Risk Factors of Premarital Sex Among University Girl Students: A Qualitative Study

1. Background

There have been various reports all around the world insinuating the increase of sexual activities among adolescents and the youth. As a result of HIV/AIDS prevalence, sexually transmitted infections (STIs), and unwanted pregnancies, the sexual behavior of the youth is considered as one of the society’s health priorities. Studies in Northern America and Europe revealed that 50% of the girls have sexual intercourse before the age of 17, and this number reaches 70% when they reach the age of 20. National studies have declared a lesser amount of premarital sexual relations in Asian countries in comparison with developed countries. In-depth studies have revealed an increase in premarital sexual activities amongst the youth (1, 2).

In Iran, 35% of the population is young (10 - 24 years old) (3). The median marriage age has increased significantly in both genders in the last few decades in Iran (4, 5). Moreover, the number and rate of recorded marriages declined by about 18% between 2010 and 2014 (5). Consequently, there has been a significant increase in the period between puberty and marriage, which might increase premarital sex (4). In Iran, premarital sex has been socially, culturally, religiously, and legally banned and unacceptable. However, recent evidence shows an increase in the prevalence of premarital relationships among the youth. If these relationships fail to end in marriage, females would suffer worse social and emotional consequences than males (4, 6, 7).

Sexual behavior is always complicated, since it is affected by the individual, society, culture, ethics, and the law (8, 9). Jaccard et al. claimed that teenagers who stated a low level of happiness with their mothers were more than twice likely to engage in premarital sexual intercourse compared to those who were highly satisfied with their relationship to their mothers (10). Forehand showed that having problems at home was linked to increased chance of getting involved in premarital sexual intercourse (11). In the United States, sexual behavior varies based on nationality, age, and place of residence (12). In Thailand and the Philippines, premarital sexual relations are dependent on family structure. For many adolescents, experiences with tobacco, alcohol, and drugs are considered the gateway to adulthood. Therefore, such experiences are predictive factors of sexual activity among female adolescents (1).

A study in Tehran revealed that the predicting factors for sexual intercourse among female university students were older age, low self-esteem, weak family environment, liberal attitude of parents, and pressure from unrestricted peers regarding virginity (13).

The Iranian society has undergone fundamental changes in recent years. Changes in sexual and social criteria, as well as communications technology have resulted in the alteration of traditional values. Free time and adventure-seeking behaviors have increased unhealthy and dangerous conducts, which could lead to the prevalence of some known STIs (14). Moreover, the number of female university students has increased since 2001 in Iran (15). For most of the young generation, university is a move toward independency from family, as well as an opportunity to find new friends. Meanwhile, for some other people, the university is an opportunity to experience sexual or romantic relationships (16).

2. Objectives

Understanding the motives and facilitators of premarital sex is somewhat a new matter in Iran. Accordingly, we aimed to investigate these concepts from the perspectives of female university students.

3. Methods

This was a qualitative study using the content analysis approach. As it was hard to find potential participants, the snowball sampling was used. For this purpose, students living in dormitories who had a history of premarital relationship and had declared this issue during student counseling were selected. Other students with similar experiences were identified and introduced by them. The participants were 24 female university students (mean age = 23 years; age range: 21 - 26 years) from different cities of Fars province studying in four different universities. Among the participants, 15 (62.5%) were from rural areas, 18 (75%) were living alone, and 12 (50%) belonged to the low to middle socio-economic class. The participants had premarital relationships with the opposite sex, varying from simple friendship to more intimate relationships. Interviews were conducted in some recreational centers in Shiraz and other counties. Considering the sensitivity of the subject and people’s concerns about confidentiality, the interviews were conducted after obtaining an informed consent from the participants.

A midwife who was expert in reproductive health interviewed the participants face to face and recorded the interviews (60 - 90 minutes). Three reproductive health and preventive medicine specialists evaluated the cogency of questions. The interview guide consisted of the following questions:

What factors did prompt sexual relationships?

How do families affect sexual relationships?

What factors encourage sexual relationships?

Which social factors affect sexual relationships?

On occasion, more than one interview was done for better underrating. Data collection continued up to data saturation. All interviews were recorded, transcribed, and coded on the same day. The second interview was performed only after coding the first one. Before coding, the typed interview transcripts were read line by line and word by word. Initial coding was done by Straus and Corbin method based on the concepts of data.

