex before marriage. It shows that 45.4% of inschool late adolescents have friends who have had sex before marriage while 54.6% say do not have friends have had sex before marriage. Table 4.11 Percentage of friends have had sex before marriage among in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Friends Have Had Sex Before Marriage N % No 3,707 54.6 Yes 3,085 45.4 Total 6,792 100.0
4.1.7 Premarital Sexual Intercourse Figure 4.1 gives us information on premarital sexual intercourse. In-school late adolescents who have not practiced premarital sexual intercourse stands at 97.6% or 6,632 respondents out of all 6,792 selected in-school late adolescents. Thus, 2.4% or 160 respondents have done premarital sexual intercourse.
Figure 4.1 Percentage of premarital sexual intercourse among in-school late adolescents, Indonesia, 2007
4.2 The Relationship between Premarital Sexual Intercourse and Socio Demographic Factors, Knowledge of Reproductive Health Issues, Attitude towards Acceptance of Premarital Sexual Intercourse, Relationship Status defined by Having a Boyfriend or Girlfriend, Risky Consumption Behaviors, and Peer
Influences
4.2.1 Premarital Sexual Intercourse and Socio Demographic Factors Regarding to the sex of respondents who have had premarital sexual intercourse (Table 4.12), it shows that there is statistically significant relationship more males than females have had premarital sexual intercourse among in-school late adolescents (4.0% and 0.7% respectively).
Table 4.12 Premarital sexual intercourse and sex among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Sex (n = 6,632) (n = 160) (N = 6,792) N % N % N % Female 3,352 99.3 22 0.7 3,374 100.0 Male 3,280 96.0 138 4.0 3,418 100.0 Chi-square = 83.135, p < 0.001 Moreover, Table 4.13 shows a significant relationship between age and premarital sexual intercourse with there are more in-school adolescents in the beginning age of late adolescents have experienced in premarital sexual intercourse than the final age of late adolescents (5.4% and 1.6% respectively). Table 4.13 Premarital sexual intercourse and age among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Age (n = 6,632) (n = 160) (N = 6,792) N % N % N % Beginning age of late adolescents 5,353 98.4 87 1.6 5,540 100.0 Final age of late adolescents 1,279 94.6 73 5.4 1,352 100.0 Chi-square = 66.342, p < 0.001 In term of place where the adolescents are living on has had premarital sexual intercourse (Table 4.14), there is no a significant relationship that place of residence have lead premarital sexual intercourse among in-school late adolescents (X2 = 3.242, p = 0.072). Table 4.14 Premarital sexual intercourse and place of residence among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Place of Residence (n = 6,632) (n = 160) (N = 6,792) N % N % N % Rural 3,276 98.0 67 2.0 3,343 100.0 Urban 3,356 97.3 93 2.7 3,449 100.0 Chi-square = 3.242, p = 0.072 Furthermore, the percentage of in-school late adolescents who have done premarital sexual intercourse who live in urban area are higher than who those who stay in rural area (2.7% and 2.0% respectively).
Lastly, Table 4.15 describes respondents age at the first puberty period on have had premarital sexual intercourse. Most of the respondents who have had premarital sexual intercourse get their first puberty period at the late age of the first puberty period. Therefore, there are insignificant relationship between age of the first puberty period and premarital sexual intercourse (X2 = 0.220, p = 0.639). Table 4.15 Premarital sexual intercourse and age of the first puberty period among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Age of the First Puberty Period (n = 6,632) (n = 160) (N = 6,792) N % N % N % Early age 2,127 97.8 48 2.2 2,175 100.0 Late age 4,505 99.3 112 2.4 4,617 100.0 Chi-square = 0.220, p = 0.639
4.2.2 Premarital Sexual Intercourse and Knowledge of Reproductive Health Issues 4.2.2.1. Premarital Sexual Intercourse and Knowledge of SRH Regarding to the respondents knowledge of SRH and having premarital sexual intercourse (Table 4.16), most of them (55 respondents) that have done premarital sexual intercourse are having fair knowledge of SRH. Table 4.16 Premarital sexual intercourse and knowledge of SRH among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Knowledge of SRH (n = 6,632) (n = 160) (N = 6,792) N % N % N % Unsatisfied 191 100.0 0 0.0 191 100.0 Poor 1,221 98.2 22 1.8 1,243 100.0 Fair 3,019 98.2 55 1.8 3,074 100.0 Good 1,888 96.4 71 3.6 1,959 100.0 Excellent 313 96.3 12 3.7 325 100.0 Chi-square = 26.981, p = 0.001
4.2.2.2. Premarital Sexual Intercourse and Knowledge of Contraceptive Methods Moreover, in knowledge of contraceptive methods
(Table 4.17), the result shows that from 160 in-school late adolescents who have had premarital sexual intercourse, most of them (86 respondents) are having fair knowledge. Table 4.17 Premarital sexual intercourse and knowledge of contraceptive methods among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse Knowledge of Contraceptive No Yes Total Methods (n = 6,632) (n = 160) (N = 6,792) N % N % N % Unsatisfied 389 97.0 12 3.0 401 100.0 Poor 1,166 97.3 32 2.7 1,198 100.0 Fair 3,715 97.7 86 2.3 3,801 100.0 Good 1,196 98.0 25 2.0 1,221 100.0 Excellent 166 97.1 5 2.9 171 100.0 Chi-square = 2.113, p = 0.715 It also shows that there is no a significant association between knowledge of contraceptive methods and premarital sexual intercourse (X2 = 2.113, p = 0.715). 4.2.2.3. Premarital Sexual Intercourse and Source of SRH Information When source of information on SRH among the respondents is considered (Table 4.18), most in-school late adolescents who learn about SRH from their friends have had premarital sexual intercourse (95 respondents). Interestingly, there are some who are gaining the knowledge from family, school and other sources (religious leader or health personal) still have had premarital sexual intercourse (1.4%, 1.8%, and 1.4% respectively). Moreover, the source of SRH has a relationship with premarital sexual intercourse at 0.05 level of significant (X2 = 11.302).
Table 4.18 Premarital sexual intercourse and source of SRH information among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Source of SRH Information (n = 6,632) (n = 160) (N = 6,792) N % N % N % Do not know 354 97.0 11 3.0 365 100.0 Friends 3,211 97.1 95 2.9 3,306 100.0 Family 563 98.6 8 1.4 571 100.0 School 1,429 98.2 26 1.8 1,455 100.0 Mass media 500 97.7 12 2.3 512 100.0 Other 575 98.6 8 1.4 583 100.0 Chi-square = 11.302, p < 0.046
4.2.3 Premarital
Sexual
Intercourse
and
Attitude
towards
Acceptance of Premarital Sexual Intercourse Regarding to the respondents attitude towards acceptance of premarital sexual intercourse on have had premarital sexual intercourse (Table 4.19), there is a statistically significant relationship more in-school late adolescents who accept premarital sexual intercourse have had premarital sexual intercourse than those who do not accept (8.0% and 0.4 respectively). Table 4.19 Premarital sexual intercourse by attitude towards acceptance of premarital sexual intercourse among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse Attitude towards Acceptance of No Yes Total Premarital Sexual Intercourse (n = 6,632) (n = 160) (N = 6,792) N % N % N % No, I disagree 5,027 99.6 20 0.4 5,047 100.0 Yes, I agree 1,605 92.0 140 8.0 1,745 100.0 Chi-square = 324.584, p < 0.001
4.2.4 Premarital Sexual Intercourse and Relationship Status defined by Having a Boyfriend or Girlfriend Table 4.20 shows there is a statistically significant association between inschool late adolescents relationship status defined by having a boyfriend or girlfriend and premarital sexual intercourse.
Table 4.20 Premarital sexual intercourse and relationship status defined by having a boyfriend or girlfriend among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse Relationship Status defined by No Yes Total Having a Boyfriend or (n = 6,632) (n = 160) (N = 6,792) Girlfriend N % N % N % No, do not have 2,298 99.8 5 0.2 2,303 100.0 Yes, I have 4,334 96.5 155 3.5 4,489 100.0 Chi-square = 67.885, p < 0.001 Moreover, there are more in-school late adolescents who have a boyfriend or girlfriend has done early sexual activity than those who do not have (3.5% and 0.2% respectively).
4.2.5 Premarital Sexual Intercourse and Risky Consumption Behaviors 4.2.5.1. Premarital Sexual Intercourse and Smoking Table 4.21 illustrates the smoking behavior on premarital sexual intercourse. It shows that most of in-school late adolescents who have done premarital sexual intercourse are currently smoking (101 respondents). It shows also that there is a significant relationship between smoking behavior and premarital sexual intercourse at 0.001 level of significant (X2 = 322.325) Table 4.21 Premarital sexual intercourse and smoking among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Smoking (n = 6,632) (n = 160) (N = 6,792) N % N % N % Never 4,099 99.4 24 0.6 4,123 100.0 Yes, currently 888 89.8 101 10.2 989 100.0 Yes, ever 1,645 97.9 35 2.1 1,680 100.0 Chi-square = 322.325, p < 0.001 4.2.5.2. Premarital Sexual Intercourse and Drinking Alcohol Drinking alcohol against premarital sexual intercourse is having a significant relationship at 0.001 level (X2 = 447.904).
Table 4.22 Premarital sexual intercourse and drinking alcohol among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Drinking Alcohol (n = 6,632) (n = 160) (N = 6,792) N % N % N % Never 5,648 99.1 52 0.9 5,700 100.0 Yes, currently 312 83.0 64 17.0 376 100.0 Yes, ever 672 93.9 44 6.1 716 100.0 Chi-square = 447.904, p < 0.001 Furthermore, Table 4.22 shows that most of respondents who have had premarital sexual intercourse are currently drinking alcohol (64 respondents). However, those who have just stop drinking alcohol and never drink at all, 6.1% and 0.9 respectively have had premarital sexual intercourse. 4.2.5.3. Premarital Sexual Intercourse and Using Drugs Regarding to using drugs (Table 4.23), almost all of the respondents interviewed are never using drugs compare to ever using drugs but those who never use drugs, 140 of them have had premarital sexual intercourse. On the other hand, two third of respondents who ever use drugs have not had premarital sexual intercourse while one third of them have had premarital sexual intercourse. Table 4.23 Premarital sexual intercourse and using drugs among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse No Yes Total Drinking Alcohol (n = 6,632) (n = 160) (N = 6,792) N % N % N % Never 6,563 97.9 140 2.1 6,703 100.0 Yes, ever 69 77.5 20 22.5 89 100.0 Chi-square = 149.913, p < 0.001 The relationship between using drugs and premarital sexual intercourse is significant with 0.001 level of significant. (X2 = 149.913).
4.2.6 Premarital Sexual Intercourse and Peer Influences 4.2.6.1. Premarital Sexual Intercourse and Discuss about Sexual Matters with Friends Table 4.24 shows the significant relationship between discuss about sexual matters with friends and premarital sexual intercourse at 0.05 level of significant (X2 = 5.347). Table 4.24 Premarital sexual intercourse and discuss about sexual matters with friends among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse Discuss about Sexual Matters No Yes Total with Friends (n = 6,632) (n = 160) (N = 6,792) N % N % N % No 2,304 98.3 41 1.7 2,345 100.0 Yes 4,328 97.3 119 2.7 4,447 100.0 Chi-square = 5.347, p < 0.021 Moreover, there are more in-school late adolescents who have had premarital sexual intercourse discuss about sexual matters with their friends than who are not. 4.2.6.2. Premarital Sexual Intercourse and Friends Have Had Sex Before Marriage According to Table 4.25, 4.9 % of in-school late adolescents who have friends have had sex before marriage have had premarital sexual intercourse while only 0.2% who do not have friends have had sex have practiced premarital sexual intercourse. Table 4.25 Premarital sexual intercourse and friends have had sex before marriage among in-school late adolescents, Indonesia, 2007 Premarital Sexual Intercourse Friends Have Had Sex Before No Yes Total Marriage (n = 6,632) (n = 160) (N = 6,792) N % N % N % No 3,699 99.8 8 0.2 3,707 100.0 Yes 2,933 95.1 152 4.9 3,085 100.0 Chi-square = 160.433, p < 0.001
Furthermore, there is a significant relationship between friends have had sex before marriage and premarital sexual intercourse (X2 = 160.433, p < 0.001).
4.3 Binary Logistic Analysis

