Keywords: sexuality, reproduction, sexual initiation, sexual practices

Abstract

The main objective of this article is to describe the reproductive sexual behavior of fifth year nursing students at POLISAL UNAN Managua, in order to approach their perspectives, analyzing the biological and psychosocial processes involved in reproductive sexual health; as a starting point in the implementation of more youth-friendly programs or spaces that promote full sexuality. An online survey was applied to 75 students, whose data was processed in SPSS version 25; during the quantitative phase of the study with a mixed approach of knowledge and experiences about reproductive sexual health of nursing students. The results reflect that the majority of those surveyed are over 20 years of age, single, heterosexual, with sexual initiation between the ages of 16-19 and who have had two or more sexual partners; In addition, they practice the Catholic religion, followed by the Evangelical. Half of the group studied used a condom in their first sexual relation and they do not have children; Among the most frequent sexual practices is vaginal sex and sometimes oral sex and masturbation.

Introduction

Sexual and reproductive health is defined by the WHO as the state of physical, mental, emotional and social well-being related to sexuality and reproduction; It is not just the absence of disease, dysfunction or disability. It includes the enjoyment of full and risk-free sexuality and reproduction, which involves a series of cultural and religious factors, rooted in childhood and that are built or deconstructed at each stage of life.

Sexual behavior is any action that an individual takes in order to resolve a sexual urge (resolve an erotic or reproductive desire). This, trying to preserve a maximum balance between the need to resolve this impulse (not limited to purely coital relationships, but on the contrary opening a range to all the behaviors that can generate erotic pleasure either alone or with a partner) and the possible consequences that this may bring. Rivera (2020) as cited in Aguirre Rivera, J. C. & Restrepo Soto, J. A. (2022)

This article shows preliminary results of the quantitative phase of the study “Knowledge and experiences about sexual and reproductive health in university students: a phenomenological view, Nursing-POLISAL UNAN-Managua 2022”. Its main objective is to describe the sexual reproductive behavior of students in the fifth year of nursing at POLISAL UNAN – Managua.

Methods

This is a nested mixed study, with a qualitative and phenomenological predominance, in its quantitative phase of a non-experimental, descriptive type, since it analyzes sexual behavior and reproduction according to demographic characteristics of the students of the fifth year of Nursing. It is a cross-sectional or cross-sectional study because the data were collected and the variables were described at a single point in time. (Hernandez, et al 2010) (pp 119)

An online survey was applied on the Kobotoolbox platform, in which 75 fifth-year students of the regular nursing careers participated in their different profiles: Public Health Nursing, Maternal and Child Nursing, Critical Care Nursing, Obstetric and Perinatal Nursing. Based on the results of the survey, a database was created and the graphs were constructed in SPSS version 25.

Results

Figure 1. Age and marital status of nursing students

Respondents are 20 years old or older, with a predominance of single marital status (72%), followed by stable union (15.3%).

Figure 2. Person with whom they had their first sexual relationship and age of onset of sexual life of nursing students

Most of the students started having sex between the ages of 16 and 19 with their boyfriend or girlfriend and only 16% have not started a sexual life.

Figure 3. Optimal Age for Sexual Initiation for Nursing Career Students

Despite the fact that the majority of young people surveyed in each of the nursing mentions (77.3%) affirm that the appropriate age to initiate sexual relations is after 20 years of age, according to data presented in Figure 2, 34.7% had their first sexual intercourse between the ages of 16 and 19 with their boyfriend or girlfriend.

Figure 4. Contraceptive method used in the first sexual intercourse of nursing students

Of those surveyed who have started a sexual life, most used a contraceptive method during the first sexual intercourse, however, only 51% used a condom.

Figure 5. Contraceptive methods currently used by nursing students

The contraceptive method most used by students is condoms, followed by hormonal contraception, however, a high percentage (26.7%) do not use any contraceptive method.

Figure 6. Economic condition and number of children of nursing students.

The majority of students (50.6%) do not have children, of which 33.3% are dependent on their parents and 17.3% have an informal job.

Figure 7. Frequency of conversation about sexuality and reproduction between nursing students and their parents of nursing students

61.4% of students reported talking to their parents about sexuality and reproduction never or almost never, followed by 32% who say they talk to their parents occasionally and only 6.7% of respondents talk frequently about sexuality and reproduction with their parents.

Figure 8. Sexual Orientation and Religion of Nursing Students

The predominant sexual orientation in the studied group is heterosexual with 85.3%, and of these 37.3% report being Catholic and 36% evangelical.

Figure 9. Age of sexual initiation and number of sexual partners of nursing students

49.4% started their sexual life between the ages of 16-19, and 46.7% of students have had two or more sexual partners.

Figure 10. Sexual Practices of Nursing Students

Regarding sexual practices, it can be seen that 54.7% of those surveyed practice oral sex frequently and occasionally; 25.3% engage in sex; 74.7% have vaginal sex; 6.6% have multiple sex; 20% consume pornography occasionally and 35.9% practice masturbation.

