The Effect of Media Exposure, Family Closeness, and Knowledge

about Sexually Transmitted Disease on Sexually Transmitted Disease

Risk Behaviors in Senior High School Students

Oki Wihardiyanto

, Flora Ramona Sigit Prakoeswa

, C. R. S. Prakoeswa

Faculty of Medicine Muhammadiyah University of Surakarta, Surakarta, Indonesia

Department of Dermatology and Venereology Muhammadiyah University of Surakarta-PKU Muhammadiyah Hospital,

Surakarta, Indonesia

Department of Dermatology and Venereology- Faculty of Medicine, Universitas Airlangga – Dr Soetomo General

Hospital, Surabaya, Indonesia

Keyword: Sexual Behaviour, Media Exposure, Family Closeness, Knowledge.

Abstract: Sexually Transmitted Diseases (STDs) is one of the reproductive health problems that caused by unsafe

sexual behavior. STDscan be caused by multiplefactors, such as influenced by media exposure, family

closeness, and the knowledge about STDs. The aim of this research is to know the correlationbetween

media exposure, family closeness, and knowledge about STDs on STDs risk behaviors in senior high school

students.This study used cross sectional method, with 95 subjects of senior high school students, using

family closeness questionnaire, media exposure questionnaire, and sexual knowledge and behavior

questionnaire, the data were analyzed by wilcoxon test and logistic regression test.Based on the wilcoxon

test, the relation of media exposure, family closeness, and the knowledge about STDswith STDs risk

behaviors obtained z scores 3.316 (p = 0.001), -8.352 (p = 0,000), -5,000 (p = 0,000), respectively. The

regression test showed a correlation value between media exposure, closeness, and the knowledge about

STDs with STDs risk behavior of each 3,561 (p=0,040), 1,417 (p=0,011), 5,553 (p=0,037). There is a

relationship between media exposure, family closeness, and the knowledge of STDs on STDs risk behaviors

in senior high school students. Knowledge about STDs is the most influential factor in STDs-risk behavior

compared to media exposure and family closeness.

1 INTRODUCTION

Sexually transmitted diseases (STDs) is the

pandemics that caused health, social, and economic

problems. STDs is one of the reproductive health

problems that caused by unsafe sexual behavior.

Based on data from the World Health Organization

(WHO) there are more than one million people

affected by STDs every day and 357 million cases

occur each year

(WHO, 2016). In Indonesia, the

incidence of STDs in 2016 is about 41.259 cases

(Indonesian Ministry of Health, 2016).

Smith (2015) stated that the transmission of

STDs can be prevented with a safe sex (Smith,

2015). But the result of Crosby’s (2012) research

showed that the safe sex is less effective than avoid

the high risk of behaviour in preventing STDs

(Crosby, 2012). According to the data of Indonesian

population and family information network

(BKKBN) 62,7% students in Indonesia had a high

risk of sexual behaviour

(BKKBN, 2015).

The high risk of sexual behaviour can be

trigerred by several things, such as social

enviroment, media exposure of pornography, family

bonding, and the knowledge of STDs (Departemen

Kesehatan Republik Indonesia, 2016). In order to

prevent the high risk of sexual behaviour and STDs

we need to know which factors that have a greater

influence of sexual behaviour.

2 METHODS

This study used cross sectional method. The number

of subject calculated with slovin formula :

Wihardiyanto, O., Prakoeswa, F. and Prakoeswa, C.

The Effect of Media Exposure, Family Closeness, and Knowledge about Sexually Transmitted Disease on Sexually Transmitted Disease Risk Behaviors in Senior High School Students.

DOI: 10.5220/0008156002950298

In Proceedings of the 23rd Regional Conference of Dermatology (RCD 2018), pages 295-298

ISBN: 978-989-758-494-7

295

43%

41%

internet

film/video

television

book/magazine

others

𝑛

𝑁

1𝑁



𝑑





1

and obtain the minimum number of subject is 92

students (𝑛  minimum sample, N = population, d

= maximum tolerantion) . To be included, subject of

this study had to meet three criteria. First, the subject

must be aged 14 – 19 years old. Second, the subject

had the score of L-MMPI less than 10. Third, the

subject is not a boarding student.

