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  1. Sexual activity among Malaysian school-going adolescents: what are the risk and protective factors?
    Ahmad N, Awaluddin SM, Ismail H, Samad R, NikAbdRashid N
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):44S-52S.
    PMID: 25070693 DOI: 10.1177/1010539514544700
    This study aimed to identify risk and protective factors associated with sexual activity among Malaysian adolescents. Data from the World Health Organization Global School-based Student Health Survey 2012 were analyzed. A total of 23 645 students aged 12 to 17 years responded using self-administered validated questionnaire. The overall prevalence of reported ever-had sex was 8.3%. Logistic regression analysis revealed that ever-had sex was positively significantly associated with ever-used drugs (adjusted odds ratio [aOR] = 7.71; 95% confidence interval [CI] = 6.51-9.13), and to a lesser extent, ever-smoked (aOR = 1.83; 95% CI = 1.62-2.07) and ever-consumed alcohol (aOR = 1.33; 95% CI = 1.15-2.53). Protective factors against ever-had sex were having a close friend (aOR = 0.63; 95% CI = 0.50-0.81), parental bonding (aOR = 0.72; 95% CI = 0.65-0.81), supportive peers (aOR = 0.77; 95% CI = 0.69-0.86), and parental connectedness (aOR = 0.88; 95% CI = 0.78-0.99). Although the prevalence of sexual activity among school-going adolescents in Malaysia is relatively low, identifying the risk and protective factors is crucial toward developing an integrated multiple approach to preventing sexual-related problems.
    Study name: Global School-Based Student Health Survey (GSHS)
    Matched MeSH terms: Sexual Behavior/psychology*
  2. Fulltext Are medical students confident in taking a sexual history? An assessment on attitude and skills from an upper middle income country
    Ariffin F, Chin KL, Ng C, Miskan M, Lee VK, Isa MR
    BMC Res Notes, 2015;8:248.
    PMID: 26082003 DOI: 10.1186/s13104-015-1220-y
    BACKGROUND: Sexual history training during undergraduate education is essential for preparing future doctors to handle patients' sexual health concerns. The purpose of this study was to assess the attitudes and perceptions of final-year medical students in Malaysia toward sexual history taking and the training they receive from their medical schools.
    METHODS: The study used a cross-sectional survey of 379 final-year medical students from three medical schools in Malaysia. Students were asked to rate their attitudes and perceptions regarding training on taking sexual histories using a newly developed questionnaire with good internal consistency (Cronbach's alpha = 0.73). Ethics approval was obtained from the relevant medical schools, and the statistical analysis was conducted using SPSS, Version 20.0.
    RESULTS: The mean age of participants was 23.58 ± 0.65 SD. Participants reported high interest in sexual health and felt it was important for doctors to know how to take a sexual history (95%). Among the participants, only half felt comfortable in taking sexual histories from patients. The participants identified cultural and religious differences between the doctor and the patient as a potential barrier for discussing sexual health. Participants were aware of their own practice and ability, as well as their limitations, in taking sexual histories. Less than half (46%) felt that the training they received adequately prepared them to take sexual histories.
    CONCLUSIONS: This study identified gaps in sexual health training among medical schools in Malaysia. The delivery of sexual health education program should incorporate confidence building and to make students feel comfortable to take sexual histories from patients. The barrier caused by differences in culture or religion between a doctor and a patient may be overcome through cross cultural and cultural competency training. This is important for multi-faith, multi cultural societies such as Malaysia and other similar countries.
    Matched MeSH terms: Sexual Behavior/psychology*
  3. Fulltext Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: implications for secondary prevention