Binary logistic regression is applied to analyze this study since it has dichotomous dependent variable. The purpose of this analysis is to measure the effect of certain independent variables which include socio demographic factors, knowledge, attitude, relationship status, risky consumption behaviors, and peer influences. This section has three models to explain factor influencing premarital sexual intercourse among in-school late adolescents in Indonesia. However, before running the binary logistic regression, finding the multicolinearity among variables may be the very best way. Therefore, from the correlation metrics, using the Pearson Correlation metrics, supposed to use 0.50 or 0.65 as the cut point, the result shows no collinearity and multicolinearity among variables. It means all the variables can be used into the model building. 4.3.1 Model 1. Socio Demographic Factors Characteristics on Premarital Sexual Intercourse In the first model, it explains effects of socio demographic factors such as sex, age, place of residence, and age at the first puberty period as the independent variables on premarital sexual intercourse as the dependent variable. Regarding to Table 4.26, the Model I, male in-school late adolescent are significant more likely to have experience in premarital sexual intercourse (P < 0.001). This significant term is also following by the age of in-school late adolescents that have the same significant level. It reveals that in-school late adolescents in Indonesia who aged at the beginning age of late adolescents are less likely to have premarital sexual intercourse than those who at the final age of late adolescents. Moreover, place residence in this first model also plays an important role to early sexual activity among adolescents. It shows that in-school late adolescents
who live in urban are more likely to have premarital sexual intercourse than those who stay in rural. When age of the first puberty period is considered, there is no a significant relationship with premarital sexual intercourse.
4.3.2 Model 2. Socio Demographic Factors, Knowledge, Attitude, Relationship Status, and Risky Consumption Behaviors Characteristics on Premarital Sexual Intercourse The second model of binary logistic regression, Table 4.26, explains
effects of socio demographic factors, knowledge (knowledge of SRH, knowledge of contraceptive methods, and source of SRH information), attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, and risky consumption behaviors characteristics such as smoking, drinking alcohol, and using drugs as the independent variables on premarital sexual intercourse as the dependent variable. The newly added variables have reduced the significant level for sex among in-school late even the direction is still the same with the first model (P < 0.1). Therefore, interestingly, the significant level of place of residence have is increasing. It reveals that selected new variables in this second model have an effect to some socio demographic factors (Model 1). Moreover, knowledge of SRH shows that only in-school late adolescents who have fair knowledge of SRH are significant less likely to engage on premarital sexual intercourse (P < 0.05). On the other hand, those who have unsatisfied knowledge of contraceptive methods have a significant positive direction to have experience in early sexual activity. Regarding to source of information, friends and mass media are having positive direction while do not know the source, family, and other are having negative association. However, only family has significant association at 0.1 level. Furthermore, this model (Model 2) shows that the attitude towards acceptance of premarital sexual intercourse has significant relationship in deciding inschool adolescents to have premarital sexual intercourse. Those who accept premarital
sexual intercourse are more likely to engage on premarital sexual intercourse than those who do not accept it. On the other hand, regarding to in-school late adolescents relationship status defined by having a boyfriend or girlfriend and premarital sexual intercourse, there is a significant association (P < 0.001). Thus, in-school late adolescents who have a boyfriend or girlfriend are more likely to have premarital sexual intercourse than who do not have. When risky consumption behaviors are considered, most of the risky consumption behaviors especially the behaviors that are currently done by in-school late adolescents are having positive significant relationship with premarital sexual intercourse. Moreover, in-school late adolescents who currently smoke, currently or ever drink alcohol, and ever use drugs are more likely to do premarital sexual intercourse (P < 0.001, P < 0.001, P < 0.01, and P <0.05 respectively). Table 4.26 Binary logistic regression of factors influencing premarital sexual intercourse among in-school late adolescents, Indonesia, 2007 Model 1 Model 2 Model 3 Variables B Exp (B) B Exp (B) B Exp (B) Sex Female Male 1.89 6.62*** 0.42 1.53 0.55 1.73* Age Beginning age of late -1.33 0.26*** -0.92 0.40*** -0.84 0.43*** adolescents Final age of late adolescents Place of Residence Rural Urban 0.38 1.46* 0.68 1.97*** 0.76 2.14*** Age of the First Puberty Period Early age -0.06 0.95 -0.20 0.82 -0.18 0.84 Late age Knowledge of SRH Unsatisfied -17.20 0.00 -16.84 0.00 Poor -0.95 0.49 -0.75 0.65 Fair -0.71 0.39* -0.43 0.47* Good -0.43 0.65 -0.37 0.69 Excellent
Knowledge of Contraceptive Methods Unsatisfied Poor Fair Good Excellent Source of SRH Information Do not know Friends Family School Mass media Other Attitude towards Acceptance of Premarital Sexual Intercourse No, I disagree Yes, I agree Relationship Status defined by Having a Boyfriend or Girlfriend No, do not have Yes, I have Smoking Never Yes, currently Yes, ever Drinking Alcohol Never Yes, currently Yes, ever Using Drugs Never Ever Discuss about Sexual Matters with Friends No Yes Friends Have Had Sex Before Marriage No Yes Log likelihood LR Chi-Square DF
1.21 0.11 -0.18 -0.21
3.36 1.12 0.83 0.82
1.69 0.33 -0.06 -0.11
5.47** 1.39 0.95 0.90
-0.03 0.07 -0.84 0.42 -0.29
0.97 1.08 0.43 1.52 0.75
0.07 0.12 -0.77 0.71 -0.11
1.07 1.13 0.47 2.02 0.89
2.33 10.23***
2.13
8.42***
2.21
9.10***
2.07
7.89***
1.11 0.36
3.04*** 1.44
1.00 0.27
2.71*** 1.31
1.53 0.66
4.60*** 1.94**
1.32 0.42
3.73*** 1.53 1.86
0.68
1.97*
0.62
0.13
1.14*
1,357.232 158.434*** 4
944.660 571.006*** 24
2.29 9.91*** 887.967 627.699*** 26
N 6,792 = 0.1, * = 0.05, ** = 0.01, *** = 0.001
6,792
6,792
4.3.3 Model 3. Socio Demographic Factors, Knowledge, Attitude, Relationship Status, Risky Consumption Behaviors, and Peer Influences Characteristics on Premarital Sexual Intercourse The last model (Model 3) from Table 4.26 includes variables of socio demographic factors, knowledge, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences characteristics such as discuss sexual matter with friends and friends have had sex before marriage. The dependent variable is still premarital sexual intercourse. The association between socio demographic factors and premarital sexual intercourse in this last model is only affecting sex among in-school late adolescent. It reveals that selected peer influences in this model have increased the significant level of sex from P < 0.1 to P < 0.05. Regarding to the knowledge, the peer influences has no effect on knowledge of SRH association with premarital sexual intercourse and still the same with the previous model (Model 2). However, there is an increase in the significant level of unsatisfied knowledge of contraceptive methods to lead in-school adolescents to engage in early sexual activity from P < 0.1 to P < 0.01. When source of SRH information is considered, the peer influences have changed the direction of in-school adolescents who do not know where they gain the SRH knowledge to be positively relationship but it is still not significant. Interestingly, the peer influences have changed mass media to be having significant positive relationship. It means in-school adolescents who gain the knowledge from mass media are more likely to have premarital sexual intercourse (P < 0.1). The last model (Model 3) also shows the same direction and significant level of attitude towards acceptance of premarital sexual intercourse and having a boyfriend or girlfriend comparing to the second model (Table 4.26). On the other hand, the peer influences has some effect in the significant level of risky consumption behaviors. The significant level of in-school late
adolescents who ever drink alcohol is reducing while for the currently drinking alcohol is still the same significant level with the previous model (Model 2). This also happens to in-school late adolescents who are using drugs. Finally, the peer influences by discussing the sexual matters with friends has significant positive relationship to encourage premarital sexual intercourse while, regarding to their friends experience, in-school late adolescents for who have friends have had sex before marriage are more likely to have premarital sexual intercourse (P < 0.001).
4.4 Discussion
As already mentioned, the adolescents sexual activity is a subject of greater concern in Indonesia these days than ever before. The adolescents in this study are young (mean age is about 16 years old) and descriptive statistics presents that generally in-school late adolescents are not doing premarital sexual intercourse. The average proportion of those who have had premarital sexual intercourse is approximately 2.4% (0.7% for female and 4.2% for male in-school late adolescents). The findings of the study show the difference by gender in premarital sexual intercourse among in-school late adolescents in Indonesia; the incidence is six times higher among males than females and significant having relationship with premarital sexual intercourse. According to Situmorang (2003), when gender is considered, males are more likely to accept of premarital sex and report having had sex compared to females and many of young men agree that they need to have an experience in sexual activity before marriage. On the other hand, the difference between female and male differential in sexual activity may be explained by the double standard regarding sexual relations in most developing countries, boys have commonly more freedom than girls (Metha et al, 1999; Situmorang, 2003). On the other hand, the early age of late adolescents of in-school late adolescents have a negative relationship with premarital sexual intercourse. It reveals that the younger the age of in-school late adolescents the less likely they practice premarital sexual intercourse. By contrast, study in some countries shows that younger
adolescents especially males are more likely to practice early sexual activity (UNFPA, 2003). However, in-school late adolescents who stay in urban area are more likely to engage in premarital sexual activity compare to the rural area. This is consistent with studies in Indonesia that found rural adolescents are more likely to have premarital sexual activity than the urban because due to the large territory of Indonesia have made the difference in terms of more exposed to education, mass media, modernization and government programs so that make adolescents are freer to engage with the opposite sex (Iswarati and Prihyugiarto, 2008; Utomo 2003). Therefore, the age of puberty periods is not having significant relationship with premarital sexual intercourse. This finding means puberty periods are not one of the main factors to lead premarital sexual intercourse because the puberty periods only may cause embarrassment and even stress for them and not directly lead them to have sex (Golub, 1983; Martin, 1996). Regarding to the knowledge of Sexual Reproductive Health (SRH), it is statistically significant only for in-school late adolescents who have an average knowledge of SRH. However, based to the findings, the model shows the increasing trend to lead premarital sexual intercourse although result shows negative association between knowledge of SRH and premarital sexual intercourse. This result mean knowledge of SRH has encouraged in-school late adolescents in Indonesia to practice premarital sexual intercourse. However, due to this study finding friends as the main source of information among in-school late adolescents, they may learn the incorrect knowledge of SRH from their friends. Friends who have had sexual experience may answer adolescents questions about SRH only based on their friends sexual experience than far away from the correct knowledge of SRH. Another issue that may address this finding is in-school late adolescents that has been chosen on this study would have a very good grade at the lesson in-school so that they can answer the questions related to SRH issues correctly. Furthermore, the knowledge of contraceptive methods is statistically significant only for in-school late adolescents who have a worse knowledge. It shows the positive association with in-school late adolescents in Indonesia to have early sexual activity if they have a worse knowledge. Thus, the findings show that the less
