Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

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Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2022 | Month : March | Volume : 16 | Issue : 3 | Page : CC01 - CC05 Full Version

Understanding Attitude towards Gender, Sexuality, Sexual Health Needs and Information Seeking Behaviour amongst First Year Medical Students: An Observational Study


Published: March 1, 2022 | DOI: https://doi.org/10.7860/JCDR/2022/53754.16107
Deepali Khatri, Mrunal R Shenwai, Priya Mardikar

1. Tutor, Department of Physiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. 2. Associate Professor, Department of Physiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. 3. Professor and Head, Department of Physiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.

Correspondence Address :
Dr. Mrunal R. Shenwai,
G/701, Kumar Padmaja, Opposite Mahesh Vidyalay, Near Ashish Garden, Kothrud,
Pune-411038, Maharashtra, India.
E-mail: drpmrunal@yahoo.com

Abstract

Introduction: The topics related to sexual attitude and reproductive health are not commonly and openly discussed. The scarcity of having open discussions especially with parents results in lack of awareness among adolescents about contraception, sexual values, beliefs and behaviour. First year medical students are usually in their last years of adolescence. In future, they are going to communicate with their patients on sexual health matters. Hence, it becomes essential to understand their own perspective regarding this.

Aim: To understand the attitude of first year medical students towards gender, sexuality, sexual health needs and their information seeking behaviour.

Materials and Methods: A cross-sectional survey was conducted, using a self-administered questionnaire. The study population comprised of 314, first year medical students aged between 17 to 20 years at Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. The questionnaire included sections on communication within family and friends, personal attitude towards sexuality and gender and information seeking behaviour. Statistical analysis was done by Chi-square test using Statistical Package for the Social Sciences (SPSS) software.

Results: Total 314 first year Bachelor of Medicine, Bachelor of Surgery (MBBS) students (135 males, 179 females with mean age of 18.35 years) participated in the study. More than 90% of students were interested to socialise with opposite sex, yet more than 50% of them did not want to be involved in premarital sex as it was against their religious beliefs. More number of boys (65.93%), as compared to girls (38.55%), agreed that it’s ok to have sex before marriage with proper contraceptive measures. Maintenance of virginity until marriage was important for girls (56.98%) as compared to boys (37.04%) which was statistically significant (p<0.001). Students lacked communication with their parents on the topics of sexuality. A 95.86% used internet to seek information on sexual health matters. Sexual problems (72.61%) and genital hygiene (73.89%) were the maximally searched topics on internet. Total 64.33% of students were interested in attending a formal course regarding sexual/reproductive health.

Conclusion: Adolescent's attitude about sexual matters is guided by their religious beliefs. There is a dearth of communication between the adolescents and their parents on sexual health matters. Majority preferred seeking information from friends and/ or via internet which can be unreliable at times.

Keywords

Adolescents, Communication with parents, Medical students, Reproductive health

Reproductive health is an important component of general health which eventually contributes towards social health as well. From 10-19 years (as per World Health Organisation (WHO) standards), a teen’s body changes drastically (1). It enters puberty and experiences many physical as well as emotional changes. This may be attributed to menarche in girls and other bodily changes in both genders, leading to awareness about sexuality as well as increase in hormones that affect the mood (2). Moreover, it also introduces the adolescent to new vulnerabilities such as human rights abuses, particularly in the arenas of sexuality, marriage, and child bearing. According to United Nations Population Fund (UNFPA), millions of girls are coerced into unwanted sex or marriage, putting them at risk of unwanted pregnancies, unsafe abortions, Sexually Transmitted Infections (STIs) including Human Immunodeficiency Syndrome (HIV), and dangerous childbirth. Adolescent boys are at risk, as well. Young people both boys and girls are disproportionately affected by HIV. Yet too many young people face barriers to reproductive health information and care (3).

The level of knowledge is closely related to the source from which they obtain the information (4),(5). Parents have a unique opportunity to instill knowledge of sexual risk as well as confidence and comfort around sexuality in their adolescents. Unfortunately, in many instances, “sex talks” between parents and their children are less than optimal. Parents tend to exclude positive topics associated with sexuality, such as pleasure, love and healthy relationships, in favour of negative topics and warnings such as unwanted pregnancy, STIs, abuse and exploitation (6),(7). The source of information such as peers and the mass media highly influence the sexual behaviour of the adolescents (8). Therefore, to improve their sexual and reproductive health it is important to understand their attitudes towards sexuality, gender, as well as their needs and information seeking behaviour in this field.

