Level of Education and Knowledge about HIV/AIDS on High School

and College Students for Premarital Sex in North Sumatera

Erond L. Damanik

Universitas Negeri Medan, Jl. Willem Iskandar Psr V Medan, 20221, Indonesia.

Anthropology Departement, Faculty of Social Science, Medan, Indonesia

Keywords: Level of education, HIV/AIDS, premarital sex, North Sumatera

Abstract: The purpose of this study is to describe and understand the level of education and knowledge about HIV/AIDS

on premarital sexual behavior among high school and college students in North Sumatra. The number of 8,272

HIV/AIDS sufferers in 2016, 41.3 percent were high school and college students. To explain this case, anomie

theory from Durkheim was used. The study was run qualitatively with an observational descriptive approach.

In addition to in-depth interviews, questionnaires with a Likert Scale were distributed to 50 informants in

Medan, Deli Serdang, Pematangsiantar, Karo and Toba Samosir. The results of the study were that there was

no relationship between the level of education and knowledge about HIV/AIDS on premarital sexual behavior

among high school and college students in the province of North Sumatra.

1 INTRODUCTION

The HIV (Human Immunodeficiency Virus) and

AIDS (Acquired Immune Deficiency Syndrome) not

only occur in adulthood but also at a young age. In the

province of North Sumatra, people with HIV/AIDS

increase significantly each year. If at the end of 2008

there were still around 3,400 people, then in the

period of January 2009-December 2017 the number

reached 8,272 people (KPA North Sumatra, 2018).

The biggest sufferers of HIV/AIDS are in Medan,

Pematangsiantar, Deli Serdang, Karo, and Toba

Samosir. The first three areas are industrial estates

while the last two are tourist destinations. Medan is a

big city and has a very large population. The number

reaches 2.9 million people. In 2018, there were

111,697 middle school students and 70,194 high

school students. In addition, there are 272 active

(college) campuses with approximately 39,600

students.

Pematangsiantar is the second largest city in

North Sumatra. There are 82 junior high schools, 72

high schools, and 62 colleges. Deli Serdang is a

district adjacent to Medan City. This area is an

industrial base around the city of Medan. In addition,

this area is a plantation area and a beach in the

Malacca Strait. The population in these three regions

is diverse. Furthermore, Karo and Toba Samosir are

tourist areas in North Sumatra. The area is directly

adjacent to Lake Toba and is always crowded on

weekends. In these two regions, there are

approximately 50 hotels, ranging from five stars to

those without stars. This study aims to look at cases

of HIV/AIDS among students and students based on

regional typologies, namely cities, industrial areas

and tourist destinations in North Sumatra. According

to the North Sumatra KPA data (2018), people with

HIV/AIDS in adults and young people in 2005-2009

in each region are shown in the following table.

Table 1: Prevalence of HIV/AIDS in North Sumatra

province, 2005-2009

Location Years

2005 2006 2007 2008 2009

Medan 45 115 110 131 134

Deli Serdang 2 12 19 8 21

Pematang Sianta

47 12 4 9

Karo - 3 8 9 6

Toba Samosi

4 5 11 8 10

The poverty factor in urban areas and the high

needs of life causes many women to choose to work

as commercial sex workers (Pekerja Seks Komersil).

While in tourist areas, commercial sex seems

inseparable from travel activities. It can be said that

the prevalence of HIV/AIDS in cities and tourist

destinations is higher than in rural areas. This disease

Damanik, E.

Level of Education and Knowledge about HIV/AIDS on High School and College Students for Premarital Sex in North Sumatera.

DOI: 10.5220/0010024500002917

In Proceedings of the 3rd International Conference on Social Sciences, Laws, Arts and Humanities (BINUS-JIC 2018), pages 561-567

ISBN: 978-989-758-515-9

561

arises because of the intensive change of partners in

sexual intercourse.

The source of the data taken from Infodatin (2014)

mentions that the highest HIV/AIDS sufferers in

Indonesia come from the productive age of 25-49

years. While the college age of 20-24 years is in the

fourth position and the age of adolescents namely 15-

19 years is in the fifth position. In North Sumatra, the

profile of HIV/AIDS patients aged 10-29 years is

shown in the table below.

