The Role of Mass Media in Iranian Youth's Premarital Sexual Relationships: A Qualitative Study.

BACKGROUND: Youth's sexual behaviors have various consequences such as unwanted pregnancy, acquired immunodeficiency syndrome and sexually transmitted infections. Little information is available about the impact of mass media in the development of premarital sexual relationships. This study aimed to explore the role of mass media on premarital sexual relationships among Iranian youth.
METHODS: This qualitative study was conducted with 26 single boys and girls aged 18-24 years who were living in Isfahan, Iran and have already been started their sexual relationships. Also, 12 other participants who were involved in such an experience were recruited in this study. Data was collected using semi-structured interviews and the observation of youth's sexual interactions in different fields. Conventional content analysis method was used for data analysis.
RESULTS: Three main categories were developed: "foreigner media as the role model", "the ease of access to sexual contents and materials" and "the ease of interactions and relationships with the opposite sex".
CONCLUSION: The prominent role of mass media in the formation of premarital sexual relationships was described in this study. This issue needs to be taken into consideration by policy makers for taking necessary actions for reducing the impact of mass media on the youth's engagement in premarital sexual relationships.

INTRODUCTION

Nowadays, the health of adolescents and young people is one of the pillars of public health throughout the world. In this respect, the International Conference on Population and Development (ICPD) in Cairo (1994), emphasized the significance of adolescents’ health.[1] In recent years, sexual behaviours by adolescents and youth are considered the main health priorities in any society, because of the ever-increasing prevalence of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), sexually transmitted infections (STIs) and unwanted pregnancies.[2]

In recent decades, girls and boys mature at younger ages across the world; they marry later and commit premarital sexual activities to a greater extent than before. During the past several decades, a significant number of teens across the world have experienced sexual activities before marriage.[3] In this regard, boys and girls with the age range of 15-24 years are at the risk for HIV infections and one third of new cases of STIs belong to the age group of lower than 25 years.[4]

Chlamydia has affected 10 percent of teenagers who are sexually active, which can lead to pelvic inflammatory disease (PID), ectopic pregnancy and infertility.[5] Unwanted pregnancy is caused by unprotected and premature sexual intercourse that can lead to unsafe induced abortions and physical and psychological problems.[4]

Despite the sexual behaviour of young people affected by hormonal factors, the role of psychosocial factors such as family, friends and peers, alcohol and drugs and mass media cannot be overlooked.[6]

Mass media are significant in the socialization teenagers and can change their beliefs and perspectives through providing an access to various materials and contents[7] especially with regard to premarital sexual relationships.[8]

The result of a study with secondary school students in Nigeria (2015) showed that about 56.3 percent of females and 26.5 percent of males affirmed that watching sex scenes on the TV affected their sexual behaviours.[9]

Furthermore, the findings of a study in the Southeastern United States showed that adolescents who were exposed to sexual contents in the media, and who perceive greater support from the media for teen sexual behaviors, reported greater intentions to engage in sexual intercourse and sexual activities.[10]

Some of the Iranian studies have been performed on this topic,[11,12] but it seems that there has not been much efforts for gaining an in-depth understanding on the effect of mass media on premarital sexual relationships. Legal restrictions and religious prohibitions and regulations on sexual relationships are available in the Iranian society. There are incidents showing risk taking sexual behaviors by Iranian teenagers and youth.[13] Therefore, this study aimed to explore the role of mass media on premarital sexual relationships among Iranian youth.

MATERIALS AND METHODS

This qualitative study was one part of a larger qualitative research using a grounded theory approach, which began in January 2011 and lasted for 18 months.

Recruitment of Participants

The participants of this study were 26 boys and girls aged 18-24 years old who were living in Isfahan, Iran and have already started their sexual relationships. Those who were willing to take part in this study were recruited. Access to the participants was made possible through visiting universities, parks, and sport clubs with a higher number of youth in such locations. The purposeful and snowball methods were applied for sampling.