in-school late adolescents knowledge of contraceptive methods, the more likely they experience in premarital sexual intercourse. In Indonesia, informing the knowledge especially on contraceptive methods due to taboo and culture is specifically only for marriage couple while for the adolescents, instead from other sources, get the knowledge of contraceptive methods from sex education that have been taught which is only telling about how to refuse sex instead contraceptive methods. This issue make adolescents who know more about contraceptive methods refusing to have early sexual activity. In term of source of SRH information, in-school late adolescents in Indonesia have a positive significant relationship with premarital sexual intercourse when they gain the knowledge from mass media while they will have negative significant association if their family give them information regarding to SRH. The difference effect of SRH information regarding to premarital sexual intercourse may happen because adolescents may learn the knowledge from the incorrect sources (mass media and friends) which are may not be the correct information. The curiosity doubled with unsatisfied gaining information from family has made adolescents want to learn more from the easiest sources such as friends and mass media. However, gaining the knowledge from these sources mostly has negative effect because the information that adolescents get might be less healthy (Syafrudin, 2008; Yelda and Prasetyo, 2010). Another issue is family source has a negative significant relationship. This term means family is still the main important environment to decide adolescents behaviours because family is the closest place for them to learn knowledge. Moreover, when in-school late adolescents attitude towards acceptance of premarital sexual intercourse is considered, the findings show a significant positive relationship with premarital sexual intercourse. It means those who accept premarital sexual intercourse are more likely to have experience in premarital sexual intercourse than those who accept. Indeed, acceptance of premarital sexual intercourse tends to encourage adolescents to practice early sexual activity. However, the previous study shows premarital sexual intercourse are acceptable for males only but not for females (Ford et al, 2007).
In term of having a boyfriend or girlfriend, the result shows that having a relationship status defined by having a boyfriend or girlfriend is significant for in-school adolescents to do early sexual intercourse. This is consistent with previous research that having a boyfriend or girlfriend may lead premarital sexual intercourse (Wingood et al, 2001). Regarding to the risky consumption behaviours, the distribution shows mostly in-school late adolescents in Indonesia are doing smoking than drinking alcohol and using drugs. However, this finding is not consistent because Indonesian government are still facing with the issue of using drugs among adolescents. Therefore, due to the lowest distribution for using drugs, doing Self Administered Questionnaire (SAQ) may be a good way to find the reliability of adolescents behaviours. Furthermore, we assumed that doing smoking, drinking alcohol and using drugs are not a daily life demand for adolescents especially in-school adolescents. As the result reveals that currently doing smoking is significant for experience in premarital sexual intercourse. Moreover, in-school late adolescent who get involved in drinking alcohol and using drugs also have significant association with premarital sexual intercourse. These findings of this study are consistent with the previous study in Nepal, Mongolia, and Finland that shows smoking, drinking alcohol, and using drugs as a strong predictor of having premarital sexual intercourse among adolescents (Adhikari, 2008; Nikula, 2009; Algaa, 2002). Cannot control themselves is the most commonly happen after doing these behaviours and lead them to be high risk in doing early premarital sexual intercourse. Moreover, smoking is a proceed behaviour that can lead someone to do another negative behaviour because smoking is really close to the perception of bad person who may have bad behaviours, attitudes, and influence in-school late adolescents to engage in premarital sexual intercourse. Another issue is since this study find that the majority of the respondents are gaining the knowledge from friends, adolescents in Indonesia may learn these risky behaviours from their friends. Discussing sexual matter with friends as the peer influence on premarital sexual intercourse is statistically significant. On the other hand, another peer influence, have friends have had sex before marriage have a significant positive association. The
results are consistent with previous study that peers play important part in deciding personality and behaviour among adolescents (Algaa, 2002). Finally, the results can answer the hypothesis that have mentioned earlier in Chapter 2. 1. Male in-school late adolescents in Indonesia are more likely to have premarital sexual intercourse. The study finds that males have positive significant direction to lead premarital sexual intercourse. It means this hypothesis is accepted. 2. In-school late adolescents in Indonesia who are at the beginning age of late adolescents are more likely to have premarital sexual intercourse. The study finds that in-school late adolescents who are at the beginning age of late adolescents are significant less likely to engage in premarital sexual activity. It means this hypothesis is rejected. 3. In-school late adolescents in Indonesia who live in urban are more likely to have premarital sexual intercourse. This hypothesis is supporting the result that significantly urban has a positive relationship with premarital sexual activity. 4. In-school late adolescents in Indonesia who get puberty period at the early age are more likely to have premarital sexual intercourse. We cannot accept this hypothesis because, according to the study, the age of first puberty period shows that those who get their first puberty at the early age are less likely insignificant to have experience in sexual intercourse. 5. In-school late adolescents in Indonesia who have worse knowledge of SRH are more likely to have premarital sexual intercourse. The result finds that in-school late adolescents who have worse knowledge of SRH are less likely to have premarital sexual intercourse. It means automatically we reject this hypothesis. 6. In-school late adolescents in Indonesia who have worse knowledge of contraceptive methods are more likely to have premarital sexual intercourse. This hypothesis supports finding that worse knowledge of contraceptive method significantly lead male in-school adolescents to have premarital sexual intercourse.
7.
In-school late adolescents who get the information of SRH from family are less likely to have premarital sexual intercourse. Family as the source of SRH information is the only one source that having significant negative association with premarital sexual intercourse. This finding supports this hypothesis.
8.
In-school late adolescents in Indonesia who accept premarital sexual intercourse are more likely to have premarital sexual intercourse. Accepting premarital sexual intercourse may encourage premarital sexual intercourse. According to the result, this hypothesis is consistent with the finding.
9.
In-school late adolescents in Indonesia who have a boyfriend or girlfriend are more likely to have premarital sexual intercourse. Significant finding support this hypothesis because the study shows that those who have a boyfriend or girlfriend are more likely to have premarital sexual intercourse.
10. In-school late adolescents in Indonesia who are currently smoking are more likely to have premarital sexual intercourse. The result shows currently smoking has a positive significant association with premarital sexual intercourse. It means we accept this hypothesis. 11. In-school late adolescents in Indonesia who are currently drinking alcohol are more likely to have premarital sexual intercourse. Finding shows that in-school late adolescents who are currently drinking alcohol have a positive significant relationship with premarital sexual intercourse. It means this hypothesis is accepted. 12. In-school late adolescents in Indonesia who are using drugs are more likely to have premarital sexual intercourse. According to the study, using drugs has a positive significant relationship with premarital sexual among in-school late adolescents. Furthermore, this hypothesis is accepted. 13. In-school late adolescents in Indonesia who discuss about sex with their friends are more likely to have premarital sexual intercourse. We accept this hypothesis because finding supports the significant association between discuss about sex with friends and premarital sexual intercourse.
14. In-school late adolescents in Indonesia who have friends have had sex before marriage are more likely to have premarital sexual intercourse. We accept this hypothesis because have friends have had sex before marriage has a positive relationship for in-school late adolescents to have premarital sexual intercourse.
Conclusion and Recommendations / 48
CHAPTER V CONCLUSION AND RECOMMENDATIONS
This chapter consists of two sections such as the conclusion as the first section and recommendations as the second section.
5.1 Conclusion
The objective of this study is to analyze the factors influencing premarital sexual intercourse among adolescents in Indonesia. Therefore, this study discuss about in-school late adolescents sexual behavior in Indonesia. The secondary data was derived from the Indonesian Young Adults Reproductive Health Survey (IYARHS) 2007. The dependent variable is premarital sexual intercourse and independent variables are socio demographic factors, knowledge of reproductive health issues, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peers influences. Of the 6,792 in-school late adolescents in Indonesia aged 15-19 year old in the study, there are 3,374 females and 3,418 males. Overall, 2.4% from total in-school adolescents in this study have had premarital sexual intercourse. Almost a half of respondents have average knowledge of Sexual Reproductive Health (SRH) and contraceptive methods. 56% of respondents agree friends are the very best source of SRH information. Regarding to their attitude, a quarter of respondents accept premarital sexual intercourse. There are 66.1% of respondents having a boyfriend or girlfriend. About 60.7%, 83.9%, and 98.7 respectively of respondents are never smoke, drink alcohol, and use drugs. In term of the peers influences, two third of respondents discuss sexual matter with their friends and approximately a half of respondents are having friends have had sex before marriage.
