This study examines factors influencing undergraduate students who are all Muslims from one of the public universities in Malaysia. Data were obtained from a survey conducted among the undergraduate students (n=255). Principle Components Analysis (PCA) revealed four latent factors: the electronic and printed media, knowledge of circumcision, the Islamic values on sexuality and their prior knowledge of sexual act. Based on the views of the respondents on the roles played by curriculum, religion and media in disseminating knowledge on sex-related matters, recommendations are drawn to assist the relevant parties in coming up with comprehensive sexuality education for Muslim adolescents.
sex/sexuality education, reproductive health, undergraduate student, Muslim, perceptions, Principle Component Analysis (PCA)
Studies which have been carried out in Muslim societies on sexual and reproductive health are limited. Many young Muslims are emitted from the learning process to cater the cultural and religious restrictions (Cok, 2000; DeJong et al., 2007; Halstead, 1997; Nurazzura, 2007; Underwood, 2000). Very little is, therefore, known about the factors that influence the Muslim youths on sexual and reproductive health. Several studies in some Muslim countries reported that Muslim youth are not well prepared and educated in sexual and reproductive health due to some contributing factors. (Burazeri et al., 2003; GÖkengin et al., 2003; Mohammad Reza et al.,2006; Nik Suryani et al., 2007; Paruk et al., 2006).
Cok (2000) described sex education in Turkey, as similar as many other Muslim countries in the world, as “there are no sexuality classes, no mention of sexuality in health courses or no sexuality textbook material in Turkish school. Other issues take priority and sexuality education is pushed aside as unimportant and irrelevant” (p.5). Moreover, he stated that Turkish Muslim adolescents are highly influenced by media especially form Europe and North America. In addition, the study on 2,227 first-and fourth -years students at Ege Univesity, GÖkengin et al. (2003) revealed that knowledge about sexual health and sexuality transmitted diseases is insufficient among their samples.
In Albania, Burazeri et al. (2003) reported the mean age at first sexual intercourse 720 undergraduate students in Tirana was 17.9 for men and 18.8 years for woman. They also found positive associations of parental education and income level with sexual activity and consistent use of condoms among Albanian undergraduate students.
Mohammad Reza et al. (2006) described the sex education in Iran that cultural sensitivities which may be a factor in young people’s poor knowledge about reproductive health. Furthermore, few programs provide sexuality education to adolescents or enable youth to ask questions and correct misconceptions about reproductive health. Indeed, large numbers of young Iranians lack information about safe sex and about the skills necessary to negotiate and adopt safe sex practices. In their study of 1,385 males aged 15-18 in Tehran about their beliefs and knowledge regarding reproductive health and their engaging in sexual activity, they found that there was a relatively high prevalence of sexual activity and the lack of knowledge regarding STIs and contraceptives pose a significant threat to the sexual and reproductive health of Iranian adolescent males. Hence, they requested programs to provide adolescents with the accurate information and skills to make safe sexual decisions.
A study conducted by Nik Suryani et al. (2007) with undergraduate students (n=300) in Malaysia , discovered that, in general, students held a positive view toward sex and sex-related matters; however, their knowledge on sexuality education, sexual and reproductive health matters calls for attention from the relevant authorities. Findings on their sources of information on sexuality education also revealed that more could be done to help them obtain an accurate picture of sex-related matters particularly with the roles played by parents, school, religion and media in disseminating knowledge on sex-related matters.
Paruk et al. (2006) presented finding on the influence of religiosity on attitude toward people with HIV/AIDS using 90 South African Muslim university students. They found that higher religiosity was significantly correlated with a more positive attitude to people with HIV.
Ojo & Bidemi (2008) conducted a study with 520 adolescent of Nigerian students on contemporary clothing habits and sexual behavior of adolescents in the South Western Nigeria. They found that there is no significant difference in the factors influencing adolescents’ dressing habits and also the fact that there is relationship between clothing habits and their sexual behavior.
In Pakistan, Qidwai (2000) surveyed perception among 188 Pakistani young men, who presented to family physicians, at the outpatient department of the Aga Khan University Hospital, Karachi, about enjoyment of sexual experiences in women. He found a high prevalence of misconceptions about female sexuality among Pakistani young men. Furthermore, Hennink, Rana, & Iqbal (2005) studied on knowledge of personal and sexual development amongst young people in Pakistan. They found that young women typically gain information from a limited number of sources while young men accessed a wide variety of information sources outside the home.
