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Abstract

Background: Purpose of the Study was to understand the vulnerability in the sexual behaviour of some adolescents in a district in Sri Lanka.

Method: Three-component study: Component I-Pregnant adolescents (Sample 450), Component II- Partners of pregnant adolescents (Sample 150), and Component III- School adolescents (Sample 2020). Data collection tools were interviewer administered questionnaires to pregnant adolescent and partners of pregnant adolescents and self-administered questionnaire to the school adolescents. Ethical approval was obtained from the Ethical Review Committee of SLMA (Sri Lanka Medical Association).

Results: Initiation of sex is non-consensual (either did not want or forced) in almost a quarter (6/23) of the sexually active school girls and one fifth of the sexually active school boys (10/46). Non-consensual first intercourse was reported by 4% pregnant adolescents and 1% partners of pregnant adolescents.

Bivariate analysis showed that male partners whose attitude towards their sexual experiences were uncertain (n=24) or forced (n=2) were more likely to report their adolescent partner’s pregnancy as unplanned. In the multivariate analysis, male partners of pregnant adolescents who said their adolescent partners’ pregnancies were not planned had odds three times higher of having non-consensual first intercourse than the partners who said they planned their adolescent partners’ pregnancies. In the multivariate analysis underage pregnant adolescents had three times odds of having a non-consensual first intercourse than the older pregnant adolescents.

Conclusions & Recommendations: A group of male and females had been equally vulnerable to be sexually victimized. This shows that non-consensual sex exists across all samples. Need appropriate policy formulation in empowering children to be protected from sexual abuse by providing them with appropriate skills from preschool age. 

Key words

first intercourse, non-consensual

Introduction

Adolescence and sexual behaviour

Adolescence is that period between childhood and adulthood and is characterised by substantial physical, cognitive and social development. It is universally accepted that adolescence is a period of sexual maturity that transforms a child into a biologically mature adult capable of sexual reproduction.

Non-consensual sex

Definitions of non-consensual sex vary. However, all definitions rest on a common foundation: a lack of full and free choice in decisions to engage in sexual relations. Intense psychological, emotional, and financial pressure or a fear of social consequences also can compel individuals to relinquish their right to resist unwanted sexual advances. While there is limited data on sexual violence in young people’s relationships, one study in the United Kingdom of 489 young people found that almost one in five girls (17.9%) reported that their boyfriends had either attempted to force, or had forced, sexual intercourse within the past year [1].

Several national surveys carried out in Sri Lanka have reported sexual abuse. UNICEF, (2004) reported 10% of adolescents being the subject of sexual abuse [2]. Thalagala [3], reported sexual abuse in 5.1 % Sri Lankan children aged 8-14 years. Basnayake S [4], reported 7% of adolescents have been sexually molested.

Age of consent

In relation to sexual activity, the age of consent is the minimum age at which a person is legally competent to consent to sexual acts. Sri Lanka’s criminal law recognizes that there is a common age of sexual consent for boys and girls at 16 years. According to the rape laws of Sri Lanka, a man is said to commit rape when “he has sexual intercourse with a woman with or without her consent when she is under 16 years of age unless the woman is married according to Islam law and his wife who is over twelve year of age and is not judicially separated from the man” [5].

Consent to marry

Consent to marry has been an important requirement of marriage under the marriage legislation in Sri Lanka for over a century, [Early marriage legislation, Kandyan Marriage and Divorce Act, (1951), and General Marriages Ordinance (1907)]. This legislation was amended in 1995 to raise the minimum age of marriage for the Kandyan girls from 14 years, and harmonize it with the age of 18 years [6]. Sri Lanka, the study setting, has impressive health and social indicators for a low-income country as well as has one of the most literate populations amongst developing nations [7].

There is little public awareness about ARH in Sri Lanka, primarily due to cultural taboos that have made it difficult for parents, teachers and community leaders to openly discuss key issues among themselves or with adolescents [8]. As a result, channels of communication, such as mother-daughter discussions, teacher-student discussion or peer-to-peer programmes through which adolescents might receive information on safe sex, relationships, reproductive health, and related issues are not widely available to Sri Lankan adolescents [8].

General objective

To conduct a rigorous population-based study including both adolescent boys and girls to explore the vulnerability in the sexual behaviour of some adolescents in a district in Sri Lanka.

Methodology

Study population                                         Sample size                                               Data collection tool

Pregnant adolescent                                         450                                              Interviewer administered Questionnaire

Partner of pregnant adolescent                     150                                              Interviewer administered Questionnaire

School adolescents                                           2020                                           Self-administered questionnaire

Population based cross sectional explorative study. The study employed three-components of data collection: Component I- Pregnant Adolescents, Component II- Partners of pregnant adolescents, and Component III- School adolescents.

Results

The results are presented in the three components studied.

