Sex is a fundamental dimension of human life, and unsafe sex among teenagers is becoming one of the important social and major public-health concerns in recent years. Sexuality-related topics have largely remained as a taboo in many Asian countries like Nepal.Friendships between girls and boys are still unacceptable in Nepal, and many rural parents even discourage their daughters from meeting or talking with boys. Sexual activities outside marriage are not accepted among the majority of Nepalese societies. Despite these traditional views, a significant proportion of Nepalese young people are engaged in pre-marital sex which lead to various consequences like teenage pregnancy, unsafe abortion, death of mother, HIV infection, depression, etc. There is a saying that says about pre-marital sex as,” you are a beautiful rose, each time you engage in pre-marital sex a precious petal is stripped away, don’t leave your husband or wife holding a bare stem.” So being loyal to future husband or future wife is to be loyal with yourself with your own health as pre-marital sex leads to the worst health and degrades ones quality of life.
Teenagers are the group of young people of age 13-19 years who are at the stage of transitional physical and mental human development tends to seek independence and experiment with youth risk behaviors and capable of taking care of themselves. The population of teen accounts 33% of total population in Nepal. Large number of teenagers are involved in unsafe pre-marital sex .Changing social morals with modernization is one of the most important causes of premarital sex. In most urban areas, having a boyfriend or girlfriend is becoming more and more acceptable. With the increasing influx of Western values through globalization and the media, many teenagers feel social pressure to pair up early and engage in sexual behavior. Lacking maturity and a proper understanding of contraceptives, teenagers often end up participating in risky sexual behavior, leading to pregnancies. Though contraception might be easily available in urban areas, teenagers, especially girls, feel uncomfortable purchasing them from pharmacists, who are mostly in high risk and such premarital sex can lead to different consequences like teenage pregnancy, unsafe abortion, death of the mother, many physical and mental illnesses likes depression can occur. 22% of teen have sex before marriage. Practice of unsafe sex among teen in Nepal is on rise in Kathmandu valley, heighten the chance of causing HIV/AIDS. According to the study, 67% teenagers had sexual relationship before crossing the age of 17.among the survey teens, only 15% said that they used condoms during their first sex.Around half of the teens said they have sexual relationship with one or two female partners. On girl side around one third said they also have sex with one or two male partners. Education about responsible sexual behavior and speciﬁc clear information about the consequences of sexual intercourse is frequently not offered in the home, at school, or in other community settings in Nepal. Young people today are growing up in a culture in which peers, TV and motion pictures, music, and magazines often transmit either covert or overt messages that unmarried sexual relationships are common, accepted, and at times expected, behaviors. Talking about sexuality of young people mean age at first sexual intercourse for the age group 15-19 years is 16.24 and for 20-14 is 18.14.Moreover; on average, young male ages 15-24 had 2.6 numbers of sexual partners in life time. There is poor communication among youths when it comes to discussion about sexual health.51.80 young girls(10-24) were reported having discussed about the issue related to marriage, pregnancy, mensuration,love,family planning, wet dreams and puberty which is more than 48.2% of young boys. Government of Nepal and various organizations have launched many AIDS related programs to aware teens of the deadful diseases. But due to lack of awareness among teens about using sexual means and programs to change their behavior, a large number of teenagers are at risk. Peer pressure, conﬂicts with parents, failure in love relationships, anxiety about the future, and the overpowering inﬂuence of disadvantaged social and economic conditions – all conspire to push young people onto the dangerous path of high-risk behavior including unsafe sexual practices. Early marriage has traditionally been common in Nepalese and other South Asian societies although the practice of delayed marriage appears to be on the increase in Nepal. With the advent of delayed marriage comes a window of opportunity for pre-marital sexual activity. This may create risks of unwanted pregnancy and Sexual Transmitted Infections (STIs), especially in an environment in which information and services on sexual health are not easily available. The Nepal Demographic Health Survey carried out in 2005 also shows that current use of modern contraceptive method is only 14% among currently married girls age 15-19. Percentage for the age group 20-24 is 28%. .though most of the study shows that awareness about condoms and its role to prevent HIV and use of condom during sexual intercourse is irregular and low. Unavailability of condoms, unpleasure, partners not ready to use condoms during sexual intercourse are the main reason for not using condoms among people. This shows that a majority of the young people in Nepal are not using any contraceptive method which is contributing to high adolescent fertility.
A qualitative study conducted among injecting drug users shows that most of the respondents have experienced unsafe sexual practices (multiple partners, female sex workers, group sex). This should be taken into account since most of the respondents were from 10 to 25. This study also documents that most of the respondents enjoy sex when they are on drug trip. Study conducted in other settings also found positive associations between drug, alcohol and sexual behavior. Another study conducted with the young men in border towns in Nepal found that young men who reported alcohol consumption had almost four times higher odds of Having casual sex than young men who did not consume alcohol. In such condition their decisions towards safer sex might be affected due to the inﬂuence of drugs and alcohol since young people recognize that alcohol reduces social and sexual inhibitions and reduces concern about disease prevention and safe sexual behavior. Process of urbanization and the increasing inﬂuences of western cultural affect on many population groups, but especially the young, are also seen to be responsible for the breakdown of traditional customs. In this sense, the increase in pre and extramarital sex is seen by many authors as a consequence of the induction of western norms and value. In addition, there could be a strong inﬂuence of popular culture (TV, movie, internet etc) on their sexual behavior and attitudes. United States evidence suggests that sexual content on media in general encourage adolescent to initiate all types of sexual activity, including sexual intercourse which could easily applicable into Nepalese society since most of the young people residing in urban areas are exposed to western TV channels. Young people of rural areas have high and risky sexual behaviors. For example, premarital sexual practice among young people is disregarded by the local culture. It envisages that Nepal is still carrying some cultural taboos which directly or indirectly inﬂuence the young people’s sexual health and behavior.
There has been practising to develop policies and programs to address sexual and reproductive health need of young people in Nepal. Different governmental and non-governmental originations working on these ﬁelds have formulated their own speciﬁc policies and program to address young people’s sexual health. However, the National Reproductive Health Strategy developed in 1998 and National Adolescent Health and Development Strategy developed in 2000 and Young People Development Program in 2002 have focused the integrated and incorporated sexual and reproductive health services. Increasing availability and accessibility of appropriate young friendly sexual and reproductive health information are the main aim of the strategies. The Government of Nepal has introduced population and reproductive health education in public schools for grades 6 to 10 and also in university curriculum.
To reduce this public health problem education about adolescent and reproductive health at school, colleges should be promoted. Knowledge about contraceptive devices should be disseminated in youth friendly manner. Early marriage practice should be discouraged. Parents should do proper counseling about sexual health with their children at homes.Awarness program about sexual health and consequences of unsafe sex practices through mass media should be encouraged.
I think our first school is our home, but we are not given education about sexual health in our own family though our own mum and papa and our elders though they are literate. Even if we ask about such topic we are scolded in Nepali culture. We still feel shame to say that I do have girlfriend or boyfriend. Teachers in many school and college skip such topic if it comes in some chapter or discussion. We even can’t express if we had a sexual relationship with someone. Is doing safe sex is crime? It’s still a debatable question??
- www.egorkhapatra.com(Kathmandu, Nov. 29,2013)
- Sexual and reproductive health status among young people in Nepal:
opportunities and barriers for sexual health education and services
Kathmandu University Medical Journal (2008), Vol. 6, No. 2, Issue 22, 248-256