Discussion

Figures 1 and 2 indicate that some young people were already sexually active when they entered college. This shows the prevalence of sexual behavior in young people in terms of early sexual initiation, at a stage of life as vulnerable as adolescence, and the latent risks it represents for sexual reproductive health in the face of unwanted pregnancies, sexually transmitted diseases and HIV. In the same way, the sexual practice without commitment is appreciated, since most of them are single, and 12% had their first sexual relationship with a friend. There is a difference between the sexual practices that two people who maintain a formal dating relationship can have and those established by two people who do not maintain any affective bond, since many times they do not even know each other (Ramírez V. et al., 2013). The initiation of sexual activity in a context of casual sex exposes adolescents to greater risks in their behaviors in their sexual and reproductive health when compared to those who initiate sexual activity in a more romantic context (González & Molina, 2019).

Figure 3 shows a contrast between what young people consider about the optimal age at which they begin their sexual life and their own experience, according to the results presented in Figure 2, since most of them began their sexual life before the age of 20. On the other hand, 20% say that there is no specific age for sexual initiation. This highlights the transformations in the socio-cultural context and perceptions of young people that lead them to make decisions about their bodies regardless of age.

Article 21, subsection “a” of the Family Code Law No. 870, Nicaragua (adopted on June 24, 2014) states that persons who have reached the age of eighteen, who have not been declared incapable, without distinction as to sex, ethnic origin, economic, social or any other condition, that persons have full exercise of the capacity to acquire rights, to enter into obligations and freely dispose of their person and property. At this age, some decide to become independent from their parents and others prefer to depend on them until they reach an academic preparation that allows them to improve their working conditions, if their parents consent to it.

Figure 4 shows that half of the group protected themselves from STDs and HIV during their first sexual intercourse, because they used condoms; but the other half were more concerned with preventing pregnancy, exposing themselves to the spread of STDs and HIV, since they used other contraceptive methods. The above indicates that there are still large gaps in achieving responsible sexuality in young people.

Figure 5 shows that the contraceptive method most used by students is condoms, however, it does not represent even 50% of the population under study, which indicates that students are not protecting themselves against STDs and HIV, they only avoid pregnancy and 26.7% do not protect themselves even from pregnancy. This represents risky behavior, based on the fact that 72% are single.

Figure 6 represents the economic condition and number of children that nursing students have, indicating that students have postponed reproduction and prioritized their academic training; However, 8% already have a child and continue to depend on their parents, which may be associated with a lack of commitment in relationships or the practice of casual encounters, the non-use of contraceptive methods and consequently teenage pregnancy.

Figure 7 shows a lack of communication with parents on the subject of sexuality and reproduction, which fosters myths and taboos around the subject in young people and, therefore, arouses curiosity in them about the unknown. In this sense, Pérez (2011) highlights the frequency of communication with parents on sexuality issues that adolescents traditionally constitute a sexually active group, but uninformed, or poorly informed, regarding the sexual issue, a highly contradictory phenomenon, since sex education is inserted in the context of the integral formation of the adolescent.

Figure 8 shows that religion is associated with sexual orientation. The results of the survey show that the majority of the participants are heterosexuals belonging to the Catholic and Evangelical religions. Historically, it has been considered that religion can influence the sexual behavior of young people, since they seek to remain in what they have learned, keeping the biblical principles that govern them. “Religion is a determining factor in the aspect of sexual preferences in society, because religion has its point of view from a divine perspective “the Bible”, therefore, homosexuality is an issue that must be treated with great caution from a religious approach” (Guaman et al., 2019). On the other hand, Sanabria (2016, cited by Palma, 2008. p. 239), states that the control exercised by religious norms on the individual is perceived by practicing Catholic students more as invitations than as obligations that must be strictly fulfilled.

Figure 9 shows that most of the students began their sexual life early, during adolescence, which predisposes to an increase in the number of sexual partners, due to emotional vulnerability and inconstancy in feelings. Loyal F.et al. (2018) found that male adolescents with early sexual initiation have a higher risk of having a greater number of sexual partners in the last year than men with non-early sexual initiation, a difference that was not observed in female adolescents and at the same time contrast these results with those of a systematic review that reports that adolescents with early sexual initiation present more risky sexual behaviors. such as increased sexual partners and sexually transmitted infections, non-use of contraception, having or repeating a pregnancy at an early age. In this case, the majority of the population is female due to the particular characteristic of the feminization of nursing careers.

Conclusion

When analyzing the information provided by the students of the Nursing career, it can be considered that most of the respondents have presented risky behaviors throughout their active sexual lives, since their sexual initiation occurred during adolescence, they did not use barrier methods for the prevention of STDs and HIV and currently do not use them either. They have also had two or more sexual partners.