POPCOM :: SPPR 02 :: Chapter 03

For many people, adolescence is a healthy transition period from childhood to adulthood during which time they acquire knowledge, values and skills that will benefit them now and in the future. Highlighted in this life stage is sexual development, which is a normal part of adolescence. Fortunately, most young people go through these changes without encountering significant problems. Nevertheless, large numbers of young men and women engage in behaviors that can potentially hurt their transition to adulthood and the consequences of which may persist through the rest of their lives8.

Sex becomes risky when done by those who are physiologically and psychologically ill prepared for its consequences. And early sex among the youth is much riskier.

The YAFS data revealed that premarital sex (PMS) is becoming more prevalent among the youth. Around 23 percent or two out of 10 Filipino youth had PMS in 2002. This is an increase from the 1994 levels of 18 percent (Figure 17). Almost all (94%) of those who already had sex said they were unwilling and unprepared to become parents25.

Figure 17: Trends in PMS Experience Among Youth by Sex: Philippines, 1994-2002

Source: Ventura & Cabigon, 2003

While PMS levels were predominantly higher among young males than females, YAFS 3 data point to a catching up among females in terms of level of PMS. In 1994, PMS prevalence for males was 26 percent while the females was 10 percent. The 2002 survey shows that PMS levels among males rose to 31 percent (20% increase) while that among females to 16 percent (55% increase)24 (Figure 17).

PMS is highest in the National Capital Region (NCR) and Eastern Visayas at nearly four out of 10 youth engaging in PMS. The three lowest incidence of PMS are in ARMM (12%), Cagayan Valley (16%) and Western Mindanao (19%)26.

PMS patterns among the youth generally indicate that once one gets initiated to it, a repeat either with the same partner or with another is most likely. From the YAFS 2, among those who ever had PMS, 38 percent among males and 72 percent among females had sexual intercourse again with the same partner after the first time. This indicates that young females are more likely to stick to their first sexual partner as opposed to young males who are more likely to engage in sex with a partner other than their first.

The “idle” (35%) and the working (32%) youth are more prone to engage in premarital sex than the students (10%)8. These findings suggest that staying in school postpones PMS.

The first sexual intercourse is an event of immense personal and social importance. It has great health implications especially when done without protection, can lead to adverse outcomes such as unplanned pregnancy and sexually transmitted infections.

The average age of initiation to sex among the youth has changed slightly (18 in 1982 and 1994, 17.5 in 2002). Surprisingly, youth who had sex before age 15 has increased eight-fold from less than two percent in 1994 to around 16 percent in 2002.

For many, the first sexual encounter, according to YAFS data, was a spontaneous event. Fifty five per cent of the youth qualify that it was something they did not plan to happen at that time, but they went along with it anyway. Forty three per cent said that it was something they wanted to happen at that time26. Forty percent of first PMS and 70 percent of most recent PMS were without any means of protection24.

It is sad to note, however, that some youth experienced their first sex under very unpleasant circumstances. Nearly three out of 10 first sex experiences were not planned or totally against the will of the youth. This is more so for younger females (5%) than males (1.3%)27 (Figure 18).

The most likely victims of rape are those with disadvantageous background or being out-of-school, of low education, no schooling at all, not currently working or in live-in situation.

Figure 18: Percentage Distribution of Youth who Experienced Forced Sex by Age Group and Gender: Philippines, 2002

Source: YAFS 3 Raymundo and Cruz, 2003

Almost four out of five young females who had PMS reported that their first experiences have been with men, usually older, whom they regard as their boyfriends or ‘steadies’. In contrast, young males were more into casual sex with about two out of five who had PMS with either a friend or plain acquaintance9.

Two-and-a-half percent of the first sex experiences of young males were with commercial sex workers. This is an evidence of the oft-mentioned ‘sponsored’ sex debuts of young males.

Homosexual sex is also emerging, five percent of boys admitted having first sex with males and less than one percent of females had lesbian sexual relationships. In fact, 12 percent of very early first sex (13 years old and below) was homosexual28.

First sex experiences were mostly with unmarried people, this is true for nine out of 10 youth. However, a growing number of sexual debuts of youth were with married people, with the proportion slightly higher among males. About four percent of girls’ experiences are with married guys or with living-in partners and around three per cent of the boys9.

The popular venue for sexual debut is the partner’s home among the females (32%) and at hotels or motels among the males (30%), especially from the urban areas (Table 3). For youth in the rural areas, the counterpart venues are the beaches, parks and farms.

Data suggest that boys are more adventurous than girls as the former identified the classroom as one of the venues for the first experience (3 % vs. 0.3%). Workplace can also be the location of these experiences, slightly more so for girls than for boys (4% vs 3%) (Table 3).

The practice of having multiple sex partners is in vogue among sexually active youth especially among boys than girls. One out of three (34%) admitted to having more than one sexual partner beside their first sex partner29.

A marked gender differential is apparent with about half (50%) of the males affirming the above behavior compared to less than a tenth (11%) among their female counterparts27 (Figure 19).

Having multiple sex partners, particularly if unprotected, pose significant risks insofar as STI transmission is concerned. Young men are at substantial risk of HIV in view of their sexual practices. Before they reach the age 25, 37 percent already had sex with at least one partner, a non-negligible portion of which had paid for sex.