From studies done in various Muslim countries, however, there is not enough information on factors influencing the basic sexual and reproductive health among Muslim undergraduate student as well as in other developing countries (Singh, Bankole & Woog, 2005). Intervention studies are largely absent. There is a need therefore to determine factors associated with Muslims’ sexual perception to develop a clear understanding in student variables, the results of which may contribute to help students on their knowledge and behavior regarding to sexual and reproductive health and it will help determine best bets for programs for sex education for Muslim youths.
The purpose of this study was to survey Muslim undergraduate students’ perceptions in sexual and reproductive health, and in doing so, to clarify the meaning of the construct itself. Thus, the study addressed the following research questions: What are the factors influencing Muslim undergraduate students’ perceptions towards sexual and reproductive health?
This study is based on the crossed different populations and geographic regions influencing factor adolescent on sexual and reproductive health studied by Manlove et al. (2001). They pointed out that there are multiple domains in an adolescent’s life associated with reproductive health outcomes. By grounded on the ecological approach, individual factor, family factor, peers, partners, school context, neighborhood, community, and social policy characteristics are all associated with sexual behaviors, adolescent pregnancy, and STI. However, this study only looked at certain dimensions which comprised (1) individual factor (religiosity, knowledge of reproductive health and attitudes and belief about sex); (2) school context (curriculum); and, (3) media.
The authors, therefore, hypothesized that there are four influencing factors of undergraduate Muslim students’ perception on sexual and reproductive health: (1) school and tertiary curriculum support, (2) Islamic values on sexuality, (3) electronic and printed media, and (4) students’ prior knowledge on sexual and reproduction health.
Results of this study are pictured to provide empirical data on factors influencing perception on sexual and reproductive health among Muslim undergraduate students that have not been fully studied. Thus, the results of this study are expected to help in the understanding of students’ perception towards sexual and reproductive health and sex education which is promoted by several factors. The findings are beneficial to understand and determine the success or failure of factors influence and the implementation of sex education in Islamic higher learning institute as perceived by students. Such information can help to improve the strategy in order to accomplish the sex education particularly for Muslim youths.
In this study, the survey method was employed. A questionnaire was selected from Nik Suryani et al. (2007) measured these relationships. It consisted of two parts. The questionnaires were distributed randomly to a sample of undergraduate in the International Islamic University Malaysia (IIUM).
The population is the undergraduate students in IIUM, Gombak campus, Kuala Lumpur, Malaysia. All were Malaysians. A random sampling was used to select participants. The principle component analysis (PCA) was conducted where the number of sample depends on the items of the questionnaire. Since the number of the item is 40, the minimum sample size is 40 x 5 = 200 participants. In this study, the participants were 255 which were more than the minimum requirement (Hair et al., 2006).
To distribute the questionnaires, researchers sought help from three students which researchers have known. The questionnaire has an attached covering letter that assures the confidentially of data collected and describes the major components of questionnaires to be completed. Students were given one week to complete the questionnaires and had to return them to the assigned persons within the time allocated. The usable returned response rate was 72.9 % (n=255) out of 350 students. The data collected was operated on January 2008.
To establish the face and construct validity of the instrument, the opinions of two experts in education were sought on the design and items used for the various dimension. The instrument was pilot tested on 30 students that was not on the list of the selected students. Based on the pilot test, 50 items from Nik Suryani et al. (2007) was tested and a few items were omitted in order to refine the instrument further. Finally, 40 items were confirmed with a reliability of Alpha Cronbach = .72.
The survey instrument was adopted from a core questionnaire developed by Nik Suryani et al. (2007). The questionnaire comprised 40 questions divided into two sections: social and demographic variables and students’ views and knowledge on a wide range of topics on sex and attitudes towards sex. It sought to find out students’ perceptions on:
(1) school and tertiary curriculum (5 items; no.1-5);
(2) Islamic values on sexuality (6 items; no.6-11);
(3) electronic and printed media (4 items; no.12-15):
(4) sexual novel (4 items; no.16-19):
(5) their prior knowledge of sexual and reproductive health
The response to each item is in the form of a five-point Likert scale of “strongly disagree’, “disagree”, “undecided”, “agree”, and “strongly agree”.
The demographic characteristic of the first section of the questionnaire contains questions with regard to the respondent’s background information (gender, age, country of origin, former school and location, faculty, year of study, CGPA, and marital status).
For the demographic data, frequency and percentage were employed. To answer the research question on factors influencing students’ perceptions of sexual and reproductive health, principle component analysis was utilized.
An explanatory factor analysis was conducted to construct-validate the factor influencing students’ perception. To find out the number of factors the following rules were used: (1) the Kaiser’s rule of 1.0 as the minimum eigenvalues, (2) the scree test and (3) the interpretability of the solutions. The degree of intercorrelation among items justified the application of the factor analysis as well as the Batlett’s test of sphericity recorded a Chi square value.
