Peer and Parental Influences on Knowledge, Attitudes, and Behaviors Related to Premarital Sex among Indonesian Adolescent Girls: Analysis of 2017 Indonesian Demographic and Health Survey (IDHS).

BACKGROUND: Premarital sexual behavior among adolescents is a significant public health concern in Indonesia. Despite strong religious and cultural prohibitions, premarital sexual behavior continues to increase. Grounded in the Theory of Planned Behavior (TPB), this study aimed to investigate the relationship between peer and parental factors and knowledge, attitudes, and behaviors related to premarital sex among Indonesian adolescent girls. METHODS: This was a cross-sectional study using the data from the 2017 Indonesian Demographic and Health Survey (IDHS). The survey involved 10,691 unmarried adolescent girls aged 15-24, of whom 7,206 unmarried girls aged 15-19 were selected. Partial Least Square Structural Equation Modeling (PLS-SEM) was implemented using SMART PLS software to evaluate pathways linking adolescent characteristics, parental and peer factors, knowledge, attitudes, dating behavior, and intention to engage in sexual intercourse (IC). RESULTS: Only 1.3% of respondents reported engagement in sexual intercourse (mean±SD=0.013±0.113), with first intercourse experienced most common at ages of 15-17. Mean±SD for key variables included: knowledge (0.33±0.21), attitude (0.71±0.26), and dating behavior (0.23±0.21). Parental (β=0.011, P=0.016) and peer (β=0.012, P<0.001) factors were significantly associated with dating behavior and knowledge. Knowledge had a significant relationship with attitudes (β=0.012, P<0.001) and dating behavior (β=0.014, P<0.001). In turn, dating behavior was significantly associated with the intention to engage in IC (β=0.014, P<0.001). CONCLUSIONS: Both parental and peer factors were significantly associated with adolescents' knowledge, attitudes, and behaviors related to premarital sex. Comprehensive interventions involving family-based communication, school education, and peer-led programs are needed to improve reproductive health outcomes.