Component 1-Pregnant adolescents

Only 409 pregnant adolescents’ data were taken for in depth analysis as 41 of the pregnant adolescents were not in their first pregnancy. From the 409, 121 (30%) was under 18 years of age and 146 (36%) said they did not plan their pregnancy (Table 1).

Table 1. Reasons given by adolescents for their first sex.

Reasons	N	%
After marriage	217	53
Eloped and living together	106	26
Believing the boy friend	41	10
Eloped and ‘married’	12	3
With intention to get married	8	2
Leading from kissing	8	2
Afraid the boyfriend will get angry	8	2
Because of love	4	1
By force	5	1
Total	409	100

When asked the reason for their first intercourse, five adolescents have divulged that they were forced in to their first intercourse (Table 2).

Table 2. Distribution of pregnant adolescents according to attitude at first sexual experience and first intercourse by age-group.

Variable	Total N=409		<18 years N=121				≥18 years N=288		c2	P
	N	%	N		%		N	%
Whether adolescent wanted the first sexual experience
Wanted to happen	385	94.2	109		90.1	276		95.8	5.09	0.02
Was not sure	12	2.9	5		4.1	7		2.4
Did not want	9	2.2	6		5.0	3		1.0
Happened forcefully	3	0.7	1		0.8	2		0.7
Pregnant adolescent reflecting how she felt after her first sexual experience
Glad, it happened	378	92.4	107		88.4	271		94.1	3.90	0.05
Was not sure	19	4.6	7		5.8	12		4.2
Regret	12	2.9	7		5.8	5		1.7
Whether adolescent wanted the first sexual intercourse
Wanted it to happen	379	92.7	104	86.0		275		95.5	11.37	<0.001
Was not sure	15	3.7	5	4.1		10		3.5
Did not want	10	2.4	08	6.6		02		0.7
Happened forcefully	5	1.2	4	3.3		1		0.3
Pregnant adolescent reflecting how she felt after her first sexual intercourse
Glad, it happened	375	91.7	102	84.3		273		94.8	12.28	<0.001
Was not sure	19	4.6	07	5.8		12		4.2
Regret	15	3.7	12	9.9		3		1.0
Pregnant adolescent reflecting how she feels about age at first intercourse
Too young	280	68.5	112	92.6		168		58.3	46.1	<0.001
About right	122	29.8	08	6.6		114		39.6
Other	07	1.7	01	0.8		06		2.1

The first sexual intercourse was forced upon five of the adolescents in the sample.15 (4%) says that they regretted having their first sexual intercourse (Table 3). However, it is important to note that the attitudes expressed by the pregnant adolescents in relation to first sexual intercourse significantly differed (p<0.05) between the two age groups, with the younger group being more likely to express negative feelings/responses (Table 2).

Table 3. Distribution of pregnant adolescents according to attitude at first sexual experience and first intercourse by planned or unplanned pregnancy.

Variable	Total     N=409		Planned pregnancy N=263		Pregnancy unplanned N=146		c2	P
	N	%	N	%	N	%
Whether adolescent wanted the first sexual experience
Wanted to happen	385	94.1	255	97.0	130	89.0	17.9	<0.001
Was not sure	12	2.9	7	2.7	5	3.4
Did not want	9	2.2	1	0.4	8	5.5
Happened forcefully	3	0.8	0	0.0	3	2.1
Pregnant adolescent reflecting how she felt after her first sexual experience
Glad, it happened	380	92.9	253	96.2	127	87.0	14.9	<0.001
Was not sure	17	4.2	8	3.0	9	6.2
Regret	12	2.9	2	0.8	10	6.8
Whether adolescent wanted the first sexual intercourse
Wanted it to happen	379	92.7	252	95.8	127	87.0	15.7	<0.001
Was not sure	15	3.7	8	3.0	7	4.8
Did not want	10	2.4	1	0.4	9	6.2
Happened forcefully	5	1.2	2	0.8	3	2.1
Pregnant adolescent reflecting how she felt after her first sexual intercourse
Glad, it happened	375	91.7	248	94.3	127	87.0	10.1	0.006
Was not sure	19	4.6	11	4.2	8	5.5
Regret	15	3.7	4	1.5	11	7.5
Pregnant adolescent reflecting how she feels about age at first intercourse
Too young	280	68.5	174	66.2	106	72.6	46.1	0.029
About right	122	29.8	87	33.1	35	24.0
Other	7	1.7	02	0.8	05	3.4

Table 4. Distribution of respondents’ according to their attitude regarding first sexual intercourse and intercourse in general.