Moreover, binary logistic regression is applied in 3 models of multivariate analysis. The first model explains effects of socio demographic factors. The second model includes socio demographic factors, knowledge of reproductive health issues, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, and risky consumption behaviors. The last model adds the second model with the peer influences. The present study finds that sex, age, place of residence, knowledge of SRH, knowledge of contraceptive methods, source of SRH information, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences have an effect on premarital sexual intercourse among in-school late adolescents in Indonesia. On the other hand, only age at first puberty period have no effect on premarital sexual intercourse. Therefore, further research is needed before this can be confirmed in the context of Indonesia. There are some important issues to be addressed regarding to this study. First of all, we should consider to the lack of knowledge of SRH, lack of knowledge of contraceptive methods and source of SRH information where in-school late adolescents gain their knowledge. They should learn the correct knowledge from the correct sources that is helpful to their health and emotional development. This could include mentoring, academic tutoring, faith based recreational activities, broad based family support, and together with the communities to promote the correct information so that in-school late adolescents will have knowledge of SRH and knowledge of contraceptive methods. On the other hand, regarding to attitude towards acceptance of premarital sexual intercourse, relationship status, the risky behavior and peers influences, paying special attention is needed to male in-school late adolescents because according to this study they are more risky than females. Due to the lack of knowledge from, the easiest way to gain it is from their peers and mass media. They do believe them because family, school, health officer, and religious leader cannot give the information that they want. Moreover, advocacy activities to the family, school, health officer, and religious leader
Conclusion and Recommendations / 50
Finally, in-school late adolescents may appear better in sexual education program. However, the program in-school and their parents attention are not enough for them to gain the correct information. Improving their reproductive health education not only at school or family level but together with the community, religious leader, health personnel, and mass media would be a perfect way.
5.2 Recommendations
Recommendations will be divided into two parts such as recommendations and need for future research. 5.2.1 Recommendations The following are the recommendations based on the findings of the present study: 1. Based on the IYARHS 2007, even though it is small percentage, the number of inschool late adolescents who have had premarital sexual is increasing comparing to IYARHS 2002. According to the finding, strengthening school based sexual education program or life skills program which is addressing SRH needed would be a good solution because beside they can gain the correct knowledge of reproductive health issues; their peers will also gain the correct knowledge so that they will share the correct knowledge of SRH. As a part of sex education programs, abstinence could be strengthen further in-school curriculum material, family resilience programs and mass media campaigns. This will be relevant to Indonesian social norms where premarital sex is strongly disapproved already. 2. This study shows that family have a considerable role play in SRH issues among school late adolescents. Efforts need to be directed to family especially parents on how to inform their children with the needs of SRH. 3. SRH knowledge for young people should be disseminated effectively. Peer educators, family involvement in programs, and various training programs on every aspect of SRH issues could be implemented due to approval of premarital sex.
4.
Programs need to raise awareness among in-school late adolescents in Indonesia and empower them. Female adolescents need to know how to acquire life and negotiation skills such as how to refuse sex while the males need to know how to control themselves not curious on practicing premarital sexual intercourse.
5.
Finally, the weak point in this study is a secondary data. Therefore, the limitation of this data set is in the way to collect the data by interviewing respondents. However, it may make the data unreliable because sometimes the respondents may not answer the truth for behavior questions such as have had premarital sexual intercourse, using drugs and other behaviors. To solve this problem, using Self Administered Questionnaire would be the best solution to get the data more reliable.
5.2.2 Need for Future Research Since the data used in this study is secondary data from the IYRHS 2007, there are some limitations to select some variables affecting sexual practices among unmarried Indonesian young adults. Doing more in-debt behavioral study especially on the experiences in out-of-school adolescents is needed. Therefore, in order for better understand about premarital sex practices among unmarried young adults in Indonesia, a qualitative study should be included into the future research.
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Biography / 60
BIOGRAPHY
NAME DATE OF BIRTH PLACE OF BIRTH INSTITUTION ATTENDED
Ronny A. P. Situmorang 26 October 1984 Samarinda, Indonesia Universitas Mulawarman, 2002- 2007 Bachelor Degree of Social (Public Administration) Mahidol University, 2010-2011 Master of Arts (Population and Reproductive Health Research)
SCHOLARSHIP
Indonesian National Family Planning Population Board (BKKBN)
HOME ADDRESS
Jalan Belimbing III No.48, Air Hitam, Samarinda, Kalimantan Timur, Indonesia, 75124 Tel.: +62541 742703 Email: redangel_842002@yahoo.com
OFFICE ADDRESS
BKKBN Provinsi Kalimantan Timur (The National Family Planning and Population Board) Jalan Letjend. M. T. Haryono, Air Putih, Samarinda, Provinsi Kalimantan Timur, Indonesia, 75124 Tel.: +62541 742922 Fac.: +62541 735872
FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE AMONG ADOLESCENTS IN INDONESIA: A CASE STUDY OF IN SCHOOL LATE ADOLESCENTS FROM INDONESIAN YOUNG ADULT REPRODUCTIVE HEALTH SURVEY (IYARHS) 2007 Ronny A. P. Situmorang
Abstract The number of Indonesian adolescents practicing sex before marriage is relatively low compared to the rate in other countries (less than 6.5%). However, this issue should be given attention because the rate increased from 5% to 6.4% between 2002 and 2007. Therefore, the main aim of this study is to analyze factors influencing premarital sexual intercourse among in-school late adolescents in Indonesia. This study uses secondary data from the research of the Indonesian Young Adult Reproductive Health Survey (IYARHS) 2007. The study population of 6,792 in-school late adolescents aged 15-19 years was selected from a total of 19,311 unmarried Indonesian young adults that were interviewed. The findings illustrate that 2.4% of the in-school late adolescents have engaged in premarital sexual intercourse. Evidence indicated that sex, age, place of residence, knowledge of sexual reproductive health (SRH), knowledge of contraceptive methods, source of SRH information, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences have a significant association with in-school adolescents that have experienced premarital sexual intercourse. This study suggests that strengthening SRH education programs in every sector in the community for adolescents should be scaled up to increase their knowledge and make them less curious about practicing premarital sexual intercourse.
Introduction As a part of human life phase with special characteristics that full of turbulent, adolescents have such unstable emotional development and life provision that have made them more prone to social unrest (Muzayyanah, 2008). They influence a far more complex world in terms of globalization, the spread of mass media, increased international migration, economic and political crisis, global violence and war, and increasing access to drugs and alcohol (Utomo, 2003). In all regions, lots of them have get involved with sexual activity where it is very risky to get sexually transmitted infections (STIs), HIV, or maybe unwanted pregnancy (Salgado & Cheetham, 2003). Moreover, following the worlds problems, Indonesia as one of the developing country may also have the same problems. Early sexual activities, which may be increasing in the world, also expose adolescents in Indonesia to unwanted pregnancy and sexually transmitted infections. Firstly, traditionally, in most Indonesian families, talking about puberty and sexuality are specifying only for married couple and active in sexual relationship. Moreover, information about these things is usually informed by a mother to her daughter only when she gets her menarche while for the boys, they learn from their peers and media (Situmorang, 2003). Regarding to this issue, study in Jakarta shows parents tend to refuse talking about sexual matters to their children (Iskandar, 1995; Utomo, 1997). The Indonesian adolescents are lack of SRH needs (Jameela, 2008). Moreover, health and educational issues has marginalized the SRH issues. Hence, inappropriate sex educations are being provided in
educational level. Moreover, communication between parents and children on term of SRH information is something exceptional because of the cultural term, parents also never had the same experience of receiving this information from their parents as well or maybe parents have a little capacity to deal with sexual information while adolescents can solve by themselves (Utomo & McDonald, 2009; Utomo, 2003; Situmorang, 2003). Secondly, while they are lack of information from their parents and educational subject also cannot give them the SRH knowledge, adolescents will adopt the knowledge from the people who are not the correct person or from the mass media such as television, films, movies, videos, magazines, books, pornographic materials, and computer networks which cannot be restrained (Utomo, 2003). Studies in Indonesia showed that in gaining knowledge of SRH, adolescents tries to seek reproductive health information from their peers (peer groups) who are the same adolescents and less healthy (Syafrudin, 2008). These groups can give them very great information through their peers better understanding comparing the knowledge from their parents (Tate, 2001). Beside from their peers, the exposure to mass media, both print (newspaper, magazines, porn books) and electronic (TV, DVD, the internet), have an influence directly or indirectly on teenagers to have premarital sex (Rohmawati et al, 2008). A research who was conducted in Indonesia shows that adolescents who have had premarital sex claimed, beside from friends, they get the idea of having sexual intercourse from the porn DVD, the internet, and magazine or newspaper (Yelda and Prasetyo, 2010). Thirdly, while they are provoked by the media about sex and sexuality, lack of accurate information about sex, reproduction, and reproductive health have influenced their behavior (Utomo, 2003). There are number of Female Sex Workers (FSWs) are adolescents aged under 19 years old in Jakarta (Utomo and Dharmaputra, 2001). Moreover, a research in Indonesia shows that teens tend to go outside to night entertainment venues to hanging out, clubbing, and other terms with some activities such as drinking alcohol, using drugs, dating, meeting new friend, kissing, petting, and one night stand (Pregiwatiningsih, 2008). Furthermore, there is also a change in attitude towards virginity in Indonesia. Study in Yogyakarta and Bali among unmarried men aged 17-24 years old mentioned around 50% of the respondents said no to preserving womens virginity until they get married (Singarimbun, 1996). By having this attitude, it is not wondering why many adolescents are involved in practicing premarital sexual activity. A survey in Indonesia also shows only 5% of adolescents has had early sexual activity in 1980s but in 2000 the percentage is increasing to 20% (BKKBN, 2001). Moreover, in 2006 shows that there were 43 million adolescents in Indonesia and almost one million adolescent boys (5%) and 200 thousands of adolescent girls (1%) have had sexual intercourse (MOH, 2006). However, even though the number of them practicing sex before marriage was relatively low (less than 6.5%) compared with other countries, Thailand (51%), Cambodia (36%), and Vietnam (65%) (BPS, 2008; Bergenstrom & Isarabkahdi, 2009; GSO, 2005). The issue should be given an attention because the number tends to increase from 1% to 3% for females and from 5% to 6.4% for males between 2002 and 2007 (Hidayat, 2005; BPS, 2004; BPS, 2008). Finally, following previous studies, the lack of knowledge of SRH manners, the peers and media influence, and changing of their attitude and behavior are the factors that can make adolescents to engage early sexual activity. Therefore, this thesis tries to examine the factors that can influence having premarital sexual intercourse among adolescents in Indonesia, specifically examining in school late adolescents aged 15-19 years old in Indonesia.