Table 2: Prevalence of HIV/AIDS for high school and

college students in North Sumatera, 2016

e ran

e HIV AIDS Total amount

10-18

ears 51 1.199 1.250

19-29

ears 65 2.037 2.102

Amount 116 3.236 3.352

The data above shows that 37.8 percent of the

3,301 HIV/AIDS sufferers in 2017 are aged 10-18

years. Whereas 43.6 percent of HIV/AIDS sufferers

aged 19-29 years. This data shows that 41.3 percent

of HIV/AIDS sufferers in North Sumatra is between

10-29 years old. School age is an age group that is

vulnerable to being infected with HIV/AIDS.

According to Guindo et al (2014), the biggest

infection of HIV/AIDS in the world comes from

school age. According to him, economic factors and

the influence of mass media influence attitudes and

perceptions of premarital sexual relations. When

looking at this social reality there is a tendency that

young people up to 30 years are vulnerable to

HIV/AIDS. The age of men with this disease tends to

be above 25 years, while the age of women tends to

be under 30 years. From the description above, this

paper intends to examine the relationship between

education level and knowledge about HIV/AIDS in

high school and college students in the province of

North Sumatra. As an assumption in this study is that

the higher the level of education, the better the

knowledge about HIV/AIDS. Furthermore, the better

the knowledge about HIV/AIDS can be prevented

from premarital sexual relations.

2 MATERIAL AND METHODS

This study was conducted in 5 regions, namely

Medan, Deliserdang, Pematangsiantar, Toba

Samosir, and Karo. The reasons for choosing this

location are: 1) the highest area of HIV/AIDS

infection from the age group 15-25 years, and 2) is an

industrial and tourist area in North Sumatra.

The study design was carried out qualitatively

with an observational descriptive approach.

According to Denzin and Lincoln (2005), this method

is carried out to describe an event objectively. Data

collection is carried out qualitatively and

quantitatively. The questionnaire contains 15

questions and 4 answer options are shared with

informants. Each answer is scored according to the

Likert Scale. Each research location consisted of 5

high school students and 5 students. Informant data in

the form of addresses, places of residence, schools

and sexual information are kept confidential. The

study was conducted in May-June 2018 involving 50

informants from 5 research locations. Determination

of informants was done randomly based on data from

hospitals at the research location. Investigations in the

form of in-depth interviews were conducted on 2

selected informants according to the highest and

lowest answers from the questionnaire.

The problem in this study is: is it true that the level

of education is related to knowledge of HIV/AIDS so

that it prevents premarital sexual relations among

high school and college students in North Sumatra?

This problem is explained by the Anomie theory of

Durkheim. The study aims to explore and describe the

relationship between education level and knowledge

about HIV/AIDS in high school and college students

and does not conclude whether informants have

HIV/AIDS.

3 RESULTS AND DISCUSSION

The profile of 50 research informants in five districts

and cities in North Sumatra, namely Medan, Deli

Serdang, Pematangsiantar, Toba Samosir, and Karo.

The 50 informants were high school students aged 12-

17 years and college-aged 18-23 years. They are not

from broken home families. All of these informants

were recorded as students at their respective schools

and campuses in the area. The profile of the informant

is shown in the table below:

Table 3: Profile of research informants

Area Students Sexs

h school Colle

High

school

College M F M F

Medan 5 5 2 3 3 2

Deli

Serdan

5 5 2 3 3 2

Pematangsi

anta

5 5 2 3 2 3

Karo 5 5 3 2 3 2

Toba

Samosi

5 5 2 3 2 3

Amount 25 25 11 14 13 12

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The data above shows that 50 informants were 10

people from each research location. From the aspect

of education level, each of the 5 informants is a high

school and college student. In terms of sex, 11 high

school students were male and 14 female, while the

college informants consisted of 13 males and 12

females. Informants of high school students are

enrolled in schools and are actively studying at the

research location. While from 25 college informants,

16 attended Medan, 4 at Brastagi and 5 in North

Tapanuli. As many as 94 percents or 47 informants of

high school and college students claimed to have had

premarital sexual relations. Whereas 6 percent or 3

people did not give an answer. The description of

premarital sexual relations based on the first time is

as follows:

Figure 1: First sexual intercourse

The data in figure 1 above shows that as much as,

6 percent or 3 informants had sexual relations in grade

3 junior high school, 38 percent or 19 informants had

had sexual relations since grade 2 high school, 22

percent or 11 people in grade 3 high school, and 28

percent or 14 informants had sexual relations in the

second year during college. As many as 6 percents or

3 female student informants did not give answers. A

total of 47 informants claimed to have had first sex

with a boyfriend. From the 25 college informants, 36

percent or 9 people had the first sexual intercourse

when they were high school students. While 64

percent or the remaining 16 people have sexual

intercourse when they are students at male boarding

houses. In fact, as many as 11 people or 44 percent of

student informants claimed to have had premarital

sexual relations more than five times. Sex is done

with a boyfriend who changes between high school

and college. While the remaining 56 percent or 14

informants claimed to have had sexual intercourse 2

or three times. Among high school student

informants, 88 percent or 22 informants claimed to

have had sexual intercourse 1 or 2 times, while the

remaining 12 percent or 3 people did not give an

answer.