The data was colected using family

questionnaire, media exposure questionnaire, and

sexual knowledge and behavior questionnaire. The

data were analyzed by wilcoxon test and regression

logistic test. The wilcoxon test used to knowing the

correlation between the variables. The regression

logistic test used to look for which variable that has

the highest influence of STDs and to predict the

amount of influence from each variable.

3 RESULTS

The number of subject with a high risk of STDs

from this study is 7,4% and the low risk of STDs is

amount 92,6%. The distribution of media exposure

showed that 7,4% subjects never had a exposure of

pornography, 69,5% subjects had a moderate

exposure of pornography, and 23,1% subjects had a

high exposure of pornography. About the family

closeness, there are 11,6% of subjects which had a

bad relation with teir family. The distribution of

knowledge about STDs on subject showed that 6,3%

subjetcs had a bad knowledge, 38,9% subjects had

an intermediate knowledge, and 54,7% subjects had

a good knowledge.

All the variables of this study had a significance

correlation to STDs risk behaviour with the p value

less than 0,005. The subject with a high exposure of

pornography had a higher responsibility to do a

sexual risk behaviour 3,561 point (p value: 0,04)

than the others. The less closeness with family

improved the responsibility to do a sexual risk

behaviour at the point 1,417 (p value: 0,011). The

less knowledge about STDs also improved the

responsibility to do a sexual risk behaviour at the

point5,553 (p value:0,037).

Figure 1: Distribution of sexual activity in senior high school students.

Figure 2: Distribution of pornoghraphy exposure in senior high school students.

11%

62%

18%

2% 2%

None

Masturbation

Kissing

Petting

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Table 1: Univariate test of variable.

Test Statistics

STDs Risk Behaviour –

Family Closeness

STDs Risk Behaviour –

Media Exposure

STDs Risk

Behaviour –

Knowledge of

STDs

Z– score

-8,352

3,316

-5,000

Asymp. Sig. (2-tailed)

,000 ,001 ,000

a. Wilcoxon Signed Ranks Test

b. Based on negative ranks.

c. Based on positive ranks.

Table 2 : Correlation between media exposure, family closeness, and knowledge about STDs on STDs risk behaviour.

Variables in the Equation

B S.E. Wald Sig. Exp(B)

Nagelkerke

R Square

Step 1

Family closeness

-4,06 1,598 6,452 0,011 1,417

0,692

Media exposure

0,579 1,276 0,206 0,04 3,561

Knowledge about STDs

-1,875 0,899 4,354 0,037 5,553

Constant

5,491 4,408 1,552 0,213 242,59

a. Variable(s) entered on step 1: Family closeness, Media exposure, Knowledge about STDs.

4 DISCUSSION

The number of subjects with a high risk of STDs

from this study is 7,4%. The family closeness from

this group categorized as a low family closeness

with a score of family closeness questionaire less

than 50%. Less score on family closeness can

increased the risk of STDs from the subjects 1,417

point. It can be occured because the low of family

closeness will make the adolescent have a low

function of enviromental control

(Mahmudah, 2016).

The recent study showed that the low of family

closeness can increase the risk of STDs 4,65 point

(Yusuf, 2017). Based on Abraham Harold Maslow’s

theory about human behaviour, behaviour can be

occured from the natural needs from the human. In

this case, if the natural needs from the adolescents

about bonding with family can not fulfilled, the

adolescents will vent their needs on the other

behaviour such as sexual behaviour

(Sarwono,

2012). Family closeness had a significant effect ti

reduce the STDs risk behaviour. Previous study

showed that family intervention can reduce the risk

of STDs on adolescents up to 20%

(Prado, 2012).

Media exposure from the subjects with high risk

of STDs is categorized as a massive exposure. The

subject with a high risk STDs had a 15,7% higher

exposure than the subject with low risk of STDs.

