Knowledge of sexual health influence the attitude toward premarital Sexual activities: A cohort study using a sample of young adults

Abstract

Background: Early, age-appropriate discussions on sex and bodies help prevent child victimization, while lack of knowledge may contribute to sexualized attitudes and increased risk. This study evaluated sexual health knowledge and attitudes toward premarital sex among the undergraduates of the University of Kelaniya to identify the gaps in child and adolescent sexual education. Method: An analytical cross-sectional study was conducted on 294 undergraduates through a self-administered online questionnaire. Scoring systems were used to assess sexual health knowledge and attitudes towards premarital sexual activities, analyzed through descriptive and inferential statistics. Results: Participants were predominantly female (61.6%), with a mean age of 23.17 years. Significant differences (P<0.05) in both knowledge and attitude were found based on age, relationship status and the age of first exposure to the concept of sex. The majority received the information through improper means, such as the internet and media. Both the age when first exposed to the concept of sex (r = -0.252; P>0.001) and the age when first understood the concept of sex (r = -0.272; P>0.001) exhibited significantly favorable knowledge scores. Similarly, the age of first exposure to the concept of sex (r = -0.204 P<0.001) and age when understood the concept of sex (r = -0.240: P>0.001) exhibited significantly favorable attitude scores towards premarital sex. Furthermore, the age when first exposed to any sexually related content exhibited a favorable knowledge score (r = -0.158; P>0.001 as well as an attitude score (r = -0.209 P>0.001. Even though 86.84% of the respondents with overall favorable attitudes had satisfactory knowledge, only 41.03% of those with satisfactory knowledge scores showed a favorable attitude. Conclusion: Attitude aligns more consistently with higher knowledge, but having knowledge does not necessarily promote a favorable attitude towards premarital sex. Therefore, providing timely, comprehensive, scientific sexual education is crucial for understanding sex, reducing stigma, and creating a safer environment.