First year medical students are of suitable age group to study adolescent’s attitudes and level of understanding towards sexuality because usually they are in their last years of adolescence and beginning years of youth (9). Being future doctors, it becomes furthermore important to assess their awareness towards reproductive health and sexual behaviours, as, while practicing they will have to take a meaningful sexual history and give effective sexual counseling with a supportive, non judgmental attitude toward patients (10).

With this background, this questionnaire-based survey was conducted in two consecutive batches of first year medical students, at the beginning of their course. The objectives of the study was to understand their attitudes towards opposite gender and sexuality, how they communicate with their parents on this topic, what their needs are and how they expect to be informed about the same. The study might offer direction for solution proposals aiming to improve adolescent’s reproductive health and subsequently the society’s as well.

Material and Methods

The present study was an observational, cross-sectional study conducted with the help of a self-administered questionnaire. The study was conducted on 314 first year MBBS students of Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India, between August 2015 (2015-16 batch) to August 2016 (2016-17 batch). The study was conducted for 2 consecutive years (August 2015 to August 2017). As it was an exploratory study, convenient or purposive sampling was done. The study was approved by the Institutional Ethics Committee (IEC Letter No: Ref.SKNMC/Ethics/App/2015/42, Dated: 24/02/2015).

Inclusion criteria: All first year medical students, willing to participate in the study were included. This avoided any selection or data recording bias.

Exclusion criteria: Students who were not willing to participate were excluded from the study.

Design of the Survey Questionnaire

A systematic search of the literature was conducted to identify relevant published papers. The questionnaire which was used, was largely adopted from a core WHO questionnaire designed by Cleland J et al., and a study questionnaire developed by researchers in a published protocol study in Saudi women (11),(12). Some modifications were done in the questionnaire to make it suitable for the study population and validated by experts (two senior faculty from the Department of Obstetrics and Gynaecology and two from Community Medicine within the institute).

The questionnaire included different sections (in English language), containing questions about communication within the family and with friends, their personal attitudes towards sexuality and gender and their information seeking behaviour. A sub-section for understanding their attitudes towards opposite gender and sexuality included questions regarding their acceptance in socialising with opposite gender, having premarital sex and their religious beliefs about it. A separate section of questionnaire was aimed to understand and assess their information seeking behaviour and their needs to remain informative through discussions. The instrument was first pilot tested on a group of students (n=20, excluded from the sample). Necessary revision was done for better understanding of the questions.

Questionnaire filling was done in small batches of 50 students, after their college hours. All the students participated willingly in the study. They were first briefed about the overall objective of the study as well as details of the questionnaire to be filled by them anonymously. Written informed consent of the students was taken and they were assured that all the information provided by them will be kept strictly confidential. A 20-30 minutes time was given to fill up the questionnaire. All the questions were close-ended, based on Likert scale, where students had to mark their responses. Questionnaire coding was done beforehand to grade student’s responses.

Statistical Analysis

Data was represented as frequency in percentage and numbers. Associations between educational parameters and communication parameters were analysed by Chi-square test. Statistical significance was set at 0.05. Analysis was done using Statistical Package for the Social Science (SPSS) 20.0 (IBM SPSS Inc).

Results

The study population included 314 first year MBBS professionals. There were 135 males and 179 females, with age ranging between 17-20 years (mean age=18.35 years). (Table/Fig 1) shows that 90.4% of the fathers, and 82.5% of the mothers of these students belonged to the graduate and above category; 86.62% (n=272) of the student population perceived their families to be traditional in values, while 13.38% (n=42) reported that their families were not at all traditional.

More than 90% of the individuals (96.09% girls and 94.07% boys) expressed that they would be comfortable being into a relationship with opposite gender for socialisation, although 57.96% of individuals expressed that their religious beliefs are against premarital sex. A statistically significant difference in the opinion was observed as number of girls agreeing to the statement on religious beliefs against pre-marital sex, was more (67.60%) as compared to boys (45.19%). A 50.32% of individuals agreed that it’s alright for boys and girls to have sex before marriage if they use proper methods to prevent pregnancy. Number of girls (38.55%) agreeing to the above statement, was less than the number of boys (65.93%) and the difference was found to be statistically significant (p<0.001). Total 48.41 of the students (56.98% girls and 37.04% boys) believed that girls should maintain their virginity until marriage. This difference in the opinion between the genders was found to be statistically significant (p<0.001) (Table/Fig 2).