Variable	N	%
Whether respondent wanted the first sexual intercourse
Wanted	124	82.7
Was not sure	24	16.0
Happened forcefully	2	1.3
Respondent reflecting how he feels about his age at first intercourse
Too young	8	5.3
About right	135	90.0
Too old	7	4.7
Respondent’s view on intercourse before marriage
Accept intercourse before marriage	35	23.3
Do not accept	115	76.7
Number of partners ever having intimate sexual relationships
One	130	86.7
Two	10	6.7
Three	7	4.6
>3	3	2.0

As shown in table 3, the adolescents who said they planned their pregnancies were significantly more likely to report that they had wanted (consensual) their first intercourse than the adolescents who said they did not plan their pregnancies. The adolescents who said they did not plan their pregnancies had reported that they did not want (non-consensual) their first intercourse. Though as already noted above, majority of the respondents across the groups reported wanting the sexual encounters to happen. Significantly more adolescents who had planned their pregnancies were glad about their first intercourse (248, 94%) than the adolescents who had not planned their pregnancies. Though the actual numbers and percentages are small, significantly more adolescents who reported they had not planned their pregnancies had not had consensual sex. Their first intercourse (9, 6%) had been unwanted or they have reported they had been forced in to their first intercourse (3, 2%). They further have responded that they regretted the first sexual intercourse (11, 8%).

Component 11-Partner

One hundred and fifty partners of pregnant adolescents were the sample in this component. Overall, the picture is predominantly one of partners who were willingly participating in the sexual encounter. As shown in table 5, when the total sample was considered, 124 (84%) men have said they wanted their first intercourse to happen. A small minority had been ambivalent (24,16%). Two (1%) has said that it had happened by force (Table 4).

Table 5. Adolescents' practices on sexuality.

Attitude and practice	Total N=2,020		Male N=521		Female N=1,499		x2	P
	No	%	No	%	No	%
Have experienced a sexual relationship	69	3.4	46	8.8	23	1.5	62.6	<0.001

Interestingly, however, the respondents’ current reflections on the age at which they had had their first sexual intercourse showed that eight (5%) thought their age at first sexual intercourse was too young, seven (5%) were of the opinion they were too old. The difference emerging is understood to reflect the range of first intercourse which was from 16 to 37 years.

Component 111-School adolescents

In response to the question 'Have you ever had any experience of a “Sexual” relationship', almost 9% boys and 1% of girls reported that they were sexually active. In all these findings, the differences between the males and females were statistically significant (p=<0.001) (Table 5).

The 69 sexually active adolescents comprised 46 boys and 23 girls. All of them were Sinhalese by ethnicity. The age at first sexual experience ranged from 12 to 19 for the girls (mean 16.36 and SD 1.74) and from 10 years to 17 years for the boys (means 15.28 and SD 1.8). As illustrated in table 8, a greater proportion of boys than girls reported sexual activity below the age of consent. Among the group, 23 (50%) boys and 5 (22%) girls reported that they were sexually active before 16 years of age (Table 5).

In relation to the question about whether first sexual experience was consensual, the responses 'did not want' and 'happened forcefully' were taken as indications of non-consensual sexual activity. As table 6 shows, in the majority of cases it was consensual although a significant minority 23% reported non-consent. In terms of their feelings after it had happened, most the boys were glad whereas most girls were ambivalent.

Table 6. Distribution of adolescents by experience on the first sexual experience according to attitude at first sexual experience by gender.

Variable	Total N=69		Male N=46		Female N=23		x2		P
	No.	%	No.	%	No.	%
Whether adolescent wanted the first sexual experience
Wanted to happen	37	53.7	28	60.8	9	39.1		5.00	0.01
Was not sure	16	23.1	8	17.4	8	34.8
Did not want	4	5.8	3	6.5	1	4.3
Happened forcefully	12	17.4	7	15.3	5	21.7
Adolescents’ reflecting how they felt after their first sexual experience
Glad it happened	35	50.7	26	56.6	9	39.1		4.32	0.03
Was not sure	18	26.1	10	21.7	8	34.8
Regret	16	23.2	10	21.7	6	26.1

^{Chi square tests were performed on the cross-tabulation of the binary categorised variables wanted it to happen/''not sure versus did not want/happened forcefully' and ‘glad it happened’/ 'not sure versus /regret' and ‘too young’ versus ‘about right/other’ against male and female.}

Table 7. Degree of 'wantedness' of first  sexual experience of males and females across the three components.

First sexual experience	Pregnant adolescent N=409		Sexually active School girl N=23		Partner N=150		Sexually active School boy N=46
	N	%.	N		N	%.	N
Wanted	385	94.1	9		136	90.7	28
Was not sure	12	2.9	8		0	0.0	8
Did not want	9	2.2	1		12	8.0	3
Happened forcefully	3	0.8	5		2	1.3	7

^{Did not want and happened forcefully taken as non-consensual sex.}

Discussion

This population based study focused on understanding the context and patterns of adolescent pregnancy and sexual behaviour in a district in Sri Lanka.

