PIP: In Peninsular Malaysia, while the female population aged 15-19 years registered a growth of some 240,000 persons between 1966-1984, the number of births occurring to teenage mothers has decreased by 15,176 from 33,348 to 18,172 during the same period. In 1966, teenage births constituted some 10.8% of the total births but has declined to 4.7% by 1984. A breakdown of the 1984 data by detailed age groups shows that only 0.9% of the teenage births had actually occurred among those below 15 years of age. The declining trend in teenage births, particularly the higher order births among the very young mothers, augurs well for the improvement in family welfare. However, in order to safeguard the health and welfare of mothers and children, concerted efforts should continue to be undertaken to integrate population, family health and family life education into the school curriculum.
PIP: Data from 297 interviews among married patients attending prenatal clinics in Malaysia in 1993 are used to determine the number, spacing, and timing of pregnancies. Only live born children are included. Findings indicate that 92.2% of women were 18-35 years old, 4.2% were under 18 years of age, and 3.6% were over 35 years old. 86.2% had 4 or fewer children and 13.8% had 4 or more children. 69.7% spaced children 2 or more years apart and 30.3% had birth spacing of under 2 years. Over 90% of women had their pregnancies during the ages of 18 and 35 years.
The study reported served 2 purposes: 1) to assess the amount of sexual information posessed by a sample of staff nurses working for the National Family Planning Board and the Public Health Dept., and 2) to gather local normative data on the Information Subtest of the Derogatis Sexual Functioning Inventory (DSFI). The subjects for the this study were 2 groups of staff nurses. 10 were employees of the National Family Planning Board currently working in 1 of its clinics and 25 were public health nurses who were at a 1 week training at the clinic. The research was a questionnaire type study. Each subject was given the DSFI. On the Information Subtest of the DSFI the subjects obtained a mean score of 12.7 with a standard deviation of 4.2. This score is much lower than the normative mean (American population) and the sexually dysfunctional women mean. The nurses had inadequate and inaccurate knowledge about anatomy, physiology and psychology of sexual relations. Error analysis revealed that as a group they had poor understanding about male sexuality, the effect of aging on sexuality fertility and menopause, and difficulty in accepting oral-genital sex and sexual fantasies. This study recommends that these nurses, in order to more effective in their work, should be trained in the area of human sexuality. This training must include not only the physiology of sex but also the human aspects of sexual union.
Early sexual debut, partner violence, pregnancy and sexually transmitted infections contribute to negative health outcomes among adolescents. While the primary care clinics offer accessible sexual and reproductive health (SRH) services to adolescents, it is uncertain whether adolescents are aware of and utilize these services. This study aimed to examine Malaysian adolescents' knowledge, utilization and barriers to primary care services for SRH. A cross-sectional survey was conducted from August to November 2011 among adolescent from five randomly selected schools in Selangor, Malaysia. A self-administered questionnaire was used to assess their knowledge, attitudes, sexual behaviors and utilization of SRH services. A total of 680 adolescents participated in the study. One in ten of the adolescents were aware of the availability of SRH services, and only 6.9% of them had ever visited a primary care clinic for SRH. About 75% of them felt uncomfortable going to a primary care clinic for SRH services. Knowledge and utilization of primary care clinics for SRH among adolescents in Malaysia is poor.
A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.
A qualitative research was carried out in Besut and Kuala Terengganu to identyy adolescents’ health problems and needs jiom adolescent perspective, and to establish a priority area in the development of Adolescent Health Clinic in the district. A total of 61 adolescents were selected and divided into four groups and stratified according to age, 13-15 years old and 16 - 17 years old. Generally all participants wished to live in an environment free hom negative health risk factors. The obstacles they perceived were mainly related to lack of care or too much control by their parents. Some of them perceived that their parents in general had inadequate knowledge and skills on parenting. Among local behavioural problems mentioned were loafing, running away from home, vandalism, school absenteeism, aggressive behaviour, substance abuse, pre-marital sexual activities, "bohsia", “bohjan" and even involvement in crimes. More than hah' agreed that counselling service is important for adolescents, and it should be made available in the community preferably outside the schools. They perceived an adolescent friendly health clinic concept as an important concept that should be introduced. To them adolescent friendly health clinic is a clinic run by professionals who are knowledgeable, caring, good listeners, non—judgemental, and who exercise confidentiality. The clinic preferably should be situated in a location which is away from the present health facilities to avoid the image of a place for sick people. Clinic hours preferably during weekends, should provide appropriate technologies and situated in a comfortable ambience. Adolescent participation in the clinic was also mentioned as an important entity for adolescent friendly health services.