    Bachireddy C, Bazazi AR, Kavasery R, Govindasamy S, Kamarulzaman A, Altice FL
    Drug Alcohol Depend, 2011 Jul 1;116(1-3):151-7.
    PMID: 21232882 DOI: 10.1016/j.drugalcdep.2010.12.001
    Pre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts.
    Matched MeSH terms: Sexual Behavior/psychology
  4. Fulltext Female international students and sexual health - a qualitative study into knowledge, beliefs and attitudes
    Burchard A, Laurence C, Stocks N
    Aust Fam Physician, 2011 Oct;40(10):817-20.
    PMID: 22003488
    BACKGROUND: International students make up an increasing proportion of university students in Australia. Research suggests that they have poor sexual health knowledge compared with local students.
    METHODS: Thematic analysis was undertaken on focus groups carried out at the University of Adelaide (South Australia), with 21 female international students from Malaysia and China.
    RESULTS: Four themes were identified: poor sexual health knowledge; complex attitudes about premarital sex; difficulty accessing sexual health information, and poor understanding the role of general practitioners in this area; and ideas about future education.
    DISCUSSION: Participants believed that international students have insufficient sexual health education when they arrive in Australia. They were concerned that some students may become more sexually active in Australia, and may not have adequate access to health services and information. All participants felt it was necessary for international students to receive better sexual health education. International students are important to Australian universities, and it should be mandatory to ensure that culturally appropriate sex education is made available to this group.
    Matched MeSH terms: Sexual Behavior/psychology*
  5. Suicidal ideation among single, pregnant adolescents: The role of sexual and religious knowledge, attitudes and practices
    Chan LF, Mohamad Adam B, Norazlin KN, Siti Haida MI, Lee VY, Norazura AW, et al.
    J Adolesc, 2016 10;52:162-9.
    PMID: 27572955 DOI: 10.1016/j.adolescence.2016.08.006
    Pregnant adolescents are a high-risk population for suicide. However, a knowledge gap still exists on how sexual and religious knowledge, attitudes and practices (KAP) influence suicidal ideation (SI) in teenage pregnancy. We aim to explore the interplay between psychiatric diagnoses, sociodemographic factors and KAP of sexual and religious issues as risk factors of SI among 114 pregnant Malaysian adolescents from 6 rehabilitation centers and a tertiary hospital. Single sexual partner was an independent predictor of SI, suggesting the role of less sexual experience as a risk factor for SI after controlling for major depression. Participants who were unsure versus those who agreed with the statement that most religions' viewed sex outside marriage as wrong had a lower risk of SI after controlling for major depression. Pregnant adolescents with a single sexual partner were significantly associated with current SI. Ambivalence towards religious prohibitions on premarital sex may protect against suicidal ideation.
    Matched MeSH terms: Sexual Behavior/psychology*
  6. Sexual function in menopausal women in Kelantan, Malaysia
    Dhillon HK, Singh HJ, Ghaffar NA
    Maturitas, 2005 Nov-Dec;52(3-4):256-63.
    PMID: 15894440 DOI: 10.1016/j.maturitas.2005.03.014
    The aim of the study was to document sexual function in Kelantanese postmenopausal women.
    Matched MeSH terms: Sexual Behavior/psychology
  7. Fulltext Predictors of sexual risk behaviour among adolescents from welfare institutions in Malaysia: a cross sectional study
    Farid ND, Rus SC, Dahlui M, Al-Sadat N, Aziz NA
    BMC Public Health, 2014;14 Suppl 3(Suppl 3):S9.
    PMID: 25437631 DOI: 10.1186/1471-2458-14-S3-S9
    BACKGROUND: In welfare institutions, it is essential to address the health-related needs of adolescent populations who often engage in sexual activities. This study examines the association between individual and interpersonal factors concerning sexual risk behaviour (SRB) among adolescents in welfare institutions in Malaysia.