Maximum variations in sampling were considered in terms of age from 18 to 24 years, genders, economic conditions, social backgrounds. Also, 12 other participants including parents, teachers, school consolers, clinical psychologists, family counselors, and healthcare providers (nurse, midwife, gynecologist) who were involved in such an experience were recruited in this study. The research ethics confirmation (ethical code: 390436) was obtained from the ethics committee affiliated with Isfahan University of Medical Sciences. The participants were informed about anonymity, confidentiality and the right of leaving this study in any desired time. Also, the written informed consent form was signed by those who willingly agreed to participate in this study.

Data Collection

In-depth, individual, semi-structured interviews were held. Most interviews were conducted in one session with each participant. However, the necessity of improving the depth of data collection led to holding more than one interview session with some participants. The interviews lasted from 45 to 135 minutes. The interviews continued until data saturation was reached.

The main question asked during the interviews was: “what do you know about relationships and friendships between single boys and girls in the society? Branching questions were asked to guide the interviews.

The place of the interviews was chosen based on the participants’ preferences.

Three girls and one boy were selected as the key informants. The reason for their selections was their experiences on the study topic. Also, they helped with access to other probable participants. The nonverbal behaviours of the interviewees were considered and some notes were taken as observations to complete the data collection. As writing notes, the researcher wrote down all ideas and coming to her mind while she was collecting or analyzing data in the forms of short and long memos. Writing the memos helped the researcher with the sampling process and conceptualization its procedure. Later, by the progresses in the coding procedure and formation of new concepts, the memos were constantly completed and re-written.

Also, the observation of youth’s sexual conversations and interactions was performed in different natural places such as the internet café, parks, coffee shops, restaurants, malls, gyms, entertainment centres, universities, shopping centres and cinemas. The key informants were asked to take care of anything that had a sexual nature and write them down their observations without any type of interpretation. To ensure the accuracy of writing the notes, some education sessions were held and in total, 40 episodes of field observation were conducted.

Data Analysis

Data analysis was carried out concurrently. The interviews were transcribed verbatim. The transcriptions and notes taken from field observations were analyzed using a conventional qualitative content analysis method. This method is suitable for the subjective interpretation of the content of textual data using a systematic process of coding for identifying categories and themes.[14]

The interviews were read several times to obtain a sense of whole. The text was divided into meaning units, which were abstracted and labeled with codes. The codes were compared based on their differences and similarities and sorted into categories and sub-categories.

For the credibility of the study, 18 months was spent on data collection. Developing a close relationship with the key informants and attracting their trust helped with the credible of the data.

In line with the long duration of data collection, prolonged engagement with the data enhanced the depth of the data analysis. Sampling with the consideration of maximum variations added to the credibility of the data.

As member checking, a brief report of the data analysis process, codes and transcriptions were sent to five participants and their feedbacks and perspectives were sought.

For confirmability, three university professors who were expert in the field of sexual behaviors, nursing, and clinical psychology were requested to assess our findings and check the process of data collection and analysis. Their perspectives and comments led to some modifications in findings.

Data transferability was ensured through asking the perspectives of two boys and two girls who had similar characteristics with the participants of the study, but did not take part in the study. With regard to reliability, external audit was performed through asking an expert researcher who was not involved in this study to provide feedbacks on findings.

RESULTS

Of 26 single youth participated in the study, 15 people were girls and 11 were boys. Also, 15 people were university students, six were working, one was jobless, and four people were working and at the same time were studying at the university. In the group of 12 participants, four people were parents, two were teachers and school counselors, one was a clinical psychologist, one was a family counselor, one was a nurse, two were midwives, and one was a gynecologist.

It was found that the mass media had a fundamental role in developing premarital sexual relationships. Three main categories were developed: “foreigner media as the role model”, “the ease of access to sexual contents and materials” and “the ease of interactions and relationships with the opposite sex”.

The examples of meaning units, codes, subcategories and main categories were shown in Tables 1-3.