Regarding cultural diversity and limitation of talking about the concept of sexual relationship, the main messages of interviews were explored by re-reading the meaning units. Then, similar or related codes were classified to a particular group, and subcategories and categories emerged.

To ensure accuracy and stability of the data, we used the four criteria of credibility, transferability, dependability, and conformability, as suggested by Lincoln & Guba (17). The credibility of the study was promoted by proper researcher/interviewee relationship, presentation of analysis results to others and using their views and additional comments, presentation of extracted codes to participants to evaluate accuracy of our understandings, and variety in samples including people with various relationships. To increase dependability, all research was documented. Then, two experts in qualitative research and reproductive health were asked to review the reports to evaluate the similarity of their results. We found similarity in more than 90% of the cases. Transferability was increased by clear and distinct data collection and analysis. To facilitate conformability, a third-party observer was also used.

4. Results

The findings were classified into three main groups, including individual determinants, family environment, and community-related determinants.

4.1. Individual Determinants

This main category consisted of three subcategories, including lack of necessary skills, personality traits, and knowledge.

4.1.1. Lack of Necessary Skills

The participants noted that lack of some necessary skills were the facilitators for entering into premarital relationships. These skills were misjudgment, lack of ability to say no, and lack of resistance to peer pressure. Most of the participants had an emphasis on the misjudgments, which led to unwanted sexual relations:

“When people start relationships, they don’t usually think about how it’s going to end, or at least they think everything is under control and going well; but the reality is always different, and there is nothing that you can do about it. More importantly, the other party usually makes promises that makes everything seem easy and doable; but when it’s time to deliver, they bailout. I believe as long as one doesn’t really know someone, one should not engage in sexual intercourse.”

4.1.2. Lack of Ability to Say No

The lack of ability to say no at the time of bargaining for sex was another issue. A participant said:

“The fact is that boys are the dominant gender; even in sexual relations, although we know that girls would get hurt, we don’t have the guts to argue, so we mostly surrender. If I could turn back the time, I’d be able to defend myself. I wish someone had told me then that I could insist on my own interests more and say no”

4.1.3. Lack of Resistance to Peer Pressure

One of the prominent subgroups of this category was lack of resistance to peer pressure. This weakness came up in almost all the interviews:

“I’m generally a weak person; for instance, although I didn’t believe in cheating on school subjects, I never could resist it. So, even though I didn’t need to cheat, I still did it. During university, I was mixed up with some bad friends, and this caused me to succumb to sexual relationships, even though I didn’t believe in it and was quite afraid.”

4.1.4. Personality Traits

Regarding personality traits, independence, lack of self-confidence, strong desire for acceptability, fear of loneliness, and curiosity were among the proposed issues.

4.1.5. Independence

In many cases, what young people believed about independence equaled to having sexual intercourse:

“We are grown up now, and our parents don’t understand that; they want to interfere in everything, but having relationships with the opposite sex is our right, and they should not interfere."

4.1.6. Lack of Self-confidence

This trait was another facilitator of premarital relationship. A participant declared:

“I know that such relationships never end well, but I can’t control myself, and I’m afraid of consulting with adults, because I know they won’t react well to me.”

4.1.7. Fear of Loneliness

Fear of loneliness was another personality trait that many of the participants emphasized on as a motivator:

“I was so alone at home, and I didn’t have a good relationship with my parents. I’m happier here; being far away from my family has given me an opportunity to make friends with boys and I don’t feel so lonely anymore. Even if these relationships are temporary, they’re still worth it; they have saved me.”

4.1.8. Curiosity

Most participants expressed that premarital relationships are a way to know the opposite sex and satisfy their curiosity:

“They always scared us of men and having relationships with them, so how are we supposed to get to know them? These relationships are necessary; however, since they have been a taboo, we are more curious to try these relationships.”

4.1.9. Knowledge

This category included two subcategories, including lack of knowledge about the consequences of a relationship such as sexually transmitted diseases (STDs) and sufficient knowledge about hymenorrhaphy to hide pervious sexual experience in traditional context of Iran.