From this study, media exposure couldincrease the

risk of STDs from the subjects 3,561 point. Based on

The Effect of Media Exposure, Family Closeness, and Knowledge about Sexually Transmitted Disease on Sexually Transmitted Disease

Risk Behaviors in Senior High School Students

297

Green Behaviour theory, media exposure include in

enabling factor of human behaviour. Massive

exposure from the enabling factor will lead the

human to had a behaviour which accordance with

the exposure. The other theory said that the human

behaviours are based on human experience and

insight. In other word, if adolescents get a massive

exposure about pornography, it can lead them to had

a high risk sexual behaviour than the others

(Burke,

2001; Sarwono, 2012)

The knowledge of STDs from the subjects with

high risk of STDs is categorized as low knowledge

with the score less than 50%. The low of knowledge

about STDs could increase the risk of STDs 5,553

point. The recent study showed that subjects with

high knowledge about STDs will decrease the risk of

STDs 8,3% compared with subjects with low

knowledge about STDs. Based on cognitive theory,

knowledge will make someone knowthe positive and

negative effect from their deeds. The higher

knowledge about STDs will make someone

understand the negative effects from unsafe sexual

behaviour. If someone know the negative effect

from unsafe sexual behaviour, it can lead them to

avoid the sexual risk behaviour

(Burke, 2001;

Mahmudah, 2016). Previous research showed that

intense intervention about knowledge of STDs can

decrease the incidence of STDs up to 19%

(Kusnan,

2016).

The knowledge of STDs is the most influence

factors on STDs risk behaviour between media

exposure and family closeness.This happens because

the knowledge is the major pradisposing factor in

behavioral theory. As a major predisposing factor,

knowledge will affect attitudes, individual values /

individual norms, and sociodemographic factors.

Accordingly, the low level of knowledge will lead

someone to get an inappropriate behaviours

(Burke,

2001; Sarwono, 2012).

5 CONCLUSION

There is a relationship between media exposure,

family closeness, and the knowledge of STDs on

STDs risk behaviors in senior high school students.

The knowledge about STDs is a more influential

factor in STDs-risk behavior (odd ratio: 5,553)

compared to media exposure (odd ratio: 3,561) and

family closeness (odd ratio:1,417).

Family closeness and knowledge about STDs

had a negative effect on STDs risk behaviour. The

lower family closeness and knowledge about STDs

will increase the risk of STDs. While media

exposure had a positive effect on STDs risk

behaviour. The more often subjects exposed with

pornography media then the risk of STDs will also

increase. To get a better result, author advises the

next researchers to find out the effect of intensive

intervention of family closeness, media exposure,

and knowledge of STDs on sexual risk behaviour in

students.

ACKNOWLEDGEMENT

The researcher presents his sincere appretiation to

Muhammadiyah University of Surakarta which has

been facillitated this study and to Capital investment

and service agency integrated one door province of

central java (DPMPTSP) for allowing us to condust

this study in Surakarta Regency.

REFERENCES

BKKBN: Survei Demografi Kesehatan Indonesia, 2015.

Indonesia Ministry of Health.

Burke, P. 2001. History of Social Theory. Jakarta:

Yayasan Pustaka Indonesia

Data dan Informasi Kesehatan Profil Kesehatan Indonesia,

2016. Departemen Kesehatan Republik Indonesia.

Health Data and Information dan Informasi Kesehatan

Profil Kesehatan Indonesia, 2016.Departemen

Kesehatan RI. Health Data and Information:

Indonesian Health Profile. Jakarta: Indonesian

Ministry of Health.

Kusnan, A., 2018. Analysis of the Determinant Factors

Related to the Prevalence of Sexual Infectious

Infection Disease of the Prostitutes in Kendari, Bau-

Bau and Muna Year 2012. Jurnal Kesehatan.

Mahmudah, Yaunin, Y. and Lestari, Y. 2016. Correlating

Factors of Sexual Behaviour In Adolescents In

Padang. Jurnal Kesehatan Andalas.

Prado, G., Pantin, H., Huang, S., Cordova, D., Tapia, M.

I., Velazquez, M. R., ... & Jimenez, G. L., 2012.

Effects of a family intervention in reducing HIV risk

behaviors among high-risk Hispanic adolescents: A

randomized controlled trial. Archives of Pediatrics &

Adolescent Medicine, 166(2), pp. 127-133.

WHO. Int., 2016.Sexually Transmitted Disease Infection,

The Importance of a Renewed Commitment in a

Achieving Global Sexual and Reproductive Health.

Yusuf, A., Khoridatul, B., Endang, H., and Wiyono, A.,

2017. Correlation Between Family Closeness and

Social Environement to Adolescents Sexual

Behaviour. Journal Ners, pp.14-21

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