Four hundred and thirty five (435) cases 0f sexually transmitted infections (STIs) were notified from 20 (twenty) primary care clinics throughout Malaysia from June 1999 till September 2000 using the syndromic approach of STI management, adapted by the Ministry of Health based upon the criteria set by the World Health Organisation (WHO). Gonorrhoea was the most prevalent STI reported (30.34 %), followed by candidiasis (28.05%), syphilis (15.17%) and non-specific urethritis (NSU) — 14.02%) . As seen in most other parts of the world, the younger age groups (those between twenty and thirty nine years old) were found to be more commonly infected with STIs. Initial analysis shows that systematic data collection based on the syndromes and clear—case definitions (algorithms for the syndromic approach} need to be developed and added further to the current manual that is being developed for the health and medical staff at the operational it level. Exploration and expansion of behavioural surveillance research, management information systems of the syndromic approach, and development of new or additional strategies in the manual for the staff too, also need improvement. The Ministry of Health is also concerned about the quantity and quality of the available data based upon syndromic management of STI as compared to laboratory based criteria. Since this programme is very much client centered, the adoption of this approach generally might offer substantial improvements in the quality and effectiveness of STI care, either within the public or the private health care settings in Malaysia.
Adolescents are known to obtain information regarding sexual and reproductive health from a variety of sources and not just during formal lessons in schools. This cross-sectional descriptive study was carried out to determine the source of information on sexual and reproductive health among Form four secondary schools girls in the Klang Valley as well as parents’ relationship profile. A total of 520 secondary school girls were recruited for the study. In this study, the source of information on puberty and sexual topics were categorized as follows: first level of importance - mothers, second level of importance - siblings, third level of importance - fathers, fourth level of importance - friends, fifth level of importance - teachers and sixth level of importance - books/internet. A majority of respondents agreed that their mothers were the first level of importance they sought for information on puberty (74.8%) and sexual topics (53.8%). Thirty nine point three percent (39.3%) of respondents reported it was very easy to have a dialogue with their mothers while only 10.0% of the respondents said it was very easy to have a dialogue with their fathers. While this was the case, only 6.3% of the respondents reported discussing sex-related matter with their mothers.
National Antenatal HIV Screening Programme has been integrated as a routine screening in antenatal care in early 1998 and in Terengganu since May 1998 involving all health centers in the state. As of December 2001, a total number of 57,882 antenatal mothers were screened (97.5% of all new antenatal mothers). The HIV prevalence rate among antenatal mothers was found to be 0.052%. All HIV positive mothers were married and majority were Malays (93 .3%). Ninety percents of them revealed that the only risk factorfor HIV was through sexual contact. HIV positive status was confirmed in 66 .7% ofthe husbands. All twenty eight mothers that managed to be followed up delivered to live birth babies. All newborns reported to have good Apgar score (9 at 5 minutes of life). Mean birth weight was 3 .08 kilograms 1- 0.45 and only 8% were premature babies. The observed rate of HIV vertical transmission was 6.25% and this is lower than the expected mother to child transmission rate of 30% without intervention.
Methamphetamine production and abuse increased significantly in Malaysia. Lesbian, gay, bisexual and transgender (LGBT) populations have higher prevalence of substance abuse compared to general population. Their unmet needs pose greater challenges in managing their substance related disorders. This paper described the agony of a Malaysian lesbian with gender identity disorder who abused substances and developed amphetamine-induced psychosis. Her sexual identity issue was explored in managing her substance related disorders to improve her outcome.