    METHODS: Data were derived from a cross-sectional study of 1082 adolescents in 22 welfare institutions located across Peninsular Malaysia in 2009. Using supervised self-administered questionnaires, adolescents were asked to assess their self-esteem and to complete questions on pubertal onset, substance use, family structure, family connectedness, parental monitoring, and peer pressure. SRB was measured through scoring of five items: sexual initiation, age of sexual debut, number of sexual partners, condom use, and sex with high-risk partners. Multivariate logistic regression analysis was used to examine the various predictors of sexual risk behaviour.

    RESULTS: The study showed that 55.1% (95%CI = 52.0-58.2) of the total sample was observed to practice sexual risk behaviours. Smoking was the strongest predictor of SRB among male adolescents (OR = 10.3, 95%CI = 1.25-83.9). Among females, high family connectedness (OR = 3.13, 95%CI = 1.64-5.95) seemed to predict the behaviour.

    CONCLUSION: There were clear gender differences in predicting SRB. Thus, a gender-specific sexual and reproductive health intervention for institutionalised adolescents is recommended.

    Matched MeSH terms: Sexual Behavior/psychology*
  8. Validity and Reliability Analysis of the 'SayangKU' (MyLove) in Intervention for Addressing Adolescents Involved in Free Sex
    Ghani FA, Latif AA, Aziz AA, Khan A
    J Relig Health, 2015 Aug;54(4):1375-86.
    PMID: 25189148 DOI: 10.1007/s10943-014-9935-y
    A module entitled 'SayangKU' (MyLove), based on the Islamic perspective, was developed as an instrument to assist adolescents that involved in premarital sexual activity. The module comprises four phases: Love of God (Allah), Love of the Prophet, Love of Oneself, and Love of the Ummah (world). From analysis of Rasch, the value of item reliability was .80 and an individual reliability was .95. Dimensionality value was more than 40 % variance explained by measures, and level of agreement among experts was 86.88 %. The posttest shows the better result from pretest and proves the effectiveness of the module.
    Matched MeSH terms: Sexual Behavior/psychology*
  9. Remitted male schizophrenia patients with sexual dysfunction
    Kheng Yee O, Muhd Ramli ER, Che Ismail H
    J Sex Med, 2014 Apr;11(4):956-965.
    PMID: 23845160 DOI: 10.1111/jsm.12246
    INTRODUCTION: Despite the high prevalence of sexual dysfunction among male schizophrenia patients, there is still a paucity of research on this area.
    AIMS: The study aims to determine the prevalence of sexual dysfunction and any association between male patients with schizophrenia in remission and the sociodemographic profile, medication, depression, anxiety, psychopathology of illness, body mass index, and waist circumference.
    METHODS: A cross-sectional study with nonprobability sampling method was conducted in a psychiatric outpatient clinic in Taiping Hospital (Perak, Malaysia) over a 7-month period. A total of 111 remitted male schizophrenia patients were recruited. The validated Malay version of the International Index of Erectile Function (Mal-IIEF-15) was administered to the patients and assessed over 4-week duration in the domains of erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction. Logistic regression analysis was employed.
    MAIN OUTCOME MEASURES: Prevalence and associated factors for sexual dysfunction in each domain are the main outcome measures.