The study employed three-components of data collection: Component I- Pregnant adolescents, Component II- Partners of pregnant adolescents, and Component III- School adolescents. In this study, a sample of 450 pregnant adolescents (Component I), a sample of 150, partners of adolescents (Component II) and 2020 school adolescents (Component III) have been the focus. However, practical considerations dictated that the method of data collection differed across the components. There were advantages of using an interviewer-administered questionnaire in Components I and II as the study population included respondents from different ethnic groups and with different levels of literacy. Face-to-face interviews were conducted by trained and experienced female and male staff to pregnant adolescents and partners of pregnant adolescents respectively. The fact that data collectors could speak to the respondents in their first language helped to ensure that the respondents felt comfortable in the interviews and there was a high level of cooperation. In contrast, a self-administered questionnaire was appropriate for Component III - the school adolescents - due to the nature of anonymity/confidentiality that could be maintained by the instrument.

Self-reporting on sensitive topics (premarital sexual behavior /adolescence sexual behavior/ sexual activity with more than one/support to their pregnant adolescent). Therefore, in this survey when there were questions with “judgment call”, wherever it was appropriate the answers were rechecked for accuracy. Examples include: How did you feel about this experience at the time? Did you want to do this? How did you feel about this experience after it had happened? Thinking about the first time you had sexual intercourse willingly, what do you think of the age at which you did this? In your opinion is it acceptable to have sexual intercourse before marriage?

Despite the overarching picture of planned and welcomed adolescent pregnancy among the study samples, the findings across the three components also alert us to a proportion of males and females whose experiences of sexual behaviour and pregnancy are not positive and who therefore appear to be vulnerable.

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Unwanted pregnancy

Out of one hundred and forty six (36%) adolescents who said they did not plan their pregnancy, 37 (9%) were not happy at all in their pregnancy and 23 (6%) had wanted to get rid of the pregnancy. The majority of these adolescents were younger than 18 years of age.

Unwanted sex

There was evidence across all three components that a proportion of boys and girls had not wanted their first sexual experience to occur. Table 8.4 shows that the experience of is non-consensual (either did not want or were forced) in almost a quarter (6/23) of the sexually active school girls and one fifth of the sexually active school boys (10/46). Almost 1% of pregnant adolescents and partners have disclosed their first sexual experience was forced, and further respondents reported that they had not wanted their first sex. This is an area of concern. Clearly, there needs to be more understanding about the circumstances of these sexual experiences and how these may vary between the genders. Steps are needed to be taken to protect these vulnerable adolescents.

When more advanced statistical analysis was done, it was shown that underage pregnant adolescent had three times higher odds of having had non-consensual first intercourse compared to the older group. Moreover, adolescents who said their pregnancies were not planned had three times higher odds of having had non-consensual first intercourse as compared to the group who planned. Bivariate analysis showed that male partners whose attitude towards their sexual experiences was uncertain (n=24) or forced (n=2) were more likely to report the pregnancy as unplanned. Data shows that being underage renders one more vulnerable to non-consensual intercourse [9].

Conclusion and recommendation

Among the adolescents who engage in sexual behaviour with some ambivalence and/or regret, there is a core of vulnerable adolescents for whom additional measures are needed to increase levels of protection and reduce exposure to harmful sexual experiences. Need appropriate policy formulation in empowering children to be protected from sexual abuse by providing them with appropriate skills from preschool age.

References

1. Hird MJ (2000) An empirical study of adolescent dating aggression in the U.K. J Adolesc 23: 69-78. [Crossref]
2. UNICEF (2004) National Survey on Emerging Issues Among Adolescents In Sri Lanka Published By UNICEF.
3. Thalagala N (2003) Physical, Emotional, and Sexual Abuse of Children in Sri Lanka -Parents’ and children’s perspectives. Unpublished report. UNICEF, Colombo.
4. Basnayake S (1996). Sri Lankan Youth: Survey on Reproductive Health Knowledge, Attitudes and Practices, Family Planning Association of Sri Lanka, Colombo.
5. Penal code (1998) Sri Lanka Penal Code.
6. Ordinance E (1995) General Marriages Registration Ordinance (Amendment act) No. 18 of 1995.
7. Gnanissara SA (2002) Final Evaluation Report: Reproductive Health Information, Counselling and Services to Adolescents and Youth Project (RAS/98/P17), EC/UNFPA Initiative for Reproductive Health in Asia, Colombo.
8. Godamune PK (2008) Sri Lankan parent’s attitudes towards adolescent reproductive and sexual health education needs: A qualitative study, Faculty of Medicine, University of Sri Lanka.
9. Rajapaksa HN (2015) Making a Future for girls-Why Adolescent Sexuality and Pregnancy Matters. Plan International.