This data is an indication that there is no

relationship between the level of education and

premarital sexual relations. Supposedly, the higher

the education, the better the knowledge of HIV/AIDS.

Through this assumption, the informant should not

have sex repeatedly and change partners. However,

this research information shows another reality. The

higher the education, the higher the intensity of

premarital sex. This kind of reality happens because

it is separated from parents, lifestyle, hedonism or the

influence of internet progress.

Ironically, 3 college female informants worked

part-time at the cafe and became 'call women' (Wanita

Panggilan) in Medan. This work was chosen because

of the reason left by the boyfriend who had taken her

virginity. While 1 person works as a 'call woman' for

reasons of high economic needs. This situation is

different from high school student informants.

Although most informants claimed to have had

premarital sexual relations, they did not tend to be

repeated. Sexual intercourse is done with fellow

schoolmates. However, at the time of continuing the

college girlfriend also took part. This girlfriend

change often has implications for repetitive sexual

relations continuously during college.

The first reason for having sex tends to be diverse.

Most of the informants claimed that they were

persuaded by boyfriends, influenced by friends, films,

lifestyle, and the effects of the internet or the media.

The 47 informants who had premarital sexual

relations, 80.8 percent or 38 informants happened

because of boyfriends' persuasion. While the rest tend

to be influenced by friends, films, lifestyles or the

internet or the media. So, dating relationships are the

main factor causing premarital sexual relations.

However, it should be emphasized that dating that is

trapped in sexual relations does not originate from

within but is influenced by external factors such as

film, the internet, and the social environment.

Besides intrinsic factors as explained above, there

are extrinsic factors. The high rates of premarital sex

in Medan, Deli Serdang, and Pematangsiantar occur

due to the effects of urban areas and industrial areas.

Social relations in cities and industries that tend to be

individualistic, loosening of values and norms, and

high economic needs are the main factors driving

premarital sex. This fact is different in Karo and Toba

Samosir which tend to be influenced by tourist areas.

As a tourist area, it is impossible that premarital sex

does not occur among young and productive people.

The tourist lifestyle greatly influences the behavior of

students and students in these two regions. Most of

the informants claimed that they did not get

information about the relationship and the impact of

premarital sex in the family. Talk about sex is still

considered taboo or contrary to cultural values.

Information about sex is obtained from fellow

friends, girlfriends or reading the internet and the

Level of Education and Knowledge about HIV/AIDS on High School and College Students for Premarital Sex in North Sumatera

563

media. Information and news consumed are not on the

impact of premarital sexual relations, but rather

sexual harassment, pornographic films or similar

information. However, 47 sexual relations informants

claimed to have never had a health check. Therefore,

this study cannot conclude whether they are positive

or negative with HIV/AIDS.

Based on the description above, this study shows

that there is no relationship between the level of

education and knowledge about HIV/AIDS on

premarital sexual relations behavior. In a sense, the

higher education and knowledge about HIV/AIDS is

not a guarantee of stopping premarital sexual

relations. In fact, the higher education and knowledge

about HIV/AIDS is the more effective it is to prevent

contracting HIV/AIDS such as condom use and

others. Research results like this are in line with

Wirahayu and Satyabakti (2014) that the knowledge,

attitudes, and actions of Indonesian-Navy Military

Army (TNI-AL) members are very good at preventing

HIV/AIDS. The same reality is obtained from the

research of Nuzzillah and Sukendra (2017) which

states that there is a known relation to the risk of

transmission but there is no relation to premarital

sexual behavior. This fact is in line with the results of

research by Rahayu, Rismawanti, and Jaelani (2017).

Their research mentions a correlation between

knowledge about HIV/AIDS and vulnerability to

HIV/AIDS. It was stated that the lower the knowledge

of HIV/AIDS had an impact on the high risk of

contracting HIV/AIDS.