Almost all participants considered the lack of knowledge about the serious consequences of relationships as an effective factor:

“It’s true, we didn’t know what these relationships really were, but it never crossed our minds how much they would affect our future; now take a look, failure, bad reputation, pessimism, lack of trust in men, and the list goes on…”

A poor knowledge about STDs was another facilitator for sexual relationships among the participants:

“Young adults don’t really know what STDs are; they think they can identify them from the faces of people! Some of my friends got genital warts; they said that it can be transmitted even if you use a condom.”

In addition, the lack of awareness of boys’ desires in a relationship makes it impossible for a girl to determine boundaries when faced with sexual desire. A participant mentioned:

“I never thought a simple friendship would lead to sex; I just wanted a boyfriend, so that I’d become popular, but when the relationship got intimate, he broke up with me; now it’s just me and my regrets.”

In some cases, having sufficient information can also act as a facilitator. Among such information, knowledge of the modern surgical methods to maintain virginity was frequently indicated:

“Even though we live in a modern society, virginity is still important to many families. It was used to prevent sexual relations in the old days, but since girls know about hymenorrhaphy, they can have relationships and hide it; so nowadays, it’s easier to have sex.”

4.2. Family Environment

The second main category was family environment. The subcategories proposed in this category were non-supportive family, strict family, divorced parents, generation gap, deviant and open family, and poor economic conditions of the family.

4.2.1. Non-supportive Families

Almost all participants expressed the family’s lack of support, which leads to rejection of the individual from the family. A participant said:

“Who do you know that would help a girl like me? I don't know anyone who can help; everyone just blames me; I know I made a mistake, but I can’t stand being lectured; do you know anyone who could help me?”

Another one declared:

“Even my family has given up on me; so, I’ve decided to find work in another city after university and migrate there permanently; after all, I have no one to support me.”

4.2.2. Strict Family

Some participants noted the strictness of parents or other family members. For example, prohibiting friendship with a boy might be an encouraging factor. A participant emphasized the fact that strict parents prevent young people from expressing their emotions:

“Prohibitions have made us even more curious about these relationships; so, we start a relationship as soon as we can. At least this was the case for me; now I see that it wasn’t that interesting. If my parents had behaved differently, maybe I would’ve had a different reaction. Our families put us on this path without intending to do so. I wasn’t even allowed to use a cellphone, even my brother’s phone was locked; of course, I knew how to deceive them and do what I desired.”

4.2.3. Deviant and Open Family

Some participants had complaints about their family’s beliefs. In fact, some families act differently from the dominant values of the society and consider themselves modern and open-minded. A participant declared:

“In my family, having a boyfriend or girlfriend is considered being classy. Even some of the mothers defend these kinds of friendships; some even tell stories about their relationships in our family parties. For instance, I have a cousin who is not involved in any relationships, and they always call him a weak coward.”

4.2.4. Divorce of Parents

Some participants believed that their parents’ divorce was the main reason they turned to these relationships. In fact, the person does not receive enough love in the family environment and looks for someone outside the home to meet her emotional needs. In this regard, one of the participants said:

"When a family falls apart, and parents are divorced, they no longer have any time or patience for their children; they’re never there when they’re needed, and we are forced to solve our own problems with the help of our friends.”

4.2.5. Generation Gap

All participants insisted on the generation gap and mentioned that their thoughts are very different from their parents' generation, and there is no mutual understanding in this case.

“The problem is that children are way ahead of their parents. They are a thousand miles ahead in sexual matters while parents are sensitive about a simple phone call.”

4.2.6. Poor Economic Conditions

Some participants discussed the significant role of financial problems in the family as a motivation for premarital relationship. A participant said:

“It mattered to me that the boy I had a relationship with appreciated me, meaning to spend lavishly; I had financial limitations while growing up and I wanted to be financially secure. However, I agree that when someone starts spending money on you, they would have other expectations as well.”

4.3. Community-related Determinants

Changes in social values, marriage-related factors, gender norms, and social rules were the sub-categories of this main determinant.

4.3.1. Changes in Social Values

This subcategory refers to any changes in the attitudes towards cultural and religious beliefs, as well as the leading role of the social media. Most of the participants did not believe in the past cultural and religious beliefs. Although most of the participants had some religious beliefs, they could not deny the changes in their perspectives with regards to daily life:

“It’s true that we believe in our prophet and accept that they were very special people, but we can’t live like them; besides, even chauvinistic people have temptations and get involved in things like temporary marriage and polygamy, which means that sex matters to them as well. However, the new generation doesn’t like these solutions; we prefer to have an intimate relationship with someone, rather than suffering the problems of being a rival wife for a lifetime; in this way, we can easily end everything with a simple goodbye.”