Furthermore, the gender association with this behaviour was also observed. Total 81.53% (n=256) of students stated that they had the tendency to discuss sexual and reproductive health matters with someone. A 18.47% (n=58) stated that they did not discuss with anyone. Female students were more open to talk to their mothers (57.5%) as compared to their fathers (8.4%) showing a significant gender difference with p-value of <0.001 whereas male students were more open to talk to their fathers (17%, n=23) (Table/Fig 3). The total percentage of males talking to both their parents was much less than that for females. The most comfortable source of seeking information for both genders was found to be their friends with whom 70-80% of individuals could talk on sexual matters. Gender association was not observed in such pattern of students’ source of information.

(Table/Fig 4) shows that the common topics discussed with the parents were pubertal changes, menstruation, reproductive systems whereas masturbation was the least likely discussed topic.

For seeking information, 95.86% of students used the internet and majority of them used their mobile internet. Sexual problems (72.61%) and genital hygiene (73.89%) were the topics that were searched maximum on the internet followed by the topics related to pregnancy and delivery (64%), contraception (29.62%) and sexually transmitted diseases (15.29%). The least searched topics were sexual intercourse (11.78%) and virginity (5.1%). Though 47.13% of the study population considered the information available on the internet as reliable, 64.33% of student population expressed interest in attending a formal course based on sexual and reproductive health.

Discussion

This was an observational study to explore adolescent’s attitude, sexual needs and information seeking behaviour. The findings of this study shows similarity with previously published studies.

Attitude towards gender and sexuality: In the present study, 86.62% of the study subjects perceived themselves belonging to traditional families. More than 90% of the students had no apprehension of being in a relationship with opposite gender, yet more than 50% of them did not want to be involved in premarital sex as their religious beliefs were against it. No gender disparity was found regarding this opinion. Similar findings were obtained by Jaya J and Hindin M, where large majority of respondents have shown their interest in having sex only after getting married. In their study, 92% males and 96% females believed that one should have sexual relationship only after marriage (13). They found a significant difference between the genders towards this conservative approach if the couple is in true love relationship.

Overall, 50.32% of the study subjects were liberal in their thoughts that it is ok for boys or girls to have sex before marriage, provided they take proper contraceptive precautions. But there was a statistically significant gender difference in the opinion amongst girls and boys with a smaller number of girls opting for premarital sex. Such abstinence until marriage was expressed by the male and female participants of a study in African population, where abstinence was viewed more positively among young women than among young men (14).

A 48.41% of the study subjects (56.98% girls and 37.04% boys) believed that girls should maintain their virginity until marriage. This difference in the opinion between the genders was found to be statistically significant. Probably one of the major reasons why more females are of such opinion is fear of getting pregnant. Present study findings go with the ones reported by Ojedokun AO and Balogun SK, where they reported that the context of early sexual experience is often very different for young men and for young women, especially in developing regions and women but not men are commonly expected to be sexually inexperienced at the time of marriage. Like present study findings, they reported that male students showed more favourable attitudes toward premarital sexual permissiveness than female students (15). Saraçog?lu GV et al., assessed the knowledge, attitude, and behaviour towards sexual health among undergraduate students in Turkey; 83.2% of the student population was in relationship with opposite gender. Out of those, 32% had experienced sexual intercourse atleast once, with statistically significant difference between genders (16.9% females v/s 83.1% males) (16). Wong L qualitatively assessed the premarital sexual behaviours exclusively in senior school going girls and undergraduate females. He performed this study on three ethnic groups in which 35% were Malay, 34% were Chinese and 31% were Indians. Regarding the permissiveness about premarital sex, the Indian and Malay girls had shown restrictive attitude as the inference of cultural, religious, and social prohibitions (17).

