Factors Predicting Intention to Prevent Sexual Risk Behavior Among Female High School Students

Abstract

Introduction Sexual risk behavior is a significant factor that severely affects adolescent health, particularly through the transmission of sexually transmitted infections (STIs) and unintended pregnancies. Preventing such behavior is therefore an effective strategy to mitigate these adverse outcomes. However, investigating factors predicting sexual risk behavior may be untimely if such behaviors have already occurred, especially among female adolescents in secondary education, a group particularly vulnerable to both engaging in risky sexual behavior and experiencing their consequences. Given that sexual risk behavior is complex, often arising from interpersonal interactions and emotional impulses without prior deliberation. Thus, investigating the intention to prevent sexual risk behaviors serves as an appropriate proxy for studying such behavior, as intention is a key determinant of actual behavior. 

Objectives This study aims to: 1) describe the level of intention to prevent sexual risk behavior among female secondary school students, and 2) identify factors predicting intention to prevent sexual risk behavior among female secondary school students.

Design This study employed a predictive correlational design, applying Phase 3 of the PRECEDE-PROCEED Model, which focuses on the diagnosis of behavioral determinants related to health behavior. The conceptual framework was based on three categories of factors: predisposing, enabling, and reinforcing factors.

Methodology The study participants consisted of 395 female students enrolled in grades 7 to 12 under the jurisdiction of Secondary Educational Service Area Office 31, located in a northeastern province. Participants were selected using a multistage random sampling. Research Instruments included questionnaires consisting of nine sections: 1) General information, 2) Sexual knowledge, 3) Attitudes toward sexual risk behavior, 4) Sexual values, 5) Self-esteem, 6) Access to sexually stimulating media and emotional triggers, 7) Family communication about sexuality, 8) Peer group influence, and 9) Intention to prevent sexual risk behavior. The content validity was assessed by five experts, revealing the content validity index for section 2-9 at .96, .96, 1.00, .94, 1.00, .82, 1.00, and 1.00, respectively. Reliability was tested, revealing Cronbach’s alpha coefficient of .70, .72, .72, .80, .93, .88, .94, and .91, respectively. Data were collected through self-administration. Descriptive and inferential statistics were employed for data analysis, including Spearman’s Rank Correlation Coefficient and Binary Logistic Regression analysis, with a significance level set at .05.

Results The participants had an average age of 15.01 years (SD = 1.82) and a mean cumulative grade point average (GPAX) of 3.57 (SD = 0.38). The majority reported not having a boy friend (79.00%) and had an average monthly expenditure of 2,683 Baht (SD = 1,164.65). While studying, most students resided at home (93.20%) and lived with both parents (84.60%). Regarding family status, 66.30% of students reported that their parents lived together. The mean score for intention to prevent sexual risk behavior was high (M = 96.37, SD = 15.26). Factors significantly associated with the intention to prevent sexual risk behavior were 1) predisposing factors including GPAX, attitudes toward sexual risk behavior, sexual values, and self-esteem (r = .294, .313, .384, .259, respectively; p < .01), 2) enabling factors including access to sexually stimulating media and emotional triggers (r = .486, p < .01), and 3) reinforcing factors including family communication about sexuality and peer group influence (r = .209, .442, respectively; p < .01). Binary Logistic Regression Analysis revealed that four factors jointly predicted the intention to prevent sexual risk behavior among female secondary school students, accounting for 35.44% of the variance (R2 = .354, p < .001). These factors were: GPAX (OR = 4.44, 95% CI: 1.89–10.43, p < .01), attitudes toward sexual risk behavior (OR = 1.23, 95% CI: 1.15–1.32, p < .001), family communication about sexuality (OR = 1.05, 95% CI: 1.01–1.09, p < .05), and peer group influence (OR = 1.07, 95% CI: 1.03–1.10, p < .01).

Recommendation Public health personnel and schools can utilize the findings of this study to develop strategies aimed at enhancing the intention to prevent sexual risk behavior among female secondary school students. This can be achieved by promoting learning capabilities and skills, fostering positive attitudes toward the prevention of sexual risk behavior, and encouraging peer groups to play a constructive role in providing guidance and mutual support. Such efforts can serve as motivational factors for risky behavioral prevention. Additionally, families should be supported in developing communication skills related to sexuality and sexual risk prevention, normalizing these discussions within the household to foster understanding and trust, ultimately contributing to the prevention of sexual risk behavior among the female secondary school students.