Conceptual Framework
Independent Variable Sex Age Place of Residence Age of the first Puberty Period Age of the first menstruation Age of the first wet dream Knowledge of SRH Knowledge of Contraceptive Methods Source of SRH Information Attitude towards Acceptance of Premarital Sexual Intercourse Relationship Status defined by Having A Boyfriend or Girlfriend Smoking Drinking Alcohol Using Drugs Discuss about Sexual Matters with Friends Have Friends Have Had Sex Before Marriage Dependent Variable
Premarital Sexual Intercourse
Objective The objective in this study is what factors are influencing premarital sexual intercourse among in school late adolescents in Indonesia.
Methods The proposed study has used secondary data from quantitative research of Indonesian Young Adult Reproductive Health Survey (IYARHS) 2007. The survey successfully interviewed 19,311 unmarried Indonesian young adults aged 15-24 years old. However, the present study includes only in school late adolescents aged 15-19 years old. Thus, there are 6,792 in school adolescents in rural and urban area are selected for the analysis in this study. Among selected respondents, considering have had premarital sexual intercourse as dependent variables, 2.4% (160) respondents have experienced in premarital sexual intercourse and 97.6% (6,632) respondents have not. This study represents the country as a whole because the sample population is drawn from the national representative survey. Furthermore, the independent variables used in the study are sex, age, place of residence, age of the first puberty period, knowledge of SRH, knowledge of contraceptive methods, attitude towards acceptance of premarital sexual intercourse, relationship status, smoking, drinking alcohol, using drugs, discuss about sexual matters with friends, and have friends have had sex before marriage. Since the dependent variable, have had premarital sexual intercourse is dichotomous (1 = yes and 0 = no), a binary logistic regression analysis is used to determine
the relationship of independent variables on premarital sexual intercourse among in-school late adolescents.
Results Characteristics of In-school Late Adolescents As mentioned earlier, the sample size is 6,792 in-school late adolescents. Among the sample size, Table 1 shows approximately the same proportion between selected female and male respondents (49.7% and 50.3 % respectively). Moreover, regarding to the age of the respondents, 80.1% of respondents are in the beginning age of late adolescents while the rest are in the final age of late adolescents. For the place of residence, 50.8% of the in-school late adolescents are living in urban area while 49.2% are in rural area. Therefore, age of the first puberty period is another socio demographic factor considered in this study. Among selected respondents, 68.0% of them get their first puberty period at the late age of puberty period while the rest (32.0%) get it at the early age of the puberty period. The puberty period indicates that the age of the first puberty period among respondents is in the late age of puberty period. Regarding to the knowledge of SRH among in-school late adolescents, the most of in-school late adolescents (45.3%) are having fair knowledge of SRH. However, only 4.8% out of 6,792 in-school adolescents have excellent knowledge related to SRH while there are 2.8% have unsatisfied knowledge. Therefore, the knowledge of contraceptive methods shows that most of the in-school late adolescents can have fair knowledge of contraceptive methods (45.3%). However, there are 191 respondents out of 6,792 in-school late adolescents have unsatisfied knowledge (2.8%) while only 171 respondents have excellent knowledge of contraceptive methods (2.5%). When source of SRH information is considered, descriptive analysis (Table 1) indicates that around a half of the respondents (48.7%) reported that their main source of SRH information is from their friends, whereas 21.4%, 8.6%, 8.4%, and 7.5% reported that they received the information from school, other sources (religious leader or health personal), family, and mass media respectively. Interestingly, 5.4% of respondents have never received SRH information from any sources. Moreover, the attitude of in-school late adolescents regarding to their opinion on having premarital sexual intercourse shows that from the 6,792 selected respondents, three quarter of them say disagree of having premarital sexual intercourse while one quarter agree (74.3% and 25.7% respectively). On the other hand, regarding to in-school late adolescents relationship status whether they have a boyfriend or girlfriend, Table 1 indicates that there are two third of respondents having or ever having a boyfriend or girlfriend (66.1%) and one third of them not (33.9%). Regarding to the respondents risky consumption behaviors, 14.6% of the selected in-school late adolescents are currently doing smoking, 24.7% just stopping it, while the rest are never having that behavior (60.7%). There are 83.9% of the respondents have never tried drinking alcohol while the rest have tried it currently and in the past (5.5% and 10.5% respectively). Thus, almost all of the respondents interviewed are never using drugs compare to ever using drugs (98.7% and 1.3% respectively). It means using drugs are not popular among in-school late adolescents. Finally, regarding to the peer influences, there are almost two third out of 6,892 in-school late adolescents has discussed about sexual matters with their friends (65.5%) while 34.5% have not discussed and 45.4% of in-school late adolescents have friends who have had sex before marriage while 54.6% say do not have friends have had sex before marriage.
Table 1 Percentage of characteristics of in-school late adolescents, Indonesia, 2007 Total (N = 6,792) Characteristics N Sex Female 3,374 Male 3,418 Age Beginning age of late adolescents 5,440 Final age of late adolescents 1,352 Mean = 16.37, Min = 15, Max = 19 Place of Residence Rural 3,343 Urban 3,449 Age of the first Puberty Period Early age 2,175 Late age 4,617 Mean = 12.60, Min = 10, Max = 19 Knowledge of SRH Unsatisfied 191 Poor 1,243 Fair 3,074 Good 1,959 Excellent 325 Knowledge of Contraceptive Methods Unsatisfied 401 Poor 1,198 Fair 3,801 Good 1,221 Excellent 171 Source of SRH Information Do not know 365 Friends 3,306 Family 571 School 1,455 Mass media 512 Other 583 Attitude towards Acceptance of Premarital Sexual Intercourse No, I disagree 5,047 Yes, I agree 1,745 Relationship Status defined by Having a Boyfriend or Girlfriend No, do not have 2,303 Yes, I have 4,489 Smoking Never 4,123 Yes, currently 989 Yes, ever 1,680
% 49.7 50.3 80.1 19.9
49.2 50.8 32.0 68.0
2.8 18.3 45.3 28.8 4.8 5.9 17.6 56.0 18.0 2.5 5.4 48.7 8.4 21.4 7.5 8.6
74.3 25.7
33.9 66.1 60.7 14.6 24.7
Table 1 Percentage of characteristics of in-school late adolescents, Indonesia, (Continued) Total (N = 6,792) Characteristics N Drinking Alcohol Never 5,700 Yes, currently 376 Yes, ever 716 Using Drugs Never 6,703 Ever 89 Discuss about Sexual Matters with Friends No 2,345 Yes 4,447 Have Friends Have Had Sex Before Marriage No 3,707 Yes 3,085
2007
% 83.9 5.5 10.5 98.7 1.3 34.5 65.5 54.6 45.4
Binary Logistic Regression Analysis In the first model, it explains effects of socio demographic factors such as sex, age, place of residence, and age at the first puberty period as the independent variables on premarital sexual intercourse as the dependent variable. Regarding to Table 2, the Model I, male in-school late adolescent are significant more likely to have experience in premarital sexual intercourse (P < 0.001). This significant term is also following by the age of in-school late adolescents that have the same significant level. It reveals that in-school late adolescents in Indonesia who aged at the beginning age of late adolescents are less likely to have premarital sexual intercourse than those who at the final age of late adolescents. Moreover, place residence in this first model also plays an important role to early sexual activity among adolescents. It shows that in-school late adolescents who live in urban are more likely to have premarital sexual intercourse than those who stay in rural. When age of the first puberty period is considered, there is no a significant relationship with premarital sexual intercourse. The second model of binary logistic regression, Table 2, explains effects of socio demographic factors, knowledge (knowledge of SRH, knowledge of contraceptive methods, and source of SRH information), attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, and risky consumption behaviors characteristics such as smoking, drinking alcohol, and using drugs as the independent variables on premarital sexual intercourse as the dependent variable. The newly added variables have reduced the significant level for sex among inschool late even the direction is still the same with the first model (P < 0.1). Therefore, interestingly, the significant level of place of residence have is increasing. It reveals that selected new variables in this second model have an effect to some socio demographic factors (Model 1). Moreover, knowledge of SRH shows that only in-school late adolescents who have fair knowledge of SRH are significant less likely to engage on premarital sexual intercourse (P < 0.05). On the other hand, those who have unsatisfied knowledge of contraceptive methods have a significant positive direction to have experience in early sexual activity. Regarding to source of information, friends and mass media are having positive
direction while do not know the source, family, and other are having negative association. However, only family has significant association at 0.1 level. Furthermore, this model (Model 2) shows that the attitude towards acceptance of premarital sexual intercourse has significant relationship in deciding in-school adolescents to have premarital sexual intercourse. Those who accept premarital sexual intercourse are more likely to engage on premarital sexual intercourse than those who do not accept it. On the other hand, regarding to in-school late adolescents relationship status defined by having a boyfriend or girlfriend and premarital sexual intercourse, there is a significant association (P < 0.001). Thus, in-school late adolescents who have a boyfriend or girlfriend are more likely to have premarital sexual intercourse than who do not have. When risky consumption behaviors are considered, most of the risky consumption behaviors especially the behaviors that are currently done by in-school late adolescents are having positive significant relationship with premarital sexual intercourse. Moreover, in-school late adolescents who currently smoke, currently or ever drink alcohol, and ever use drugs are more likely to do premarital sexual intercourse (P < 0.001, P < 0.001, P < 0.01, and P <0.05 respectively). The third model as the last model (Model 3) from Table 2 includes variables of socio demographic factors, knowledge, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences characteristics such as discuss sexual matter with friends and friends have had sex before marriage. The dependent variable is still premarital sexual intercourse. The association between socio demographic factors and premarital sexual intercourse in this last model is only affecting sex among in-school late adolescent. It reveals that selected peer influences in this model have increased the significant level of sex from P < 0.1 to P < 0.05. Regarding to the knowledge, the peer influences has no effect on knowledge of SRH association with premarital sexual intercourse and still the same with the previous model (Model 2). However, there is an increase in the significant level of unsatisfied knowledge of contraceptive methods to lead in-school adolescents to engage in early sexual activity from P < 0.1 to P < 0.01. When source of SRH information is considered, the peer influences have changed the direction of in-school adolescents who do not know where they gain the SRH knowledge to be positively relationship but it is still not significant. Interestingly, the peer influences have changed mass media to be having significant positive relationship. It means in-school adolescents who gain the knowledge from mass media are more likely to have premarital sexual intercourse (P < 0.1). The last model (Model 3) also shows the same direction and significant level of attitude towards acceptance of premarital sexual intercourse and having a boyfriend or girlfriend comparing to the second model (Table 2). On the other hand, the peer influences has some effect in the significant level of risky consumption behaviors. The significant level of in-school late adolescents who ever drink alcohol is reducing while for the currently drinking alcohol is still the same significant level with the previous model (Model 2). This also happens to in-school late adolescents who are using drugs. Finally, the peer influences by discussing the sexual matters with friends has significant positive relationship to encourage premarital sexual intercourse while, regarding to their friends experience, in-school late adolescents for who have friends have had sex before marriage are more likely to have premarital sexual intercourse (P < 0.001).