Information-seeking behaviour: In the present study, it was observed that 95.86% of students used ‘internet’ and majority of them used their mobile internet for seeking information on sexual health. Their major sources of information regarding sexual and reproductive health issues were internet and discussion with peers. This finding was consistent with other studies where they have reported that for 80.5% of adolescents, the preferred source of sexual health information was the internet (18). Quite a similar report has been published by WHO where it is mentioned that adolescents prefer internet, friends and TV to acquire sexual knowledge in developing countries (19). In a Nigerian study, Asekun-Olarinmoye OS et al., observed the effect of mass media and internet on sexual behaviour of undergraduates. Almost 74.5% of the students were accessing internet to watch explicit sexual material. More than half of the total study population had the opinion that uncontrolled use of internet had negative impacts on sexual behaviour. Higher frequency of using internet to search the sexual material has been marked as predictor of having multiple sexual partners (20).

Regarding communication on sexual health matters, the present study shows that girls are more likely to communicate with their parents as compared to boys and the difference was found to be statistically significant. The less comfortable sources of information for the students were siblings, physicians, teachers, and other relatives in decreasing order. It has been reported in the studies that privacy is the main concern for opting internet over discussing the issues with experts (21).

Madeni F et al., evaluated the effectiveness of reproductive health awareness program in adolescents. They found that the adolescent girls who often communicate with their parents had significantly higher knowledge about reproductive health than those who did not communicate (22). Another study had shown the higher efficacy of parent-child communication in terms of their sexual behaviour and decision making (23). This study was also consistent with the present finding that daughters are communicated well and earlier on various topic related to sexuality as compared to the sons.

In the medical profession, communication skill of a doctor plays a significant role in patient’s treatment. It becomes more important especially when the doctor deals with patient’s sexual issues. Ariffin F et al., assessed the skills and attitudes among medical undergraduates to take patient’s sexual history confidently. They reported only half of the students felt comfortable in taking patients’ sexual history. A 54% of them felt that the training they receive was not adequate to prepare them for such important tasks (24). In a Brazilian study, FacioJr FN et al., evaluated the effect of one day course regarding sexual education delivered during last two years of medical undergraduates. They observed that students’ confidence level had improved to deal with patients’ sexual issues (25). Coleman E et al., reported and recommended that inclusion of integrated sexual health curriculum throughout the medical course has its multi beneficiary effects from the inter-personal to professional fronts (26). A study by Aggarwal O et al., reported that 85% of medical students favoured the introduction of sex education at the school level (27). Similarly in present study, though the majority were dependent on internet as their main source of sexual health information, 64.33% expressed the need for introducing some formal and well-structured course based on sexual and reproductive health topics.

The topics related to sexuality and reproductive health are not commonly discussed with adolescents by their elders. This study was an attempt to understand the awareness, attitude towards sexuality and the need to be informed by a formal sex education program among urban adolescent’s population.

Limitation(s)

Small sample size and study population from only one institute was one of the limitations and authors wish to extend it further to other medical institutes. Being children’s first educator, the parents’ perspective regarding the above discussed issues is equally important to be understood. That would be yet another area for further exploration.

Conclusion

The results of this study indicated that there is a dearth of communication between the adolescents (even though they are into medical profession) and their parents regarding sexual and reproductive health matters. Adolescent’s attitude about sexual matters is guided by their religious beliefs. Majority of the adolescents preferred discussion with their peers and acquiring information through internet which can be unreliable at times. Hence, in order to develop positive sexual attitudes and maintain their reproductive health, this study recommends the inclusion of formal sexual education program in the early years of adolescence.

Acknowledgement

Authors would like to express their gratitude towards the Dean of the institute, Dr. K.B. Patil (Professor and former Head of Department, Department of Physiology) for the guidance and support during implementation of the project. Authors sincere thanks to Dr. Abhay Mane, Professor, Department of Community Medicine, SKNMC, Dr. Shraddha Kulkarni Department of Preventive and Social Medicine and Ms. Tejashree Kulkarni for statistical assistance.

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DOI and Others

DOI: 10.7860/JCDR/2022/53754.16107

Date of Submission: Jan 05, 2022
Date of Peer Review: Jan 20, 2022
Date of Acceptance: Feb 01, 2022
Date of Publishing: Mar 01, 2022

AUTHOR DECLARATION::
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jan 12, 2022
• Manual Googling: Jan 31, 2022
• iThenticate Software: Feb 02, 2022 (9%)

Etymology: Author Origin

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