    RESULTS: All five domains of sexual functioning in patients showed a high prevalence of dysfunction ranging from 78.4% to 97.1% with orgasmic dysfunction being the least impaired and intercourse satisfaction the worst impaired. Among the domains, only orgasmic dysfunction was significantly associated with race, i.e., Chinese at lower risk for impairment than the Malays (OR = 0.23; 95% CI: 0.07, 0.76; P = 0.018); education, i.e., patients with education higher than primary level were at higher risk for dysfunction (OR = 6.49; 95% CI: 1.32, 32.05; P = 0.022); and Positive and Negative Syndrome Scale (PANSS)-positive subscale, i.e., higher PANSS-positive score was a protective factor for orgasmic dysfunction (OR = 0.54; 95% CI: 0.33, 0.89; P = 0.015).
    CONCLUSIONS: The prevalence of sexual dysfunction was generally high. Malay patients and those with education higher than primary level were at higher risk for orgasmic dysfunction whereas higher PANSS-positive score was protective against the impairment. The high rate of sexual dysfunction in schizophrenia patients warrants a routine inquiry into patients' sexuality and the appropriate problems being addressed.
    Study site: Psychiatric clinic, Hospital Taiping, Perak, Malaysia
    Matched MeSH terms: Sexual Behavior/psychology
  10. Views and experiences of Malaysian family medicine trainees of female sexual dysfunction
    Lai PS, Tan SY, Liew SM
    Arch Sex Behav, 2016 Nov;45(8):2081-2089.
    PMID: 27502351 DOI: 10.1007/s10508-016-0796-1
    Sociocultural factors have been shown to be important influencers of sexual health and sexuality. Hence, the aim of our study was to explore the views and experiences of family medicine trainees regarding female sexual dysfunction (FSD) with a focus on the barriers and facilitators towards the initiation of conversation on this topic. A qualitative study design involving semi-structured focus group discussions (FGDs) was conducted with 19 family medicine trainees in Malaysia. The conceptual framework used was based on the Theory of Planned Behavior. Thematic approach was used to analyze the data. Participants perceived FSD as being uncommon and unimportant. According to our participants, patients often presented with indirect complaints, and doctors were not proactive in asking about FSD. Three main barriers were identified: doctor factors, perceived patient factors, and system factors. Lack of confidence, knowledge, experience, time, and embarrassment were the key barriers identified at the doctors' level. Lack of awareness, among patients regarding FSD, and local cultural and religious norms were the perceived patient barriers. System barriers were lack of time and privacy. Various facilitators, such as continuous medical education and public forums, were suggested as means to encourage family medicine trainees to initiate discussion on sexual matters during consultations. In conclusion, family medicine trainees found it difficult to initiate conversation on FSD with patients. Interventions to encourage conversation on FSD should target this and other identified barriers.
    Matched MeSH terms: Sexual Behavior/psychology*
  11. Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia
    Lechmiannandan S, Panirselvam M, Muninathan P, Hussin N, Rajan R, Sidi H, et al.
    Obes Surg, 2019 05;29(5):1571-1575.
    PMID: 30706310 DOI: 10.1007/s11695-019-03722-w
    INTRODUCTION: Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery.