Table 2 Binary logistic regression of factors influencing premarital sexual intercourse among in-school late adolescents, Indonesia, 2007 Model 1 Model 2 Model 3 Variables B Exp (B) B Exp (B) B Exp (B) Sex Female Male 1.89 6.62*** 0.42 1.53 0.55 1.73* Age Beginning age of late -1.33 0.26*** -0.92 0.40*** -0.84 0.43*** adolescents Final age of late adolescents Place of Residence Rural Urban 0.38 1.46* 0.68 1.97*** 0.76 2.14*** Age of the First Puberty Period Early age -0.06 0.95 -0.20 0.82 -0.18 0.84 Late age Knowledge of SRH Unsatisfied -17.20 0.00 -16.84 0.00 Poor -0.95 0.49 -0.75 0.65 Fair -0.71 0.39* -0.43 0.47* Good -0.43 0.65 -0.37 0.69 Excellent Knowledge of Contraceptive Methods Unsatisfied 1.21 3.36 1.69 5.47** Poor 0.11 1.12 0.33 1.39 Fair -0.18 0.83 -0.06 0.95 Good -0.21 0.82 -0.11 0.90 Excellent Source of SRH Information Do not know -0.03 0.97 0.07 1.07 Friends 0.07 1.08 0.12 1.13 Family -0.84 0.43 -0.77 0.47 School Mass media 0.42 1.52 0.71 2.02 Other -0.29 0.75 -0.11 0.89 Attitude towards Acceptance of Premarital Sexual Intercourse No, I disagree Yes, I agree 2.33 10.23*** 2.13 8.42*** Relationship Status defined by Having a Boyfriend or Girlfriend No, do not have Yes, I have 2.21 9.10*** 2.07 7.89***
Smoking Never Yes, currently Yes, ever Drinking Alcohol Never Yes, currently Yes, ever Using Drugs Never Ever Discuss about Sexual Matters with Friends No Yes Friends Have Had Sex Before Marriage No Yes Log likelihood 1,357.232 LR Chi-Square 158.434*** DF 4 N 6,792 = 0.1, * = 0.05, ** = 0.01, *** = 0.001
1.11 0.36
3.04*** 1.44
1.00 0.27
2.71*** 1.31
1.53 0.66
4.60*** 1.94**
1.32 0.42
3.73*** 1.53 1.86
0.68
1.97*
0.62
0.13
1.14*
944.660 571.006*** 24 6,792
2.29 9.91*** 887.967 627.699*** 26 6,792
Discussion As already mentioned, the adolescents sexual activity is a subject of greater concern in Indonesia these days than ever before. The adolescents in this study are young (mean age is about 16 years old) and descriptive statistics presents that generally in-school late adolescents are not doing premarital sexual intercourse. The average proportion of those who have had premarital sexual intercourse is approximately 2.4% (0.7% for female and 4.2% for male in-school late adolescents). The findings of the study show the difference by gender in premarital sexual intercourse among in-school late adolescents in Indonesia; the incidence is six times higher among males than females and significant having relationship with premarital sexual intercourse. According to Situmorang (2003), when gender is considered, males are more likely to accept of premarital sex and report having had sex compared to females and many of young men agree that they need to have an experience in sexual activity before marriage. On the other hand, the difference between female and male differential in sexual activity may be explained by the double standard regarding sexual relations in most developing countries, boys have commonly more freedom than girls (Metha et al, 1999; Situmorang, 2003). On the other hand, the early age of late adolescents of in-school late adolescents have a negative relationship with premarital sexual intercourse. It reveals that the younger the age of in-school late adolescents the less likely they practice premarital sexual intercourse. By contrast, study in some countries shows that younger adolescents especially males are more likely to practice early sexual activity (UNFPA, 2003).
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However, in-school late adolescents who stay in urban area are more likely to engage in premarital sexual activity compare to the rural area. This is consistent with studies in Indonesia that found rural adolescents are more likely to have premarital sexual activity than the urban because due to the large territory of Indonesia have made the difference in terms of more exposed to education, mass media, modernization and government programs so that make adolescents are freer to engage with the opposite sex (Iswarati and Prihyugiarto, 2008; Utomo 2003). Therefore, the age of puberty periods is not having significant relationship with premarital sexual intercourse. This finding means puberty periods are not one of the main factors to lead premarital sexual intercourse because the puberty periods only may cause embarrassment and even stress for them and not directly lead them to have sex (Golub, 1983; Martin, 1996). Regarding to the knowledge of Sexual Reproductive Health (SRH), it is statistically significant only for in-school late adolescents who have an average knowledge of SRH. However, based to the findings, the model shows the increasing trend to lead premarital sexual intercourse although result shows negative association between knowledge of SRH and premarital sexual intercourse. This result mean knowledge of SRH has encouraged inschool late adolescents in Indonesia to practice premarital sexual intercourse. However, due to this study finding friends as the main source of information among in-school late adolescents, they may learn the incorrect knowledge of SRH from their friends. Friends who have had sexual experience may answer adolescents questions about SRH only based on their friends sexual experience than far away from the correct knowledge of SRH. Another issue that may address this finding is in-school late adolescents that has been chosen on this study would have a very good grade at the lesson in-school so that they can answer the questions related to SRH issues correctly. Furthermore, the knowledge of contraceptive methods is statistically significant only for in-school late adolescents who have a worse knowledge. It shows the positive association with in-school late adolescents in Indonesia to have early sexual activity if they have a worse knowledge. Thus, the findings show that the less in-school late adolescents knowledge of contraceptive methods, the more likely they experience in premarital sexual intercourse. In Indonesia, informing the knowledge especially on contraceptive methods due to taboo and culture is specifically only for marriage couple while for the adolescents, instead from other sources, get the knowledge of contraceptive methods from sex education that have been taught which is only telling about how to refuse sex instead contraceptive methods. This issue make adolescents who know more about contraceptive methods refusing to have early sexual activity. In term of source of SRH information, in-school late adolescents in Indonesia have a positive significant relationship with premarital sexual intercourse when they gain the knowledge from mass media while they will have negative significant association if their family give them information regarding to SRH. The difference effect of SRH information regarding to premarital sexual intercourse may happen because adolescents may learn the knowledge from the incorrect sources (mass media and friends) which are may not be the correct information. The curiosity doubled with unsatisfied gaining information from family has made adolescents want to learn more from the easiest sources such as friends and mass media. However, gaining the knowledge from these sources mostly has negative effect because the information that adolescents get might be less healthy (Syafrudin, 2008; Yelda and Prasetyo, 2010). Another issue is family source has a negative significant relationship. This term means family is still
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the main important environment to decide adolescents behaviours because family is the closest place for them to learn knowledge. Moreover, when in-school late adolescents attitude towards acceptance of premarital sexual intercourse is considered, the findings show a significant positive relationship with premarital sexual intercourse. It means those who accept premarital sexual intercourse are more likely to have experience in premarital sexual intercourse than those who accept. Indeed, acceptance of premarital sexual intercourse tends to encourage adolescents to practice early sexual activity. However, the previous study shows premarital sexual intercourse are acceptable for males only but not for females (Ford et al, 2007). In term of having a boyfriend or girlfriend, the result shows that having a relationship status defined by having a boyfriend or girlfriend is significant for inschool adolescents to do early sexual intercourse. This is consistent with previous research that having a boyfriend or girlfriend may lead premarital sexual intercourse (Wingood et al, 2001). Regarding to the risky consumption behaviours, the distribution shows mostly inschool late adolescents in Indonesia are doing smoking than drinking alcohol and using drugs. However, this finding is not consistent because Indonesian government are still facing with the issue of using drugs among adolescents. Therefore, due to the lowest distribution for using drugs, doing Self Administered Questionnaire (SAQ) may be a good way to find the reliability of adolescents behaviours. Furthermore, we assumed that doing smoking, drinking alcohol and using drugs are not a daily life demand for adolescents especially in-school adolescents. As the result reveals that currently doing smoking is significant for experience in premarital sexual intercourse. Moreover, in-school late adolescent who get involved in drinking alcohol and using drugs also have significant association with premarital sexual intercourse. These findings of this study are consistent with the previous study in Nepal, Mongolia, and Finland that shows smoking, drinking alcohol, and using drugs as a strong predictor of having premarital sexual intercourse among adolescents (Adhikari, 2008; Nikula, 2009; Algaa, 2002). Cannot control themselves is the most commonly happen after doing these behaviours and lead them to be high risk in doing early premarital sexual intercourse. Moreover, smoking is a proceed behaviour that can lead someone to do another negative behaviour because smoking is really close to the perception of bad person who may have bad behaviours, attitudes, and influence in-school late adolescents to engage in premarital sexual intercourse. Another issue is since this study find that the majority of the respondents are gaining the knowledge from friends, adolescents in Indonesia may learn these risky behaviours from their friends. Discussing sexual matter with friends as the peer influence on premarital sexual intercourse is statistically significant. On the other hand, another peer influence, have friends have had sex before marriage have a significant positive association. The results are consistent with previous study that peers play important part in deciding personality and behaviour among adolescents (Algaa, 2002).