Figure 19: Percent Distribution of Youth with PMS Experience who had Multiple Sex Partners by Age Group and Sex: Philippines, 2002

Source: YAFS 3 Raymundo and Cruz, 2003.

While the female youth are expected to be responsible for the use of contraceptives since they are the ones who could get pregnant (UCWSF, 2003), the YAFS 2 data reveal however that more females did not use any contraceptive method during their first sexual encounter (62% females vs. 28% males) and last (74% females vs. 66% males) (Figure 20).

The reasons given by the youth for not using contraceptives in 2002 are: not knowing about contraception (16%); objection of partner (7%); sex is not fun with contraception (6%); and contraception is either wrong or dangerous to health (7%)27. Another reason also cited in 1994 is that they tend to desire spontaneity of sexual encounters and are thus, not likely motivated to use protection or be prepared when the opportunity presents itself17.

For those who used contraception, 40 percent used withdrawal, 20 percent used the condom and 13 percent the pill. Contraception is highest among the younger ones: 24 percent among those aged 15-19 and 14 percent among those aged 25-2724.

Males reported using a condom during casual or commercial sex although use was largely determined by the situation (e.g. unplanned) and their condition (e.g. drunk, or too aroused to stop)18.

Figure 20: Percentage Distribution Among the Youth with PMS Experience who used Contraceptives by Age Group and Sex: Philippines, 2002

Source: YAFS 3 as cited in Raymundo and Cruz, 2003

Young people continue to look positively on marriage and consider the ideal marrying age for women to be 25, with men one to two years older6. They like to have three children, the first coming one year after marriage, the others following three years apart.

YAFS 3 results reveal that 11 percent of young women and 26 percent of young men think that it is all right to live together even if they have no plans to marry, confirming the liberal attitudes of a growing number of our youth. This is more apparent among older compared to younger males (28% vs. 25%) and females (14% vs. 9%) (Figure13).

A focus group discussion on the topic conducted among young people shows that’“living-in allows couple sufficient time to know one another” and”“getting out of it is a lot easier compared when two people are married”23.

According to YAFS 2, one-third of young women in the age group 20-24 years old had already given birth to their first child before reaching their 21st birthday. Teenagers who have begun childbearing are increasing, from the nine percent reported in the 1993 National Demographic Survey (NDS), and rose to 11 percent in the 1998 National Demographic and Health Survey (NDHS).

Young pregnancies account for 30 percent of all births, six percent of spontaneous abortions, three out of four maternal deaths25. This is so because young pregnant women are prone to pregnancy complications. In addition, adolescent mothers are less likely to seek prenatal care.

Also, 74 percent of illegitimate births are from this age group. Some 21 percent of these illegitimate births occurred among the 15-19 age group, 53 percent among the 20-24 age group.

Worth noting also are other information about early pregnancy and childbearing:
• At age 18, 10% are already mothers
• At age 20, 25% are mothers
• At age 24, 50% are mothers, and 1/3 of Filipino young women already have 2-3 children

Pregnancy is common among young females who are out-of-school, in low-paying jobs and residing in rural areas25.

Abortion is illegal in the Philippines yet it has been estimated that about 400,000 abortions are performed every year. In a study of hospital cases of abortion complications, nearly four out of 10 of these cases were reported among the youth.

About 36 percent of women who were treated for abortion complications in the selected hospitals of the YAFS 2 study areas (Manila, Cebu, Davao and Tuguegarao) belong to those aged 15 to 24 years30.

In the 1994 YAFS, the reasons given for having abortions by married youth are economic reasons (34%), having too many children (38%). Those in live-in status cited economic difficulties (29%), too many children (26%), instability of relationship (11%), and having married partners (6%). The single youth cited studying (22%), fear of parents (20%), father of child is married (14%) (Figure 21).

The abortion methods used were: taking unprescribed drugs like cytotec (40%), taking prescribed drugs (16%), and taking herbs and related concoctions (9%). The “hilots” are the most popular service provider to the young women in distress (29%)30.

Figure 21: Reasons for Abortion by Marital Status, Philippines, 2001

Source: Raymundo et. al. 2001

Twice as many females (about 70%) as males (about 35%) reported having experienced any reproductive health (RH) problem and their levels have not changed much over the 1994-2002 period. However, RH problems among females are less serious compared to the males although a significant increase in the levels of serious RH problems (18% in 1994 to 23% in 2002) was observed among females (Table 4).

Males had significantly higher levels of serious RH problems than females (25% vs. 23%) in 1994. The levels of serious RH problems among males increased slightly from 23 per cent in 1994 to 26 percent in 200224 (Table 4).

The RH problems of males include: painful urination, pain/itching in the genital area (13%), both indicative of STD (21%), and diminished desire for sex (15%) (Table 5).

The most commonly reported problems of females are: painful intercourse, inability to have orgasm, pregnancy-related problems, life-threatening complications, (hypertension or induced or spontaneous abortion) and painful urination, which could be symptomatic of UTI.

As a general practice, our young people do not seek medical help for their reproductive health problems. More males than females seek health care for their RH problems, perhaps because the problems they experience are more serious. The percentages of boys who consulted health personnel for their conditions are as follows, from highest to lowest: Infection from circumcision (22%), painful urination (20%), penile discharge (17%), reddish and swollen testicles (15%) and itching in the genital area (11%)24.