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Exploring the Perceptions and Values of Sri Lankan Sinhalese Buddhist Female Youth Regarding Their Sexual Health: A Qualitative Descriptive Study

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Holroyd, Eleanor
Mohammed, Jalal

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Master of Public Health

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Auckland University of Technology

Abstract

This qualitative descriptive study explores the perceptions and values of Sri Lankan Sinhalese Buddhist female youth concerning their sexual health (SH) and their previous experiences with secondary school-based sex education (SE) in Sri Lanka. Participants were selected through purposeful and snowball sampling. In total 14 female youth participants in the age bracket of 18 to 25 were selected, and in-depth interviews were conducted, using a semi-structured interview guide. All participants were of Sinhalese Buddhist ethnicity from the city of Panadura in the Kalutara district, in the Western province of Sri Lanka; participants all hailed from low to middle income families and were either in tertiary education, employed, or unemployed. The thematic analysis revealed three overarching themes. Firstly, “The importance of family expectations”, highlighting the role of the family in value formation around SH in participants, with a strong emphasis on family matriarchs. Secondly, “Sociocultural and religious expectations”, shedding light on the importance of cultural, religious, and societal norms, such as “virginity and purity”, “menstrual taboos” and “the role of women in family and society” as key drivers in the formation of SH values among female youth. And finally, “Barriers to accessing quality SE”, illuminating participants’ perceptions of prior SE in their schooling and their current challenges in accessing accurate SH knowledge and SH services. This cohort of female youth perceived that they lacked an in depth understanding of SH knowledge and associated health risks. Furthermore, participants exhibited an openness to globalised sexual trends, such as “placing little value on rituals associated with menstruation”, “challenging the notion of virginity”, "exercising sexual independence and achieving equality in intimate relationships”, “having open conversations around SH”, and the need for “better informed SE”, while concurrently maintaining strong traditional ideals, particularly concerning attitudes towards “sexual promiscuity”, ”negative attitudes toward abortion”, and “extramarital intimacy”. The findings provided valuable insights into the intersection of cultural, religious, and gendered values for Sinhalese Buddhist female youth, within an ever-evolving landscape of increasing exposure to modernity and information, through the Internet and social media. Recommendations from this study focused on large-scale school SE reforms, including a review of the current school SE curricula, co-designed with multiple stakeholders, enhanced teacher SE training programmes, and the development of online platforms to complement in-school SE classes. Further, localised initiatives were advocated for, such as creating and disseminating appropriate SH information for both adults and female and male youth at the grassroot community level and establishing safe online and physical spaces for young women to discuss SH without fear of embarrassment or shame. In conclusion, the current study recognised that it is crucial to tailor SE policies and school SH education to be culturally and religiously sensitive, acknowledging the coexistence of modern and traditional values. Furthermore, it is essential to recognise the importance of expanding future research to include other ethnic communities, genders, sexual orientations, and individuals from diverse socio-economic backgrounds. With large-scale research projects, based on these findings, utilising co-design approaches to develop focus group discussions, surveys, and in-depth interviews which will help advance a deeper understanding of the SH needs of youth in Sri Lanka.

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