This paper looks at some of the problems encountered when cases of abuse and injuries occur in children placed in child care in an urban community in Malaysia. It is based on the study of 37 children referred to our hospital's Child Protection Services over the past four years for injuries and incidents where the child-minders came under suspicion. They constituted 12% of the 285 children referred to the Child Protection Team during that period for evaluation of suspected child abuse. Twenty six children had experienced physical trauma. Fifty eight percent of these were young infants with cranial injuries or limb fractures but no history to explain their occurrence. Four had superficial injuries from accidents secondary to inadequate supervision. The other 11 children had been sexually abused. The perpetrators in 73% of cases were either the husbands or sons of the child-minder. Ninety five percent of the incidents occured at home-based nurseries. Prospects of any punitive measures were remote in most instances due to uncertainty about the perpetrator, or insufficient corroborative evidence required in sexual abuse cases. There were three documented cases where the family refused to lodge a police report or co-operate with investigations out of a reluctance to implicate or offend the child-minders who were mainly neighbours, relatives or friends in 58% of cases. Ninety seven percent of the facilities were unregistered, making surveillance for recurrent incidents and adherence to safety standards difficult. These incidents were almost certainly an underestimate of the problem. Training of child-care providers, improved legislation and enforcement as well as education of parents to choose suitable facilities are issues which need to be tackled.
Sexual orientation other than heterosexuality is believed to be unnatural, sinful and dangerous in a country like Malaysia that is steadfast in religion and culture. Children sexual orientation has subsequently been a sensitive, challenging, and frightening topic for parents. Past studies have documented the role of nature and nurture in the development of social orientation. Although preliminary studies have found genetic to be a significant factor, it was inconclusive if it was the only factor in determining sexual orientation. Hence, this paper will highlight the role of parents in nurturing sexual orientation of children. Despite lack of studies in local and Western context, the few stud-ies available indicated that a secure attachment bond between parent and child is essential for healthy psychosexual and identity development. Additionally, this paper highlights the importance of communication, unconditional love and support between parent and child throughout the developmental stages leading to adulthood. Furthermore, this paper will briefly discuss possible treatment options for children with sexual orientation issues and its impact on chil-dren psychological health and well-being. This paper will conclude with suggestions on future research to further understand the development of sexual orientation in children.
Introduction: Teenage pregnancy is common and has become a key public health concern for all. This study aims to discover the meaning of lived experiences and to strategize in addressing the phenomenon from the previous or current unwed pregnant girls’ or young women’s perspective. Methods: A qualitative study was conducted among 10 girls or young women recruited during their stay at two shelters in Selangor but came from various state in Malay- sia; who have experienced becoming unwed mothers when they were between 10 to 19 years old. All participants gave informed consent. In-depth face-to-face interviews were conducted, audiotaped and transcribed. All quotes were encoded using Qualitative Data Analysis (QDA) Miner program. Data were analyzed using interpretative phe- nomenological analysis. Results: The themes emerged from the analyses; i) Trajectory of sexual activity, ii) struggles of motherhood to un-wed teenage mother. Most of these girls were pregnant due to consensual sexual intercourse although there were some refutes but their actions have led them for this to happen. They described how indirect relationship such as communication via telephone and the internet may have initiated the desire for sexual activity which led to a short first-time meeting and short term partnership, caused them to enact the sinful deed. They were overwhelmed with ambivalence feelings of wanting to terminate the pregnancy, abandon the newborn or to endure the journey of motherhood together with their ex-nuptial baby. Conclusion: The findings of this study showed that the strength of indirect relationship is able to evoke sexual desire that contributes to out-of-wedlock pregnancy. Max- imum support is needed from all; peers, parents, educators and the whole community structures.
Introduction: HIV/AIDS is one of the leading health problems worldwide. There is an increasing rate among the ages between 13 to 49 years old. School based intervention is an important component of community-based interventions for HIV/AIDS and is the best stage to promote abstinence which is best maintained among those not sexually experienced. Objectives: This study was carried out to determine attitude towards sex among secondary school children in Selangor state. Methods: A cross-sectional study design was used. Four out of nine districts in Selangor state were selected at random. Students were divided according to gender, academic performance (good or poor) with no behavioural problems
and students with evidence of behaviour problems (at risk). Results: Out of 149 students, the majority (56.4%) were females. The majority of students did not think sex should be discussed in depth and do not speak to parents, teachers, religious teachers, counselors, relatives, doctors or nurses but speak to friends regarding sex. More than half watch pornography. A significantly higher percentage of male students in the weak and at-risk group admit to thinking of intimacy (hugging and kissing) with the opposite gender. A higher number of these students would try sex out of curiosity, for fun, because it was difficult to say ‘no’ to and that they would like it. A significantly higher percentage will try sex because they did not want to hurt their girlfriends’ feeling by saying ‘no’. While the majority of students think intimacy will end in sex, a significantly higher percentage of male at-risk students think just talking with the opposite gender will end in sex. The majority of male students responded feeling attracted to the picture of a girl in sexy clothing but a significantly higher percentage of at-risk students also felt attracted to the picture of a girl properly attired. A significantly higher percentage of male at-risk students say parents do not say sex before marriage is wrong and a significantly higher percentage of
male students of weak and at-risk groups say girlfriends say sex before marriage is okay. A significantly higher percentage of weak and at-risk students speak to doctors regarding sex and think sex should be discussed in depth. Conclusion: Weak and at-risk male students appeared to have a more vulnerable attitude towards sex. This may predispose them to risky sexual behaviours leading to HIV/AIDS. Poor academic performance and behaviour problems may not be different as potential sexual risk predictors. The information obtained will be useful in designing intervention programmes in the prevention of HIV/AIDS.