Another aspect of changes in social values and cultural beliefs is a different definition of protecting honor:

“Now, I know a lot of women who regret being limited before their marriage. They believe if they were more courageous, they would’ve found a better husband; protecting their honor wasn't as beneficial as they had thought. Well, their words moved me and I’m not so sorry now, because as a modern girl, a lot of people want me.”

We could not ignore the role of the media (even TV or satellite), particularly the social media, in changing the social values. In this regard, most participants blamed the media for promotion of sexual behavior. A participant declared:

“Look, even in Iranian movies they depict scenes of premarital relationships, many of which end up in marriage! Yes, it’s true, they only show genuine friendships, but how would I know how to control myself when I enter a relationship? If they are showing such friendships on TV, then they should also teach us how to control our relationships. At the same time, I think satellite TV is also quite destructive; everything always goes so well in the movies, but in real life it's full of problems. Well, adults watch these movies with us and quite enjoy them, so I’m not sure if they would disprove. I mean I know that they are sensitive about their daughter, but how am I supposed to know right from wrong? Look, even all of those who used to say don’t watch satellite TV are now watching it themselves; I mean, absolutely everyone in our family owns a satellite receiver now; and you know, that’s why we gradually mimic everything; clothing, makeup styles, as well as their lifestyle. In addition, social media has facilitated access to different content and familiarity with different people.”

4.3.2. Marriage-related Factors

The subcategories of marriage-related factors consist of increased age of marriage, lack of trust among the youth, post-marital limitations, and disbelief in traditional marriage.

Many participants mentioned that the increase in average age of marriage has led to premarital sexual relationships. A participant declared:

“There is a long period between puberty and marriage and they can’t just prohibit us; this needs to be dealt with.”

Another important issue was the lack of trust among young people, which naturally makes it harder to select a suitable partner for life. Therefore, they prefer to have premarital relationship to meet their needs. A participant said:

“When the ability to date is considered as a criterion for superiority, no one can trust anyone anymore, because people easily become friends and let go even easier. I, for example, don’t know any of my friends who would trust anyone easily.”

Some of the participants mentioned post-marriage limitations. In fact, they preferred to have a free relationship without the obligations that we are required to comply with in marriage. One of the students stated:

“Marriage is no longer a fantasy as it was before; you might not believe it, but I know women who come here from small towns to go to university, and since there is a more open environment here, they find a boyfriend. We didn’t even know our classmate was married; well, when I see such things, I think they must have suffered from limitations. You know, many of the divorces happen because the boy is used to being free and says he’s not accustomed to being with only one girl for more than six months.”

Another marriage-related factor which facilitated premarital relationship was disbelief in traditional marriage. Most participants stated that marriage without prior relationship with the person is unacceptable.

“Nowadays, girls want to have the right to choose as well; they don’t like to sit around to be selected. That is why when they see someone that they like, they are willing to initiate a relationship themselves.”

4.3.3. Gender Norms

Double standards, the society’s belief regarding men being fickle, and impossibility of temporary marriages for girls were placed in this category:

Double standards and the gender discrimination against girls regarding freedom of having relationships was mentioned frequently. One of the girls stated:

“The discrimination between boys and girls in having relationships has motivated many of my friends to get a boyfriend; why is freedom and having a lot of relationships considered an honor for men while we are limited? We are equal from every aspect, so we should have equal rights in this matter as well, and society shouldn't have the right to interfere.”

Almost all participants agreed that boys and girls had different perspectives regarding sexual relationships:

“Boys and girls think differently when it comes to relationships; to my knowledge, girls never initiate sexual relations; they’re too afraid of the consequences, but when the boy insists that this is the only way to prove your love, what can she do?”

Some participants believed that the society should be blamed for the bad education which has led men to be fickle when it comes to sex:

“When we, our parents, teachers, and the society say that men are fickle and cannot be changed, naturally men wouldn’t hold themselves responsible; so, they act the way they desire.”