Table 1

The examples of meaning units, codes, sub-categories and main category

Meaning unit	Code	Sub-category	Main category
“…on the satellite TV I saw a movie in which a girl had a love story. It was based on girls and boys friendships. It’s really effective and spreads friendship among girls and boys.”	Spreading friendships among girls and boys through satellite channels	Taking a model in friendship with the opposite sex	Foreigner media as the role model
“…Especially now oral sex is quite common. One of its main reasons is watching such movies (sexy movies) and CDs!!!”	Being common to have oral sex followed by watching pornographic movies	Mimicking to have sexual acts

Table 2

The examples of meaning units, codes, sub-categories and main category

Meaning unit	Code	Sub-category	Main category
“…The youth use the internet more because they can easily search any desired subjects.”	The possibility of the easy search on the internet related to sexual issues	The ease of sexual subjects’ search	The ease of access to sexual contents and materials
“…A girl or a boy looks for sex movies, renders sell them and so they buy and watch them!!!”	Easy access to sex CDs	Easy exchange of sexual contents

Table 3

The examples of meaning units, codes, sub-categories and main category

Meaning unit	Code	Sub category	Main category
“…As an example one of my friends a couple of weeks ago happened to meet a girl by sending a message. They didn’t know and see each other previously. They lived in different cities.”	Beginning a friendship via cell phones	Shaping friendships	The ease of interactions and relationships with the opposite sex
“…In a sexy web, first it is a face to face meeting, then they start sexual dialogues. It’s actually like a real sex. They take off clothes and then show their genitalia. While they see each other’s, they massage their genitalia and continue to be satisfied.”	The possibility for the girls and boys to be satisfy through sexy web	The possibility to have sexual experiences

Foreigner Media as the Role Model

The participants mentioned that in recent years the expanded access to satellite channels have increased premarital sexual relationships. They believed that some youth and parents were affected by the foreigner’s culture, and found no problem with free relationships before marriage.

“I don’t think there are other reasons rather than the western culture in forming pre-marital relationships among girls and boys. It means that we freely can talk with opposite sex and go for relationships…. But in the past, it wasn’t so.”(Boy, 23 years old)

The participants mentioned that role models in the media such as internet, satellite channels, CDs from these sources, mobile phone Bluetooth and pornographic materials changed sexual relationships as something ordinary for the participants. Therefore, they experienced anal and oral sexual relationships. The participants mentioned that the formation of such experiences among boys and girls meant being updated, open-minded and being from high class families.

“…. One of its main reasons is the CDs that youth watches. When they see a girl easily does so [sexual relationships], girls also enjoy it and want to experience it somehow. They also think that such things are ordinary and must be present in boy and girl relationships.”(Boy, 24 years old)

According to the participants’ comments, having the role model from western mass media in the case of parties and gatherings, the use of alcohol drinks led to sexual behaviours (Table 1).

“… They usually try something before sex. It could be drug, alcohol, something that they can enjoy.”(Boy, 23 years old)

The Ease of Access to Sexual Contents and Materials

The participants mentioned that internet was an expanded source for gaining easy and fast information in different fields such as sexual acts, how to have more pleasure in sexual relationships, features of hymen, and methods for prevention of pregnancy.

The participants mentioned that a universal access to mass media such as mobile phones and Bluetooth made the process of access to these materials easier.

“... The great numbers of pornographic films are accessible. In any house you go, you can find a computer and it is impossible not to have a film in it.”(Boy, 23 years old)

The participants mentioned the increased sexual thirst and excitement coming by watching such materials were the reason for having vaginal and non vaginal sexual relationships (Table 2).

“.... Well, everyone needs sexual relationships. However, not until it is evoked. All girls at this period of time have tried watching pornographic movies. When they watch these movies alone, they feel like meeting their sexually needs and try to establish relationships with the opposite sex.”(Girl, 24 years old)

The ease of Interactions and Relationships with the Opposite sex

The participants emphasized the formation of opposite sex friendships using mobile phones.

“…10 or 15 years ago a child or even a university student didn’t have mobile phone. Now, it’s enough to cross over in front of a high school and see the case of the mobile phone usage.”(Family consular)

The participants stated that the internet facilitates friendships between girls and boys through dialogue and social networks such as the Face book. Also, following virtual friendships there will be meetings in real space that continues. In addition, through dialogue and rooms’ features, sharing of photos, audio and video (via web cameras and real-time video communication) on the internet is possible. Girls and boys engage in sexual experiences through cyberspace. Such experiences were named “sexy chat” and “sexy web”. According to the participants, the “sexy chat” between male and female occurs when sexual dialogue takes place. In the “sexy web”, girls via web cameras show images of different parts of their own body (mostly breast and genital organs), and touch or rub their genitals.