Conclusion The objective of this study is to analyze the factors influencing premarital sexual intercourse among adolescents in Indonesia. Therefore, this study discuss about in-school late adolescents sexual behavior in Indonesia. The secondary data was derived from the Indonesian Young Adults Reproductive Health Survey (IYARHS) 2007. The dependent variable is premarital sexual intercourse and independent variables are socio demographic
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factors, knowledge of reproductive health issues, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peers influences. Of the 6,792 in-school late adolescents in Indonesia aged 15-19 year old in the study, there are 3,374 females and 3,418 males. Overall, 2.4% from total in-school adolescents in this study have had premarital sexual intercourse. Almost a half of respondents have average knowledge of Sexual Reproductive Health (SRH) and contraceptive methods. 56% of respondents agree friends are the very best source of SRH information. Regarding to their attitude, a quarter of respondents accept premarital sexual intercourse. There are 66.1% of respondents having a boyfriend or girlfriend. About 60.7%, 83.9%, and 98.7 respectively of respondents are never smoke, drink alcohol, and use drugs. In term of the peers influences, two third of respondents discuss sexual matter with their friends and approximately a half of respondents are having friends have had sex before marriage. Moreover, binary logistic regression is applied in 3 models of multivariate analysis. The first model explains effects of socio demographic factors. The second model includes socio demographic factors, knowledge of reproductive health issues, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, and risky consumption behaviors. The last model adds the second model with the peer influences. The present study finds that sex, age, place of residence, knowledge of SRH, knowledge of contraceptive methods, source of SRH information, attitude towards acceptance of premarital sexual intercourse, relationship status defined by having a boyfriend or girlfriend, risky consumption behaviors, and peer influences have an effect on premarital sexual intercourse among in-school late adolescents in Indonesia. On the other hand, only age at first puberty period have no effect on premarital sexual intercourse. Therefore, further research is needed before this can be confirmed in the context of Indonesia. There are some important issues to be addressed regarding to this study. First of all, we should consider to the lack of knowledge of SRH, lack of knowledge of contraceptive methods and source of SRH information where in-school late adolescents gain their knowledge. They should learn the correct knowledge from the correct sources that is helpful to their health and emotional development. This could include mentoring, academic tutoring, faith based recreational activities, broad based family support, and together with the communities to promote the correct information so that in-school late adolescents will have knowledge of SRH and knowledge of contraceptive methods. On the other hand, regarding to attitude towards acceptance of premarital sexual intercourse, relationship status, the risky behavior and peers influences, paying special attention is needed to male in-school late adolescents because according to this study they are more risky than females. Due to the lack of knowledge from, the easiest way to gain it is from their peers and mass media. They do believe them because family, school, health officer, and religious leader cannot give the information that they want. Moreover, advocacy activities to the family, school, health officer, and religious leader Finally, in-school late adolescents may appear better in sexual education program. However, the program in-school and their parents attention are not enough for them to gain the correct information. Improving their reproductive health education not only at school or family level but together with the community, religious leader, health personnel, and mass media would be a perfect way.
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Recommendations The following are the recommendations based on the findings of the present study: 1. Based on the IYARHS 2007, even though it is small percentage, the number of in-school late adolescents who have had premarital sexual is increasing comparing to IYARHS 2002. According to the finding, strengthening school based sexual education program or life skills program which is addressing SRH needed would be a good solution because beside they can gain the correct knowledge of reproductive health issues; their peers will also gain the correct knowledge so that they will share the correct knowledge of SRH. As a part of sex education programs, abstinence could be strengthen further in-school curriculum material, family resilience programs and mass media campaigns. This will be relevant to Indonesian social norms where premarital sex is strongly disapproved already. 2. This study shows that family have a considerable role play in SRH issues among school late adolescents. Efforts need to be directed to family especially parents on how to inform their children with the needs of SRH. 3. SRH knowledge for young people should be disseminated effectively. Peer educators, family involvement in programs, and various training programs on every aspect of SRH issues could be implemented due to approval of premarital sex. 4. Programs need to raise awareness among in-school late adolescents in Indonesia and empower them. Female adolescents need to know how to acquire life and negotiation skills such as how to refuse sex while the males need to know how to control themselves not curious on practicing premarital sexual intercourse. 5. The weak point in this study is a secondary data. Therefore, the limitation of this data set is in the way to collect the data by interviewing respondents. However, it may make the data unreliable because sometimes the respondents may not answer the truth for behavior questions such as have had premarital sexual intercourse, using drugs and other behaviors. To solve this problem, using Self Administered Questionnaire would be the best solution to get the data more reliable. 6. Since the data used in this study is secondary data from the IYRHS 2007, there are some limitations to select some variables affecting sexual practices among unmarried Indonesian young adults. Doing more in-debt behavioral study especially on the experiences in out-of-school adolescents is needed. 7. Finally, in order for better understand about premarital sex practices among unmarried young adults in Indonesia, a qualitative study should be included into the future research.
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BPS. (2004). Indonesian Demographic Health Survey (IDHS) 2002-2003. Jakarta: BPS and Marco International. BPS. (2004). Indonesian young adult reproductive health survey (IYARHS) 2002-2003. Jakarta: BPS and Macro International. BPS. (2008). Indonesian Demographic Health Survey (IDHS) 2007. Jakarta: BPS and Marco International. BPS. (2008). Indonesian young adult reproductive health survey (IYARHS) 2007. Jakarta: BPS and Macro International. Ford, N.J., Shaluhiyah, Z. and Suryoputro, A. (2007). A rather benign sexual culture: sociosexual lifestyles of youth in urban Central Java, Indonesia. Population, Space and Place, 13, 59-76. Golub, S. (1983). Menarche: The begining of menstrual life. Lifting the Curse of Menstruation: A Feminist Appraisal of the Influence of Menstruation on Women's Lives, edited by S. Golub. New York: The Haworth Press, 17-36. Hidayat, Z. (2005). Remaja Indonesia dan permasalahan kesehatan reproduksi. Warta Ekonomi, 4, 14-22. Iskandar, M.B. (1995). The final report of development of reproductive health EIC module for the family with school age children and adolescent. Jakarta: Pusat Penelitian Kesehatan UI, BKKBN and UNFPA. Iswarati., & Prihyugiarto, T.Y. (2008). Faktor-faktor yang mempengaruhi sikap dan perilaku seksual pranikah pada remaja di Inonesia. Jurnal Imliah KB dan KR, Tahun II, No. 2, 2008, Puslitbang KBKR, BKKBN. Jameela, A.R. (2008). Remaja Indonesia sangat membutuhkan informasi kesehatan reproduksi. Last updated on May 30, 2008. Retrieved on February 20, 2011, from: http://www.kesrepro.info/?q=node/407/ Martin, K.A. (1996). Puberty, Sexuality, and the Self: Girls and Boys at Adolescence. New York: Routledge. Mehta, S., Groenen, R., & Roque, F. (1999). Adolescents in changing times: Issues and perspectives for adolescent reproductive health in the ESCAP Region. Population Program, Economic and Social Commission for Asia and the Pacific (ESCAP). Retrieved on July 2, 2011, from: http://www.unescap.org/esid/psis/population/icpd/sec7.asp MOH of Indonesia. (2006). Lebih 1,2 juta remaja Indonesia sudah lakukan seks pranikah. Retrieved on February 20, 2011, from: http://karodalnet.blogspot.com/2008/08/lebih-12-juta-remajaindonesiasudah.html. Diakses 7 Januari 2010 Muzayyanah, S.N. (2008). Youth reproductive health education: What to do?. Last updated on May 19, 2008. Retrieved on February 20, 2011, from: http://halalsehat.com/index.php/Anak-Sehat/PENDIDIKAN-KESEHATANREPRODUKSI-REMAJA-BAGAIMANA-MENYIKAPINYA-*.html Nikula, M. (2009). Young mens sexual behavior in Finland and Estonia: Opportunities for prevention of STI. Finland: National Institute of Health and Welfare and Department of Public Health University of Helsinki. Pregiwatiningsih, E. (2008). Studi deskriptif gaya hidup remaja yang dugem di Malang. Retrieved on February 20, 2011, from: http://digilib.umm.ac.id/gdl.php?mod=browse&op=read&id=jiptummpp-gdl-s12008-yuanitapus-12946&PHPSESSID=42d6ee65b827a38f44956092d28ba985
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Rohmahwati D.A., Lutfiati, A., & Sri, M. (2008). Pengaruh pergaulan bebas dan VCD porno terhadap perilaku remaja di masyarakat. Retrieved on February 20, 2011, from http://kbi.gemari.or.id/beritadetail.php?id=2569 Salgado, A.M., & Cheetham, N. (2003). The sexual and reproductive health of youth: A global snapshot. Retrieved on February 20, 2011, from: http://www.advocatesforyouth.org/publications/1300?task=view Shaw, D. (2009). Access to sexual and reproductive health for young people: bridging the disconnect between rights and reality. International Journal of Gynecology and Obstetrics, 106 (2), 132-136. Singarimbun, M. (1996). Population and change. Pustaka Pelajar, Yogyakarta. Situmorang, A. (2003). Adolescent reproductive health in Indonesia. Jakarta: STARH Program/John Hopkins University, Center for Communication Program, Jakarta. Syafrudin. (2008). Remaja dan hubungan seksual pranikah. Retrieved on January 21, 2011, from http://id.shvoong.com/medicine-and-health/1799376-remaja-dan-hubunganseksual-pranikah/ Tate, T.F. (2001). Peer influencing and positive cognitive restructuring: Reclaiming children and youth. The International Child & Youth Care Network January 2006, Issue 84. UNFPA. (2003). STATE OF WORLD POPULATION 2003: Notes. Retrieved on April 24, 2011, from: http://www.unfpa.org/swp/2003/english/notes/page2.htm#43 Utomo, I.D. (1997). Sexual attitudes and behaviour of middle-class young people in Jakarta. Unpublished Ph. D. Thesis, The Australian National University, Canberra. Utomo, I.D. (2003). Adolescent reproductive health in Indonesia: Status, policies, programs and issues. The Australian National University, Canberra. Utomo, B., & Dharmaputra, N. G. (2001). Findings of the behavioral surveillance surveys (1996-2000) among female CSWs and male respondents. Jakarta. CHR-UI, FHI/HAPP. Utomo, I.D., & Mc. Donald, P. (2009). Adolescent reproductive health in Indonesia: Contested values and policy in action. Studies in family Planning, 40 (2), 133146. Wingood, G.M., DiClemente, R.J., McCree, D.H., Harrington, K., and Davies, S.L. (2001). Dating Violence and the Sexual Health of Black Adolescent Females. Pediatrics 2001; 107; e72. Yelda, F. & Prasetyo, S. (2010) Hubungan media pornografi dengan prilaku seks pra nikah. Retrieved on January 24, 2011 from: http://id.shvoong.com/medicine-and-health/epidemiology-public-health/2070984hubungan-media-pornografi-dengan-prilaku/