Impossibility of temporary marriages for girls was also mentioned. Most of the respondents did not like the solutions that society had provided for young people’s sexual relief and emphasized the impossibility of temporary marriages for girls. A participant said:

“Honestly, how many boys would be willing to marry someone who had been engaged in a temporary marriage? It might be a good solution for boys, but it doesn’t suit girls; it’s better if girls experience relationships in secret, so they wouldn’t have to suffer the consequences.”

4.3.4. Social Rules

This subcategory includes judicial punishment for relationships, wrong attitude, and accusations towards conspicuous relationships which act as encouraging factors. Many participants believed that judicial punishment for relationships that are intertwined with human nature would prevent premarital relationships from becoming public:

“As long as no one dares to reveal their problems to anyone, things are going to stay the same. Look, I have friends who had just slipped once, but because the other person had evidence against them, such as a picture or something, they couldn’t talk to anyone; they were afraid they were going to incriminate themselves more.”

Moreover, wrong social attitude and accusations towards premarital relationships had propelled the participant to engage in more intimate relationships:

“My problems with my family first began over cellphones; I was a shy person and I didn’t even have the courage to talk to boys, but since I had hidden my SIM card from my family, they accused me of horrible things. So, I decided to do whatever I wanted if they acted this way. I became stubborn and now I regret it… Of course, even now, my parents won’t take any responsibility if I ask them.”

5. Discussion

This study revealed various motivators of premarital sexual relationships among female university students in four universities of Fars province, Iran. The facilitators of having premarital relationships were categorized in three main groups, including individual determinants, family environment, and community-related determinants.

5.1. Individual Determinants

As individual determinants, lack of skills such as bargaining, resisting peer pressure, and good judgment were considered as important factors in early sexual relationships. Results from other studies were consistent with our findings, so that individual characteristics and personality traits such as fear of loneliness were considered as significant factors. In a similar study among female university students in Zambia, loneliness and living in rentals without parents’ supervision played a role in early initiation of relationships (18). In fact, independency and bargaining power results in healthier sexual relations (19), preventing risky behavior by resisting peer pressure (20), and postponing the first sexual experience (21), and finally self-control (22).

Another dimension of individual determinants was the emphasis on unfamiliarity with the consequences of uncontrolled sexual experience and lack of proper knowledge regarding STDs and HIV/AIDS, as well as unfamiliarity with the burden of financial problems of unwanted pregnancies; two studies in Nigeria and Tanzania verified the same results (23, 24).

5.2. Family Environment

The significant role of family was highlighted in this research; very strict or too open-minded families were both considered as the main causes of early sexual experience. Regarding the role of family, Ream and Savin-Williams showed that the more time girls spend with their parents, especially their mothers, the less eager they would become to have sexual experience; and even if they do enter a sexual relationship, they do it when they are older and more mature. Apart from that, the quality of the relationship is also important (25). In a study, Somers emphasized that families with warm and intimate relationships can have protective effects on young boys and girls with respect to initiation of irresponsible sexual relations (26). Roche’s research revealed that the low number of limiting laws and unsupervised freedom of adolescents have a direct correlation with early sex initiation (27).

Sionéan et al. showed that the parents’ divorce and solitude of adolescents, especially long hours of being alone in the house, would affect early establishment of these relationships (19). Ten different studies verified that as the number of sexually active friends increases, one’s willingness to engage in sexual intercourse (22), initiate early relationships with the opposite sex (28), and participate in sexual activities would also increase (29).

5.3. Community-related Determinants

The changes in social values were considered as social facilitators of premarital sexual relationships. Premarital relationship was not as common as now in the religious and traditional value-centered society of Iran. Undoubtedly, these changes are connected to socio-cultural changes in Iran (30). Many factors act as a basis for the society’s change toward modern values. Participants in this study mentioned that the media was one of the most important factors affecting people’s viewpoints and beliefs. Some other studies reported the significance of the media in changing traditional social values and ethical judgments of adolescents and the youth (31). Along with these changes in social values, family values would inevitably change. During the interviews, the girls from more liberal families admitted that they accept the modern values of society and engage in premarital relationships easier; these results are consistent with results from Farahani et al.’s study in Tehran, Iran (7). According to our participants, changes in religious values and beliefs have had a significant effect on youth sexual relations; other studies were congruous with ours (32). Previous studies had indicated the preventive effects of religious beliefs on premarital sexual behavior, especially among Muslim communities (33). An instance of these changes would be the change in attitudes toward virginity; some respondents stated that despite the importance of maintaining virginity before marriage, hymen repair surgery has made it easier to initiate sexual experience. Meanwhile, Iran’s traditional values recognize this kind of relationship as a sin or a taboo (34). On the other hand, the American University of Obstetrics and Gynecology (ACOG), which is a well-known source relating women’s surgical procedures, did not verify the safety of this procedure and emphasized that it should be avoided (35).