According to Nurachmah and Mustikasari (2009),

young people infected with HIV/AIDS caused the

loss of the productive era. This is due to risky

behavior among school age and being vulnerable to

contracting HIV/AIDS. Having HIV/AIDS occurs

due to intrinsic and extrinsic factors. The level of

knowledge, understanding, and attitude about

HIV/AIDS comes from oneself, while the influence

of friends, films, lifestyle, and environment comes

from outside. Both of these factors are strongly

influenced by industrialization which has an impact

on fundamental changes in the system of social values

and norms. Industrialization changes the function of

the nuclear family, fosters anomie and hedonism and

secularism. Anomie is the waning of old social and

cultural norms while the new order has not been

formed (Ritzer, 2011). This situation strengthens self-

liberation from collectivity towards individualism in

the form of individual cults that foster hedonism

(Turner, 2012). In addition, loosening social norms

and waning nuclear family functions have an impact

on premarital sexual relations among students and

students. Encouraged by curiosity and wanting to try,

it has implications for changing partners. This fact is

vulnerable to an increase in the prevalence of

HIV/AIDS at the age of 16-25 years.

The informant trapped in premarital sexual

relations is an anomie situation or loss of social

norms. Losing these norms becomes a factor in losing

role models, guidelines or guidance. Therefore, the

more public the anomie, the higher the vulnerability

to premarital sexual intercourse. Therefore, the

function of norms must be restored through the role

of education and family. Emotional relations in the

family that are implicated through speech and

behavior play a major role in avoiding humans from

anomie (Horton and Hunt, 1980).

The family functions strengthen spiritual and

physical endurance in order to distance themselves

from deviant behavior. The families that are not based

on strong religious commitment have a risk of four

times greater "broken home", including disloyalty,

changing partners and various other forms of

promiscuity. This fact has resulted in zero growth of

norms within the family so that children's behavior

becomes out of control.

During 2005-2016, cases of HIV/AIDS continued

to increase. According to Kepmenkes data (2016), the

highest HIV/AIDS sufferers were DKI Jakarta

(38,464), East Java (24,104), Papua (20,147), West

Java (17,075), and Central Java (12,267). Whereas

North Sumatra is ranked 7th out of 34 provinces in

Indonesia. The biggest HIV/AIDS sufferer in North

Sumatra is the city of Medan, which is 5,360 people

(Dinkes Medan, 2011). This number increased

significantly from 2013 totaling 3,410 people

(Antara, 2018). The data on people with HIV/AIDS

in North Sumatra, 2014-2017 are as follows:



Figure 2: HIV/AIDS sufferers in North Sumatra, 2014-2017

The data in figure 2 above shows that as of

December 2017 there were 8,272 positive people with

HIV/AIDS (Berita Sumatera Utara, 2017). This

number increased by 160 people from 8,112 people

from 2016 (Pojoksatu Sumatera Utara, 2016). In

2014, there were only 6,689 people with HIV/AIDS

(Tribunnews, 2015). HIV/AIDS prevalence in 2016

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was 28.9 per 100,000 population. That is, as many as

29 people out of 100,000 people in North Sumatra are

positive for HIV/AIDS (Metronews, 2016). A total of

3,301 people out of a total of 8,112 were HIV-

infected. They are 2,474 men and 827 women.

Whereas AIDS patients in the same year were 4,811

people. They were 3,756 men and 1,055 women.

The findings of this study strengthen the social

reality in North Sumatra that 41.3 percent of young

and productive age suffer from HIV/AIDS. The

emergence of this disease because as much as 94

percent of the age of students and students have had

premarital sex with multiple partners. Sex first

occurred during school at the high school level and

continued to repeat until college. Therefore, the study

concluded that the absence of educational relations

and knowledge about HIV/AIDS with premarital sex

behavior among students in North Sumatra.

Based on the data described above, it is known

that urban areas such as Medan and Siantar District

tend to have high premarital sex. The same reality

occurs in tourist areas such as Karo and Toba

Samosir. The same phenomenon is found in industrial

areas such as Deli Serdang.

This fact occurs for several reasons: first, the

socio-economic conditions of families classified as

relatively poor, secondly, the high cost of living as

students and students, thirdly, the lifestyle in urban,

industrial and tourism areas which is strongly

influenced by others and fourth, low moral and ethical

values for students and students.

The tendency of students and students to have

premarital sex tends to be caused by: first, the free

association between students and students through

dating, secondly the influence of internet technology

through news and porn films, and the three factors

want to feel or try sex. Not all students and students

who have premarital sex have HIV/AIDS. Although

some of the research informants said that they had

repeated premarital sex, they did not have the deadly

disease. This fact occurs because of sufficient

knowledge to anticipate the spread of the disease.