Table 1 shows out of 255 students, 152 (59.6%) were females and 101 (39.6%) were males. A majority of the students (91.4%) were between 20 and 25 years of age, the remaining being distributed between the age group of younger than 20 (7.4%) and older than 25 (1.2%). Approximately, 239 (93.7%) of the respondents were Malaysians while 16 (6.3%) were international students. Most of students (37.2%) graduated from urban day school, followed by religious school (27.1%), boarding school (16.5%), rural day school (9.0%), private school (5.9%), and others (1.9%). The respondents were represented from different faculty with nearly half (42.4%) being law students (AIKOL). The other half was distributed between Human Sciences (24.3%), KENMS (11.8%), ENGINEERING (7.1%), KAED (5.5%), INSTED (3.9%), KICT (2.7%), and IRK (2.4%) respectively.
Majority of students were second year student (32.5%), the remaining being almost distributed between the final year (29.8%), the first year (21.2%), and the third year (16.5%). In general, almost more than half of the students (49.4%) had CGPA more than 3.0, while the rest (28.7%) had less than 3.0. Almost 95.7% students were single which 131 (53.7%) were not attached to someone and 110 (45.1%) were having attached to someone, only 11 (4.3%) students were married.
Variables
N
Percent
1. Gender:
Male
101
39.6
Female
152
59.6
Missing Value
2
0.8
2.Age
<20
19
7.4
20-25
233
91.4
>25
3
1.2
3.Country of Origin
Malaysian (local student)
239
93.7
Non-Malaysian (international student)
16
6.3
4. Former School and Location
Urban Day School
95
37.2
Rural Day School
23
9.0
Boarding School
42
16.5
Religious School
69
27.1
Private School
15
5.9
Others
6
2.4
Missing values
5
1.9
5. Faculty
Information and Communication Technology (KICT)
7
2.7
Engineering
18
7.1
Laws (AIKOL)
108
42.4
Human Sciences (HS)
62
24.3
Islamic Revealed Knowledge (IRK)
6
2.3
Institute of Education (INSTEAD)
10
3.9
Economics and Management Sciences (KENMS)
30
11.8
Architecture and Environmental Design ( KAED)
14
5.5
6. Year of study
1st year
54
21.2
2nd year
83
32.5
3rd year
42
16.5
4th year
76
29.8
5. CGPA
< 2.00
1
0.4
2.00-2.49
11
4.4
2.50-2.99
61
23.9
3.00-3.49
102
40
>3.50
24
9.4
Missing Value
56
21.9
6. Marital status
Single
244
95.7
Single and have attached to someone
110
45.1
Single and have not attached to someone
131
53.7
Missing Value
3
1.2
Married
11
4.3
n = 255
Perceptions toward Sexual and Reproductive Health
Table 2 summarizes the results of the descriptive analysis of the students’ perceptions on sexual and reproductive health. The data showed that the mean scores ranged between 1.83 (items PRO23) and 4.57 (items REL10); the standard deviations ranged from .66 (items SEX34) to 1.18 (items PRO23). The mean scores were located within the expected range (none of the items are included a mean score of zero, at 95 % level of confidence, with a reliability of Alpha Cronbach = .72). The data showed that the dispersion of the scores for each item sufficiently discriminated the students’ perceptions. In addition, the degree of bivariate correlation among most of the 40 items matric variables ranged from low to high. However six of them (items EDU1, EDU2, PRO24, SEX28, SEX31, and CIR39) were found to link weakly and negatively with the rest of the items.
Items
Code
M
SD
r
1. The content of information on sexual related matters taught at school is sufficient.
EDU1
2.95
1.157
.081
2. Courses like Family Management and Parenting at undergraduate level should openly discuss sexual and reproductive health matters.