According to the findings, changes in marriage-related factors are clear in Iran, as an Islamic society. These changes are to some degree caused by the general increase in women’s education, employment, and activities in social areas. The increased age of marriage, and consequently the increased gap between puberty and marriage, were among the proposed changes in marriage-related factors in Iran. The increased age of marriage has resulted in increased premarital sexual experiences, a fact verified by previous studies (13, 36). Also, changes in attitudes toward traditional marriage are also significant. According to the definitions, traditional marriage is permanent, child-baring is an integral part of it, and the man is the breadwinner and makes all the decisions and the woman is responsible for raising the children and governing the household. Based on this definition, the requirements of a traditional marriage are permanence, monogamy, and reproduction (37). The results highlighted the differences between the young generation’s viewpoints regarding traditional marriage and the changes in their marriage-related attitudes. Some of the participants considered the negative views related to post-marriage limitations and spread of distrust among the youth as factors causing people to postpone marriage or choose to stay single.

Sexual norms were also considered effective in this study. According to our participants, subordination of girls was a common sexual norm in traditional or developing societies such as Iran, which would lead to promotion of sexual relationship; this means that there is gender inequality and power imbalance. According to previous studies, power imbalance and gender inequality increase the probability of violence and spread of diseases such as HIV/AIDS (38, 39). Other studies verified the effects of gender inequality on premarital sexual relationships, the differences in interest of men and women, and the fact that power imbalance could lead to men becoming abusive (6). Our results showed the important effects of media and friends in the sexual decision making of participants. As the International Planned Parenthood Federation (IPPF) stated the youth encounter two different aspects related to sex, including conflicting messages and norms. On one side sex is seen as negative and associated with blame, anxiety, and disease, but through the media and friends it is represented as positive and desirable (40).

Surrendering to partners might even reinforce the sense of power among women and lead to further subordination and advanced sexual activities. Double standards and differences in the society’s attitudes towards men and women in premarital relationships would increase the senses of discrimination among girls. Efforts to reduce discrimination amongst young girls motivate them to engage in premarital relationships. The belief regarding men being fickle was also considered as a sexual norm (41). This confirmed the double standards and gender discrimination in society, which still cares about girls’ virginity until marriage. Another issue regarding sexual norms was the unacceptability of temporary marriages for bachelorettes. This double standard along with the significance of a bachelorette’s virginity prompt hidden relationships (34). It’s quite important to note that although premarital relationships are acceptable for some young people, the families are still bothered by it. This research showed that due to the importance of virginity to families and considering the increased age of marriage and suppression of sexual needs, some girls use hymen repair surgery to justify having premarital relationships, while being completely unaware of its consequences (42). According to article 647 of the Islamic Penal Code of Iran, ‘if before marriage, any one of the parties deceives the other party with unreal claims such as higher education, financial ability, social status, special career or position, being single, etc., and the marriage contract is dissolved on the basis of such claims, the offender shall be sentenced to six months to two years imprisonment’ (43). Therefore, such illegal acts would have consequences for many people, including the girl herself, as well as the surgeon and/or any other parties involved.

5.4. Limitations

The face-to-face interviews and snowball sampling method were among the limitations of the study. Because of snowball sampling, only people who were more easygoing entered the study. So, people with different personal characteristics may not have participated in the study.

5.5. Conclusions

Various determinants shaped premarital sexual relationships among female university students. Understanding motivated individual and social factors can help policymakers design an appropriate program. In individual determinants, it is important to improve individual skills such as self-control, resilience to peer pressure, and the skill of saying no, along with teaching self-knowledge. To control the effect of family environment, educating parents and promoting moderate behavior with their children can be effective. To reduce social pressure, programs should be considered for girls to express themselves and their emotions. Moreover, some new policies are needed to reduce legal restrictions for unmarried females.