Exhibitionism is a distressing condition which may have a link with the increasing availability and usage of online sexual activities (OSA). We highlight a 42-year-old man who presented with a constant craving for OSA to achieve his sexual satisfaction which included exposing his genitalia to virtual partners, unsuspected strangers, and colleagues in public areas. His sexual behaviours were further reinforced by an online video chatting with genitalia exposure, which ended commonly with an exchange of masturbatory acts. He denied any problem with his erection and able to achieve orgasm via common sexual acts. There was no past psychiatric history nor family history of mental disorder. He volunteered to seek psychiatric help and subsequently given a psycho education on his illness and how to cope with the distress associated with his sexual acts. He was scheduled for an intensive psychotherapy to instil insight and hope to deal with his sexual difficulties.
With the availability of the Internet, pornographic materials are readily accessible. Pornographic materials may have a link to addiction and other deviant sexual behaviour. In this case report, we highlighted a link between voyeuristic disorder and internet sex addiction. Mr. SK is a 22-year-old single gentleman who was referred for psychiatric assessment due to voyeuristic acts. He had been watching pornographic materials since 16 years old and became addicted to it.
Adulterated premixed coffees have turned into an issue in Malaysia lately and have caught the eye of the authorities due to death reports linked to these products. The major cause of this issue is reported that these premixed coffees have passed food inspection test and eventually released to the market for public consumption. These coffees were claimed to be spiked with several sexual enhancers like sildenafil, tadalafil, and vardenafill, which are common drugs used to treat erectile dysfunction. Methods: Chemometrics approach using UV-Vis spectroscopy was developed to detect the selected sexual enhancer drugs found in commercial coffees by employing SIMCA-P software for the multivariate statistical analysis. Seven brands of coffee samples were purchased from local stores, and 30 sachets each were tested, hence totalling to 210 samples. Each sample was named H, J, G, W, N, T, and K, respectively. Results: Three multivariate models were generated, namely principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), and partial least squares discriminant analysis (PLS-DA). OPLS-DA was selected as the best model for the overall results as it displayed minimal discriminate. Sildenafil, tadalafil, and vardenafil were detected in sample H, while vardenafil in brand J, and none in samples G, W, N, T, and K. Conclusion: OPLS-DA analysis showed discrimination for the sexual enhancer drugs in two brands of premixed coffee. The UV-Vis spectroscopy-based chemometrics method proved to be reliable and efficient in determining the selected drugs, as well as in saving time and cost.
Background: Social misconduct amongst adolescents is a worrying and ever growing problem in Malaysia, despite efforts taken to overcome it.
Methods : A cross sectional study was conducted among secondary school students in Melaka Tengah District to measure the prevalence and determine the factors associated with social misconduct amongst adolescents. A total of 414 form four students were recruited by systematic random sampling fulfilling the study criteria between Jun to September 2008, from eight randomly selected secondary schools in the district. Data were collected using a structured self-administered questionnaire and analyzed using SPSS software version 12.0. Socio-demographic, housing and family factors in relation with social misconduct were studied.
Results : The prevalence of the social misconduct in this study was 70.5%. The most prevalent misconduct includes loitering (37.4%), truancy (30.0%), watching pornographic films (28.7%), and involved in pre-sexual activities (23.7%). The factors that showed significant association with social misconduct were sex and race.
Conclusion : The prevalence of social misconduct is high among adolescent and males as well as Malays are at higher risk. Activities planned for adolescents should be stressed on the danger and effects of social misconduct and be more focused towards male and Malay adolescents.