Attitudes Toward and Experience of Singles with Premarital Sex: A Population-Based Study in Shiraz, Southern Iran.

The population of Iran is young and millions of youths are at risk for unprotected sexual relationships and their consequences. This questionnaire-based study was conducted in Shiraz, southern Iran. Singles were asked about premarital sex (PMS) and sexual health issues. A total of 1076 participants (634 males, 58.9%) with a mean age of 24 ± 5.8 years participated in this study. One out of 2 singles reported PMS and 1 out of 2 singles with PMS reported multiple partners. Median age at first sexual contact was 18 years. Of all singles, 452 (41.9%) were heterosexual, 61 (5.6%) were bisexual, 366 (33.9%) were alcohol users, 252 (23.3%) were smokers, 57 (5.2%) were opium users, and 392 (36.3%) did not know about preventive methods for HIV. Of 528 singles who had PMS, 126 (23.8%) never used a condom, 223 (42.2%) used it inconsistently, and 59 (11.1%) used it mainly against sexually transmitted diseases. In the regression analysis, alcohol use was the strongest associated factor of PMS in singles (OR 4.9, 95% CI 3.3-7.4), followed by lack of religious beliefs (OR 2.3, 95% CI 1.4-3.8). As a result, the PMS situation in our setting is cause for alarm and to protect singles against the risks associated with PMS, a multidisciplinary intervention including improving access to sexual behavioral counseling centers, education about sexual health and especially condom use, abstinence from alcohol use, and commitment to religious values is urgently needed to be established by health policymakers.