“... When a boy makes a relationship with a girl and they also have real sex experiences with each other. What happens if a boy says show me yourself. Show yourself via the web.”(Boy, 24 years old)

According to the participants, in the friendship of girls and boys, relationships and sexual experiences also take place through mobile phones, which is called as “phone sex”. They believe such sexual experiences (among boys and girls) happen in cases where access to each other in a private area for the sake of engagement in sexual activity is not possible and phone sex is an alternative. In “phone sex”, sex dialogs between male and female happen and genital organs are touched and rubbed (Table 3).

“... In a phone sex, for example, a boy says, imagine you are beside me. We want to have sex. What will you do? The girl will talk with the boy and he touches himself.”(Girl, 21 years old)

DISCUSSION

According to the findings of this study mass media affects the formation of sexual behaviours among youth and adolescents by the means of transferring values and sexual norms. These are regarded as a facilitative factor and develop opposite sexual friendships.

In this regard, the media is considered a facilitating factor for sexual socialization among adolescents.[10] Sexual socialization is a process in which sexual knowledge, attitudes, skills, norms, and expectations are being internalized and accepted in a society. This long process is being continued during life.[15] According to social scientists, the mass media can empower or weaken social norms.[16] Social pressures for experiencing sexual relationships and being misguided by the mass media are opposite to the effects of social and religious values for achieving chastity.[17] Sexual contents and materials through the mass media is effective in developing premarital sexual relationships.

Despite the limitations and inhibitions of premarital sexual relationships in the Iranian society, the participating young people in the present research had sexual relationships under the influence of the media. The results of present study were similar to the findings of a study conducted in the USA. The researchers found that exposure to sexual content in music, movies, television, and magazines accelerated white adolescents’ sexual activities and increased the risk for engaging in an early sexual intercourse.[18]

Furthermore, in a study on adolescents, researchers observed the substantial association between the sexual content viewed by adolescents and advances in their sexual behaviour during the subsequent year.[19] Numerous studies showed that having access to sexual contents through the media affected the formation of sexual relationships.[20,21] In this regard, a constant confrontation with such topics in young ages changed in sexual behaviours and increased youth’s involvements in such relationships.[7]

The result of a study in the north east of Ethiopia showed that premature sexual relationships were related to watching pornography movies. Those youths who watched such contents in the ages of fewer than 18 years, the possibility of relationships were 2.9 percent higher than those who watched such contents after the age of 18 years.[22]

We found that, youth faced the media pressure to engage in premarital sexual relationships, which increased the risk for unintended pregnancy and STIs/HIV/AIDS.

Moreover, compared to other age groups, biological factors of adolescence, age highly exposed them to HIV/AIDS and STIs. Adolescents are among those groups who are the most susceptible people to HIV/AIDS and STIs.[17] Therefore, it is possible to help adolescents and youth through education about HIV/AIDS and STIs and inform them about these diseases. In this regard, empowering and informing youth about sexual relationships and informed decision-making move them toward a more responsible approach with regards to sexual health. Therefore, it is necessary to plan for educational programs about sexual health for teenagers and adolescents.

Educational programs related to adolescents and youth sexual health can be carried out by using the peer-based educational approach.[23]

Planning educational programs by the healthcare policymakers such as national organizations for youth and ministry of education help youths to learn about life skills such as critical thinking and decision making. These can be effective in reducing their involvements in sexual relationships.

As a limitation of this study, although the present study used the maximum variation in sampling, but there is a possibility for the participants were limited to small networks of peers and friends. Despite such a limitation, our findings can improve our understandings of the role of the media in Iranian youth’s premarital sexual relationships.

CONCLUSION

The participants defined the important role of the media in shaping youth’s premarital sexual relationships. This issue needs to be taken into consideration by policy makers and necessary actions should be made for decreasing the impact of the mass Media on youth engagement in sexual relationships. Through making the youth informed of the risks for sexual relationships and providing them with comprehensive education about HIV/AIDS and STIs, premarital abstinence could be highly emphasized. In this regard, more research is needed regarding the effect of educational interventions on youth’s sexual relationships.