EDU2
4.11
.876
.023
3. Sexual education should be taught as subject of its own at secondary schools.
EDU3
3.28
1.176
.227
4. Sexual education should be taught as a separate subject at the tertiary level.
EDU4
3.60
1.043
.195
5. Sexual education should be taught in pre-marital courses.
EDU5
4.38
.686
.176
6. Qur’an provides me with information on sexuality in a decent manner.
REL6
4.38
.789
.239
7. My religious knowledge provides basis for me to develop the conscience not to engage in premarital sex
REL7
4.52
.728
.192
8. Religion helps me suppress my sexual desire.
REL8
4.26
.847
.237
9. Fasting is one of the best ways to keep my sexual desire under control.
REL9
4.31
.910
.327
10. Watching pornography is forbidden in Islam.
REL10
4.57
.767
.303
11. The only way to eliminate illicit sex is by implementing the Syariah Law.
REL11
4.19
.922
.389
12. Electronic media portrays negative perception of sexuality.
MED12
3.70
1.079
.339
13. Printed media portrays negative perception of sexuality.
MED13
3.65
1.075
.372
14. Electronic media leads young people to embark on pre-marital sexual relationship.
MED14
4.10
.927
.357
15. Printed media leads young people to embark on pre-marital sexual relationship.
MED15
3.94
.987
.412
16. Reading sexy novels leads people to having pre-marital sex.
NOV16
3.42
1.036
.354
17. Novels are most descriptive about sexual intercourses than other sources.
NOV17
2.98
1.072
.350
18. Novels with sexual descriptions increase my desire to masturbate.
NOV18
2.69
1.107
.324
19. Novels with sexual descriptions increase my sexual fantasies.
NOV19
2.95
1.093
.268
20. There is fertility problem if pregnancy does not occur in the first year of marriage.
PRO20
2.52
.972
.218
21. Unprotected sexual intercourse will guarantee pregnancy.
PRO21
3.32
1.175
.339
22. Protected intercourse guarantee pregnancy won’t occur.
PRO22
2.70
1.085
.235
23. Kissing and touching can lead to pregnancy.
PRO23
1.83
1.177
.153
24. The use of contraceptives or protected sex ensures safety from sexually related diseases.
PRO24
3.41
.996
.069
25. Islam forbids the use of contraceptives.
PRO25
2.87
1.010
.169
26. Preservation of virginity is most important for both men and women before getting married.
SEX26
4.53
.781
.125
27. Sex is painful for first timers.
SEX27
3.44
.933
.100
28. Sex is painful for women.
SEX28
3.22
.886
.069
29. Sex is pleasurable to both men and women.
SEX29
4.04
.853
.162
30. Only matured people enjoy sexual relationship.
SEX30
2.88
1.088
.100
31. Sexual relationship is for young people only.
SEX31
1.91
.909
-.057
32. Good Communication between spouses ensures satisfying sexual relationship.
SEX32
4.32
.839
.100
33. Knowledge about sex is a pre requisite for enjoying sex.
SEX33
4.05
.876
.246
34. Understanding between each other’s needs help improve sexual satisfaction.
SEX34
4.39
.660
.168
35. Circumcision is mainly for health reasons.
CIR35
3.93
1.090
.192
36. Circumcision is for cultural reasons.
CIR36
2.43
1.033
.189
37. Circumcision for women reduces sexual satisfaction.
CIR37
2.89
.935
.116
38. Circumcision for women represses their sexual desires.
CIR38
2.96
.856
.235
39. Circumcision for men reduces sexual satisfaction.
CIR39
2.59
.977
.076
40. Circumcision for men represses their sexual desires.
CIR40
2.92
.969
.105
To identify the factors that influence undergraduate Muslim students’ response toward sexual and reproductive health, the data collected from the sample of 255 respondents were subjected to principal component analysis. Nevertheless, the present analysis used only the responses on the 34 of the 40 items (Table 3). Based on the results of item analysis as described in the preceding section, 6 of the items (items EDU1, EDU2, PRO24, SEX28, SEX31, and CIR39) were excluded because they were behaving poorly in the item-total correlation.
Table 3 summarizes the correlations among the 34 items supported the use of principal component analysis. Specifically, the Bartlett Sphericity Test yielded statistically significant intercorrelation c2 (561) = 2525.854, p = .001 with an overall MSA of .65, which exceeded the value of .60.
Thus, the data matrix has sufficient correlation to justify the use of the exploratory factor analysis. The principal component analysis yielded a seven -factor dimension structure, accounting for 60.69% of the variance. This indicates that four underlying dimensions explain more than 60% of the variance among the 34 variables.
The eigenvalues, ranging from 1.616 to 3.0622 (which is greater than 1 as required), satisfied the standards of important factors as prescribed by Hair, Jr. et al. (2006).