    MATERIAL AND METHODS: This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher's exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared.

    RESULTS: Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value sexual domains and should be considered as a management option in this group of women.

    Matched MeSH terms: Sexual Behavior/psychology
  12. High rates of unprotected anal intercourse with regular and casual partners and associated risk factors in a sample of ethnic Malay men who have sex with men (MSM) in Penang, Malaysia
    Lim SH, Bazazi AR, Sim C, Choo M, Altice FL, Kamarulzaman A
    Sex Transm Infect, 2013 Dec;89(8):642-9.
    PMID: 23787168 DOI: 10.1136/sextrans-2012-050995
    OBJECTIVE: To assess the prevalence of unprotected anal intercourse (UAI) and its correlates among ethnic Malay men who have sex with men (MSM).
    METHODS: In 2010, a convenience sample of 350 MSM in Penang were recruited to participate in an anonymous, computerised survey with rapid HIV testing. Participants who were not of Malay ethnicity (n=44) or who did not report sex with another man in the previous 12 months (n=22) were excluded, resulting in 284 participants in the final analysis. Correlates of UAI were examined separately for regular and casual partnerships using bivariate and multivariate logistic regression.
    RESULTS: Four men (1.9%) tested HIV positive. In the past 12 months, 64.7% of participants had regular sexual partners, 77.1% had casual sexual partners and 41.9% had both. Most participants (83.1%) reported UAI, which was more common in regular partnerships. Over two-thirds of participants had never been tested for HIV. In multivariate analysis, agreement about sexual risk reduction practices was associated with a reduction in UAI with regular partners (adjusted OR (AOR)=0.14, 95% CI 0.05 to 0.40). Reporting difficulty in using condoms was associated with an increase in UAI with casual partners (AOR=9.07, 95% CI 3.35 to 24.5), and any exposure to HIV prevention was associated with a decrease in UAI with casual partners (AOR=0.22, 95% CI 0.09 to 0.54).
    CONCLUSIONS: Despite highly prevalent HIV risk behaviours, HIV seropositivity and prior HIV testing were low. Increasing sexual negotiation skills and access to HIV testing and other prevention services may improve future prevention efforts.
    KEYWORDS: HIV; Homosexuality; Prevention; Sexual Behaviour
    Matched MeSH terms: Sexual Behavior/psychology
  13. Fulltext The syndemic of HIV, HIV-related risk and multiple co-morbidities among women who use drugs in Malaysia: Important targets for intervention
    Loeliger KB, Marcus R, Wickersham JA, Pillai V, Kamarulzaman A, Altice FL
    Addict Behav, 2016 Feb;53:31-9.
    PMID: 26436520 DOI: 10.1016/j.addbeh.2015.09.013
    Substance use and HIV are syndemic public health problems in Malaysia. Harm reduction efforts to reduce HIV transmission have primarily focused on men with substance use disorders.
    Matched MeSH terms: Sexual Behavior/psychology
  14. How do men perceive erectile dysfunction and its treatment? A qualitative study on opinions of men
    Low WY, Ng CJ, Choo WY, Tan HM
    Aging Male, 2006 Sep;9(3):175-80.
    PMID: 17050117 DOI: 10.1080/13685530600914601
    INTRODUCTION: Erectile dysfunction (ED) is a common medical disorder affecting the aging male. A man's perception of a disease affects his health seeking behaviour. This study aimed to explore perceptions of ED among men with ED and how these perceptions came about.
    METHODS: This qualitative study utilized in-depth interviews involving 17 urban men aged between 40 and 75 years old.
    RESULTS: Misconceptions existed regarding the definitions of ED. Most men perceived impotence to be more serious than ED. Although most were aware of the medical causes of ED, 'overuse of penis' and black magic were mentioned as culturally-related causes. ED was perceived as a serious problem associated with loss of manhood and it had a significant impact on relationships with their partners. However, some adopted an 'accepting' view and attributed it to aging and fate. Most men were only familiar with PDE-5 inhibitors and traditional therapies. PDE-5 inhibitors were perceived to be effective but they were concerned about side effects and costs.
    CONCLUSIONS: Identifying men's perceptions of ED and its treatment would help doctors in their consultation, and inform health policy makers in planning appropriate public education and services.
    Matched MeSH terms: Sexual Behavior/psychology
  15. Fulltext Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial
    Mansor N, Ahmad N, Md Said S, Tan KA, Sutan R
    J Med Internet Res, 2023 Oct 20;25:e48968.
    PMID: 37862090 DOI: 10.2196/48968
    BACKGROUND: Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults.

