What they think and what they know Authors: Shahrzad Rahimi-Naghani, Mahnaz Motamedi Presented by: Nasrin Eizadyar What they think and what they know Attitudes and Awareness towards Sexual Reproductive Health in contemporary Tehran (March 2014 - May 2015)

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi background Sexual health programs in Iran are tailored for married people and limited to contraceptives, prenatal care, pregnancy, childbirth, and breastfeeding1. Educational services in the field of sexual health are not provided in government centers1. A significant population of Iranian youth is involved in premarital sex (10-15% females, 20% males) 2. Majority of sexually experienced youth have high-risk sex with multiple partners and condom usage is inconsistent3.

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi background Previous studies have focused on adolescents (15-18 years) and young people (18-24 years) – there is little information about the sexual health of adults in Iran. A vacuum exists in terms of work done on sexual and reproductive health (SRH) in Iran.

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi objectives Two studies focusing on sexuality were conducted, with the aim to: Assess sexual and reproductive health knowledge among men and women aged between 15 - 49 years in metropolitan Tehran Explore potential associations between classifications of sexual and reproductive health knowledge with age, gender, education and/or marital status Explore potential associations between sexual attitudes with age, gender, education, religiosity and/or marital status

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Methods A cross-sectional, descriptive study of 755 participants (411 females and 344 males) between 15 - 49 years, residents of Tehran (mean: 29.4) Multi-stage cluster random sampling WHO Illustrative questionnaire4 adapted in June 2014 Clearance from the ethics review board of Tehran Medical University and Isfahan University of Medical Science were obtained

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Methods Multi stage cluster random sampling from different regions of Tehran

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Measures Two points scale was considered for each SRH knowledge question The correct answer to each item Vague answer and wrong answer Total SRH knowledge scores could range from a Minimum of 26 and Maximum of 52 physiology knowledge ranged from 3 to 6 contraception knowledge ranged from 11 to 22 HIV/STIs knowledge ranged from 7 to 14 condom knowledge ranged from 5-10 Scored 2 Scored 1

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Measures Each item of attitude of sexual permissiveness was measured by three-point Likert scale Agree scored 3 Not sure scored 2 Disagree scored 1 The score of attitude scale ranged from between 9 – 27 Higher score accepting of pre-marital sex – classified as ‘liberal attitude’ Lower score against pre-marital sex – classified as ‘conservative attitude’ Intermediate score no definite view on pre-marital sex – classified as ‘not very conservative attitude’

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Results (summary) Women, younger people and ever-married people had more SRH health knowledge Levels of education had no impact on SRH knowledge older, ever-married & more religious respondents were less accepting of sexual/nonsexual interactions and had more conditions for any such interactions men (81%) and women (82%) were supportive of dating before marriage, with no gender difference. Males (69%) were open to non-sexual, tactile interactions, than females (50.5%).

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Results Mean Scores of Attitudes toward Sexual Permissiveness by Selected Social and Demographic characteristic

results Marital status vs attitude Religosity vs. attitude What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi results Mean Scores of Attitudes toward Sexual Permissiveness by Selected Social and Demographic characteristic Marital status vs attitude Religosity vs. attitude

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi results Comparison of mean score knowledge in different domain by selected socio- demographic factors

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Results Mean Scores of knowledge toward Sexual reproductive health Selected Social and Demographic characteristic

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi conclusion Research confirmed conventional wisdom in some ways, but upturned it in others: Identified a growing need for disseminating evidence-based sexual knowledge to diminish misconceptions among all age groups, regardless of marital status It was shown that both society and culture reinforce behaviors; therefore, mixed method studies and qualitative exploration is recommended (mapping practices) As it showed the need for providing SRH training to both genders within the educational curriculum.

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Acknowledgments We are highly obliged to thank all the staff of the Institute of International Health and Tropical Medicine in Charite- Universitätmedizin, Berlin, for their continuous assistance in my endeavors. Our special thanks to the participants who shared their private sexual matters with us. Also, I would like to express my gratitude to Dr. Safieh Shah for helping me to prepare the abstract and OP for this event.

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi Thank you!

What they think and what they know: attitudes and awareness towards sexual reproductive health in contemporary Tehran (March 2014 - May 2015) Shahrzad Rahimi-Naghani, Mahnaz Motamedi References 1. Khoei E, Whelan A, Cohen J. Sharing beliefs: What sexuality means to Muslim Iranian women living in Australia. Culture, Health & Sexuality. 2008;10(3):237-248. 2. Khalajabadi Farahani FCleland J. Perceived norms of premarital heterosexual relationships and sexuality among female college students in Tehran. Culture, Health & Sexuality. 2015;17(6):700-717. 3. Mohammad K, Farahani F, Mohammadi M, Alikhani S, Zare M, Tehrani F et al. Sexual Risk-Taking Behaviors among Boys Aged 15–18 Years in Tehran. Journal of Adolescent Health. 2007;41(4):407-414. 4. Asking young people about sexual and reproductive behaviours: Illustrative Core Instruments. John Cleland, Roger Ingham, Nicole Stone. 2001