EDU3
EDU4
EDU5
REL6
REL7
REL8
REL9
REL10
REL11
MED12
MED13
MED14
MED15
NOV16
NOV17
NOV18
NOV19
PRO20
PRO21
PRO22
PRO23
PRO25
SEX26
SEX27
SEX29
SEX30
SEX32
SEX33
SEX34
CIR35
CIR36
CIR37
CIR38
CIR40
EDU3
.548
EDU4
-.284
.557
EDU5
-.134
-.128
.747
REL6
.051
-.046
-.085
.769
REL7
-.021
.017
-.107
-.385
.735
REL8
.061
-.006
.027
-.125
-.233
.724
REL9
-.052
.028
-.011
-.130
-.104
-.210
.771
REL10
.015
-.084
-.110
-.084
-.023
-.234
-.002
.742
REL11
.007
.040
-.099
.027
-.140
.031
-.194
-.153
.782
MED12
.062
.071
.045
-.034
.068
.107
-.062
-.183
-.005
.669
MED13
-.162
-.074
.029
-.025
-.014
-.082
.046
.100
-.202
-.784
.666
MED14
.046
.052
-.088
.045
-.021
.080
.110
-.118
.071
.005
-.172
.664
MED15
-.032
-.025
.017
.003
.001
-.124
-.044
.120
-.113
-.074
.052
-.763
.688
NOV16
.162
-.022
.047
-.145
.047
.001
-.010
-.069
-.191
.020
.072
-.138
-.034
.757
NOV17
-.020
-.056
.094
.046
.028
.017
-.174
.000
.125
.028
-.029
.045
-.141
-.328
.713
NOV18
-.034
.113
-.078
-.017
-.081
.124
-.030
-.024
.209
-.019
-.076
.141
-.089
-.188
-.191
.591
NOV19
.085
-.105
-.101
.183
-.018
-.168
.126
.040
-.053
-.004
-.012
-.011
.013
-.001
-.047
-.663
.588
PRO20
-.106
.172
.097
-.095
.194
-.099
.024
-.007
-.015
-.018
-.118
-.040
.033
-.075
.118
.036
-.051
.630
PRO21
.032
-.077
-.059
.056
-.056
.056
-.098
.072
-.002
.006
-.031
.051
-.044
-.124
.065
-.090
.049
-.093
.610
PRO22
-.055
-.041
.006
-.023
-.001
.022
-.140
.004
-.097
-.053
.109
.067
-.031
.108
-.111
-.081
.059
-.147
-.290
.485
PRO23
-.120
.028
.054
-.017
.112
-.070
.003
.149
-.198
-.060
.040
-.141
.111
.042
-.050
-.087
.012
.010
-.045
-.196
.619
PRO25
.088
-.126
.092
-.052
.056
.126
-.134
-.206
.005
.114
-.030
-.028
-.017
-.015
.002
.025
-.096
-.120
-.169
.099
-.126
.490
SEX26
.004
-.041
.071
-.092
-.141
.034
-.010
-.063
-.056
-.031
.023
-.049
.067
.080
-.175
.047
.036
-.006
-.204
.086
.101
.057
.671
SEX27
.079
.083
-.093
.080
-.078
-.056
.098
.135
-.107
.051
-.024
-.100
.015
.098
.074
-.135
.085
.026
.196
-.244
.092
-.128
-.197
.319
SEX29
-.085
-.058
-.089
-.088
.013
-.091
.011
-.055
.033
-.086
.153
.029
-.007
.048
-.105
.135
-.199
-.211
-.196
.120
.069
.111
.114
-.195
.572
SEX30
-.023
.064
-.009
-.090
.118
.029
-.161
-.055
.048
-.006
.000
-.110
.075
-.117
-.027
.114
-.097
-.009
.011
-.001
.036
.092
.101
-.143
.147
.536
SEX32
-.243
.095
.094
-.039
.066
-.068
-.006
.074
-.018
-.148
.127
-.028
.018
.047
-.001
-.043
-.004
.231
-.038
.114
.041
-.106
-.040
-.103
-.054
.089
.640
SEX33
-.023
.060
.014
.163
-.195
.084
-.110
-.149
.058
.090
-.043
.062
-.055
-.124
-.088
.088
-.092
-.192
.057
.133
-.119
.097
-.036
-.040
.056
-.046
-.193
.570
SEX34
.127
-.132
-.039
-.139
.173
-.044
.020
.067
-.049
.105
-.085
-.076
.025
.064
.193
-.167
.075
.158
.006
-.155
.072
.032
-.058
.123
-.256
-.054
-.333
-.463
.555
CIR35
-.103
.093
.052
-.006
.018
.025
-.115
-.101
-.075
-.026
.058
-.053
.056
.011
-.026
-.020
-.012
.065
-.052
.054
.038
-.065
-.104
-.074
.019
.018
.053
.128
-.237
.600
CIR36
.003
-.139
.060
-.085
.159
-.147
.181
.069
-.084
.015
.045
-.014
.021
.025
-.197
-.173
.174
-.052
-.137
.084
.010
-.068
.108
-.114
.020
-.026
.032
-.170
.133
-.113
.613
CIR37
-.145
.013
.021
.044
-.011
.168
-.081
.037
.072
-.034
.015
-.086
.068
-.157
.067
.104
-.121
.003
.126
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