    OBJECTIVE: This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting.

    METHODS: This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention.

    RESULTS: There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; Psexual and reproductive health among young adults in Malaysia can consider the implementation of this module.

    TRIAL REGISTRATION: Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

    Matched MeSH terms: Sexual Behavior/psychology
  16. Fulltext Engagement in Chemsex among Men Who Have Sex with Men (MSM) in Malaysia: Prevalence and Associated Factors from an Online National Survey
    Maviglia F, Wickersham JA, Azwa I, Copenhaver N, Kennedy O, Kern M, et al.
    Int J Environ Res Public Health, 2022 Dec 24;20(1).
    PMID: 36612617 DOI: 10.3390/ijerph20010294
    Background: Chemsex is the use of illicit drugs—particularly methamphetamine, gamma hydroxybutyrate (GHB), and gamma-butyrolactone (GBL)—to enhance sexual activity. Chemsex, which occurs primarily among communities of men who have sex with men (MSM), is associated with greater HIV risk behaviors, including multiple sex partners, group sex, condomless sex, and injection drug use. Despite evidence showing chemsex engagement among Malaysian MSM, there is a paucity of research on chemsex among MSM in Malaysia. Methods: This cross-sectional study was conducted through an online survey (August to September 2021) among 870 Malaysian MSM. Participants were recruited through targeted advertisements on social networks. We collected information regarding participants’ recent (<6 months) engagement in chemsex, demographic characteristics, psychosocial factors, pre-exposure prophylaxis (PrEP) knowledge and history, and recent sexual- and drug-related behavior. Multivariable logistic regression was used to identify factors associated with recent (<6 months) chemsex engagement. Results: Just under 1 in 10 (9.0%) of participants reported having engaged in chemsex in the previous six months. More than two-thirds of participants (69.1%) had not disclosed their sexual orientation to anyone in their family and 35.2% reported moderate to severe depressive symptoms. Multivariable analysis found that recent injection drug use (adjusted odds ratio: aOR = 6.61; 95% confidence interval: CI, 2.30−19.03), having shared pre-exposure prophylaxis (PrEP) with someone else (aOR = 5.60; 95% CI, 1.76−17.77), higher perceived HIV risk (aOR = 3.15; 95% CI, 1.25−7.93), knowing someone using PrEP (aOR = 2.93; 95% CI, 1.62−5.31), recent engagement in transactional sex (aOR = 2.38; 95% CI, 1.06−5.39), having a recent STI diagnosis (aOR = 2.36; 95% CI, 1.25−4.44), recent engagement in anal sex (aOR = 2.21; 95% CI, 1.07−4.57), and recent sexual intercourse with an HIV-positive partner (aOR = 2.09; 95% CI, 1.07−4.08) were associated with recent engagement in chemsex. Conclusions: Malaysian MSM who practice chemsex are vulnerable to several HIV risk factors, such as transactional sex, HIV-positive sexual partners, and injection drug use. There is an urgent need for programs that integrate drug, sexual health, and mental health services, with a focus on harm reduction (e.g., condoms, access to and utilization of HIV testing and PrEP services, drug knowledge, and safer drug use) tailored for MSM who practice chemsex.
    Matched MeSH terms: Sexual Behavior/psychology
  17. Fulltext Psychosocial determinants of adolescent romantic relationship in Malaysia: Social media use, pornography surfing, sexual and reproductive health knowledge, and depression
    Mud Shukri MI, Baharom A
    PLoS One, 2023;18(12):e0295933.
    PMID: 38117759 DOI: 10.1371/journal.pone.0295933
    It is socially natural that adolescents engage in romantic relationship. However, there are negative health implications when they are not properly monitored and guided. The engagement in unsafe sexual practices has been reported to cause various adverse health and social implications affecting Malaysian adolescents. To date, why adolescents engage in romantic relationship has remained understudied. Prior studies on adolescent romantic relationship mainly focused on the western context. Hence, the reported findings are deemed not applicable for the Malaysian population. There are insufficient data on the prevalence and determinants of adolescent romantic relationship within the Malaysian context. Thus, the current study aimed to identify the prevalence and determinants of romantic relationship among adolescents in Seremban, Negeri Sembilan, Malaysia. Adopting a cross-sectional research design, this study's self-administered questionnaire survey, which was conducted from 25 May 2021 to 5 June 2021 in residential areas that were part of the "Healthy Community Empowers the Nation" programme (KOSPEN), involved 396 adolescents who fulfilled the study's selection criteria. In terms of age, the respondents were of between 14 and 19 years old, with median age (IQR) of 19 (2). Adolescent romantic relationship in this study recorded prevalence of 24.1%, which was comparatively lower than that of the western countries. The results further revealed social media use (AOR: 2.162, 95% CI: 1.202-3.888, p = 0.01), pornography website surfing (AOR 2.748, 95% CI: 1.517-4.977, p = 0.001), poor SRH knowledge (AOR: 3.885, 95% CI: 2.144-7.040, p < 0.001), and depression (AOR: 2.830, 95% CI: 1.323-6.055, p = 0.007) as significant determinants of adolescent romantic relationship. Thus, this study demonstrated the significant role of social media use, pornography website surfing, SRH knowledge, and depression on adolescent romantic relationship. Further longitudinal studies to investigate the temporal relationships between depression and romantic relationship are recommended. The highly significant association between SRH knowledge and romantic relationship in this study suggests that strategies on improving the level of SRH knowledge among adolescents should be prioritised.