However, some of them cannot avoid contracting

HIV/AIDS. In general, those who contract HIV/AIDS

are students and students caused by first, not having

enough knowledge to anticipate HIV/AIDS, and

secondly, having the shame of asking fellow friends

how to anticipate this deadly disease.

The trap of students at premarital sex starts from

dating. In other words, premarital sex for the first time

is done with her boyfriend. Premarital sex is done

repeatedly with his girlfriend. In fact, some

informants said that they had done it since junior high

school and repeated it during high school and also

when they were students. Student and student social

life like this occurs in urban areas, industries, and

tourist areas. In these areas, relationships and

interactions with parents tend to be limited. Even

among students and students do not live with their

parents (living in dormitories or boarding houses).

The life of free dating, the desire for sex and a

lifestyle among students makes them trapped in

premarital sex done repeatedly. Ironically, sex with a

boyfriend does not continue the marriage. A number

of informants in this study mentioned that broken

hearts with boyfriends made them sell themselves to

every man. This fact has implications for the

character of sex, namely: first, done with the first

girlfriend boyfriend, second boyfriend, and third

boyfriend and so on, second, done with another man.

In the second character, this student uses pimps or

through reflexology or night entertainment centers

such as in the city of Medan.

Based on this study, several things were found:

first, there was no relationship between the level of

education and knowledge of HIV/AIDS on premarital

sex. All informants in this study acknowledged the

dangers of premarital sex to HIV/AIDS. In fact, they

know this danger from various reports in newspapers,

television, and information from their friends.

However, the danger does not make them avoid

premarital sex. Second, the level of education and

knowledge of HIV/AIDS is not a major factor for the

use of HIV/AIDS prevention tools. During premarital

sex, HIV/AIDS prevention tools such as condoms are

used to prevent pregnancy. So, the main thing that is

concerned with premarital sex offenders is preventing

pregnancy and not preventing contracting the deadly

disease. The fact obtained from this study states that:

the level of education and knowledge of HIV/AIDS

does not dampen the desire not to have premarital sex.

This is contrary to the fact that there should be higher

levels of education and knowledge of HIV/AIDS so

this fact has implications for the low level of

premarital sex.

The level of education and knowledge about

HIV/AIDS is one of the factors that should influence

the low level of premarital sex. This fact is caused by

the role of schools (education) to instill the danger of

sex for students. That meant not only the potential for

the outbreak of the deadly disease, but also for the

dignity of a student. Educational factors should be

able to instill social values, ethics, and norms in

which students understand the dangers of premarital

sex. In this case, the role of teachers and parents

requires synergy to control students from their daily

lifestyles.

Level of Education and Knowledge about HIV/AIDS on High School and College Students for Premarital Sex in North Sumatera

565

Sometimes, technology 4.0 today has a negative

impact on students. For example, it's easier to access

pornographic movies through smartphones.

However, the reliability of education and knowledge

for students is sure to be able to use the smartphone

in a better direction. The reliability of education and

knowledge is also able to reduce the desire for

premarital sex, namely the courage to do so before

marriage. This goal should be achieved from

education and knowledge which is able to form

students who have skills, not only for themselves but

also for others.

Education and knowledge are keywords for

avoiding premarital sex. However, this study presents

another fact that education and knowledge have no

impact on preventing premarital sex. Therefore,

another study needs to be done to find out the factors

that cause premarital sex outside the factors of

education and knowledge of HIV/AIDS. A study of

other factors to reduce premarital sex is very

important, given the high level of premarital sex in

North Sumatra. Although they do not all suffer from

this dangerous disease, the high percentage of

premarital sex offenders needs attention. Education

and knowledge must be able to shape students to have

good moral ethics. Education and knowledge must be

able to change students, namely understanding social

ethics. If education and knowledge are unable to

prevent premarital sex among students, it means that

education fails to create ethical students.

4 CONCLUSION

Novelty research is the absence of a relationship

between the level of education and knowledge about

HIV/AIDS with premarital sex in high school and

college students in North Sumatra. This finding is

reinforced by research data that 94 percent of research

informants had premarital sex during high school.

This deviant behavior keeps repeating because of

changing girlfriends during high school and college.

The characteristics of the research location namely

industrial and tourism areas have an impact on

deviant behavior in the form of premarital sex. This

fact strengthens the social reality of North Sumatra

until December 2017 where young and productive

age is 10-29 years with HIV/AIDS.

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