Factors Influencing Premartial Sexual Intercourse

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FACTORS INFLUENCING PREMARITAL SEXUAL INTERCOURSE AMONG ADOLESCENTS IN INDONESIA: A CASE STUDY OF IN-SCHOOL LATE ADOLESCENTS FROM INDONESIAN

YOUNG ADULT REPRODUCTIVE HEALTH SURVEY (IYARHS) 2007

COPYRIGHT OF MAHIDOL UNIVERSITY

Mr. Ronny A. P. Situmorang Candidate

Assoc. Prof. Sirinan Kittisuksathit, Ph. D. Major advisor

Lect. Charamporn Holumyong, Ph. D. Co-advisor

Mr. Ronny A. P. Situmorang Candidate

Asst. Prof. Pimonpan Isarabhakdi, Ph. D. Chair

Assoc. Prof. Sirinan Kittisuksathit, Ph. D. Member

Fac. of Grad. Studies, Mahidol Univ.

Risky consumption behaviors

LIST OF TABLES (cont.)

LIST OF TABLES (cont.)

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1.2 Problem Identification

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1.3 Research Question

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1.4 Scope of Research

1.5 Research Objectives

1.6 Definition of Key Words

CHAPTER II LITERATURE REVIEW

2.1 General Review

Figure 2.1 Social Cognitive Theory

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Believe about outcomes Evaluation of these outcomes

Attitudes towards the behavior

Perceived behavioral control

Figure 2.2 Planned Behavior Theory Components and Linkage

2.2 Premarital Sexual Intercourse

2.3 Socio Demographic Factors

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2.4 Knowledge of Reproductive Health Issues

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2.5 Attitude towards Acceptance of Premarital Sexual Intercourse

2.6 Relationship Status defined by Having a Boyfriend or Girlfriend

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2.7 Risky Consumption Behaviors

2.8 Peer Influences

2.9 Conceptual Framework

Premarital Sexual Intercourse

Figure 2.3 Conceptual Framework

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2.10 Research Hypotheses

CHAPTER III RESEARCH METHODOLOGY

3.1 Study Population and Sample

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3.2 Operational Definitions

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Variable Place of Residence Age of the First Puberty Period

Measurement Scale Nominal Ordinal

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2.29 9.91* 887.967 627.699* 26

N 6,792 = 0.1, * = 0.05, = 0.01, * = 0.001