    Matched MeSH terms: Sexual Behavior/psychology
  18. Meanings of Sexuality: Views from Malay Women with Sexual Dysfunction
    Muhamad R, Horey D, Liamputtong P, Low WY, Sidi H
    Arch Sex Behav, 2019 04;48(3):935-947.
    PMID: 30066036 DOI: 10.1007/s10508-018-1228-1
    In Malaysia, female sexual dysfunction (FSD) among Malays is common, so understanding the meanings of sexuality becomes crucial, as they can vary with identity, and this may influence each woman's subsequent reaction to sexual experience. In this article, we explore the meanings of sexuality that Malay women had developed throughout their lived experience. This qualitative study, situated within a social cognitive theory and a phenomenological framework, was conducted through in-depth and photograph elicitation interviews with 26 Malay women who had self-reported experiencing FSD. The findings suggest that the meanings of sexuality for these women linked closely with fundamental factors of Malay identity, which is comprised of tradition (Adat), religion (Islam), and language, that all influence gendered roles. Malay women understood sexuality to be sexual intimacy within marriage, privileging their marital role as a "good wife" over their personal rights within a sexual relationship. This understanding of sexuality was reinforced by meanings attributed to procreation, which Malay women linked closely to the purpose of marriage and their role as a "good mother." The findings should provide useful evidence that could be used in sexual health promotions to help reduce FSD and in clinical practice to generate appropriate therapy in Malaysia and elsewhere.
    Matched MeSH terms: Sexual Behavior/psychology*
  19. Managing Women with Sexual Dysfunction: Difficulties Experienced by Malaysian Family Physicians
    Muhamad R, Horey D, Liamputtong P, Low WY
    Arch Sex Behav, 2019 04;48(3):949-960.
    PMID: 30238183 DOI: 10.1007/s10508-018-1236-1
    Recognizing barriers to managing sexual issues makes it more likely that effective ways to overcome them will be found. In Malaysia, where discussion of sexual issues is taboo, sociocultural factors may influence how physicians manage patients with these types of problems. This article focuses on the challenges encountered by 21 Malay family physicians when women experiencing sexual problems and female sexual dysfunction (FSD) attended their clinics, an uncommon occurrence in Malaysia, despite their high prevalence. This qualitative study employed a phenomenological framework and conducted face-to-face in-depth interviews. Three main barriers to managing women with sexual problems were identified that can hinder assessment and treatment: insufficient knowledge and training; unfavorable clinic environments; and personal embarrassment. Some barriers were associated with physician characteristics but many were systemic. These were further evaluated using social cognitive theory. Professional attitudes appear important as those physicians with an interest in managing women's health seemed to make greater effort to explore issues further and work to gain trust. Physicians who appeared indifferent to the impact of FSD showed greater reluctance to find solutions. Systemic issues included unfavorable clinical settings, lack of training, and lack of local evidence. Any strategy to address FSD needs to be underpinned by appropriate policies and resources.
    Matched MeSH terms: Sexual Behavior/psychology*
  20. Fulltext Questionnaire development and validity to measure sexual intention among youth in Malaysia
    Muhammad NA, Shamsuddin K, Mohd Amin R, Omar K, Thurasamy R
    BMC Public Health, 2017 02 02;17(1):157.
    PMID: 28152993 DOI: 10.1186/s12889-016-3949-1
    BACKGROUND: From the Theory of Planned Behaviour perspective, sexual intention is determined by a permissive attitude, perception of social norms and perceived self-efficacy in performing sexual activity. The aim of this study was to develop and validate the Youth Sexual Intention Questionnaire (YSI-Q), which was designed to measure sexual intention among youths in Malaysia.

    METHODS: A total of 25 items were developed based on literature reviews encompassing four main constructs: sexual intention, attitude, social norms and self-efficacy. The YSI-Q then underwent a validation process that included content and face validity, exploratory factor analysis (EFA), reliability analysis, and confirmatory factor analysis (CFA). This study was conducted on unmarried youths aged 18 to 22 years who were studying in colleges around Klang Valley, Malaysia.

    RESULTS: EFA supported the four factor structure, but five items were removed due to incorrect placement or low factor loading (<0.60). Internal reliability using Cronbach's alpha ranged between 0.89 and 0.94. The CFA further confirmed the construct, convergent and discriminant validity of the YSI-Q with χ 2 = 392.43, df = 164, p sexual intention (five items), attitude (five items), social norms (six items) and self-efficacy (four items) of practicing sexual activity. YSI-Q was shown to be a reliable and valid tool to be used among Malaysian youths.

    Matched MeSH terms: Sexual Behavior/psychology*
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