Background: The purpose of this study is to assess attitudes toward premarital dating and sexual encounters in individuals aged 15–49 years in Tehran. Methods: Utilizing the attitudes section of an original cross-sectional study ( n = 755) aimed at assessing sexual health needs of adults, this paper examined personal attitudes towards premarital dating, non-sexual relationships and sexual encounters in both male and female adults aged between 15–49 years. Multi-stage cluster random sampling and a validated/reliable questionnaire were used. Descriptive, bivariate and multivariate analyses were conducted using statistical software. Results: The results indicated that the majority of the participants were supportive of dating. Almost three-fourths of the males were more positively inclined towards non-sexual, yet tactile, affectionate interactions between unmarried males and females as opposed to only half of the females (70 % vs. 50.5 %). Also, males held significantly more liberal attitudes than females in their acceptance of premarital sex. On preserving virginity prior to marriage, 43 % of the males felt that it was important for a female to be a virgin, whereas only 26 % felt it was important for males to remain a virgin. Interestingly, more females (61 %) supported the importance of a female’s virginity compared with the importance of males’ virginity (48 %). This study showed that, being a male, of a younger age, single, and being less religious or being secular were important determinants of a liberal sexual attitude. Conclusion: These results might reflect a socio-cultural transition in the sexual attitudes of different age groups of participants - a phenomenon that will need empirical studies to unpack in the Iranian socio-cultural context.

This paper reviews the evidence on the sexual and reproductive health (SRH) of young people in Iran from 2001 to 2019 and maps needs, challenges, and opportunities in this area. From among 125 papers, 43 articles were examined for this review. Findings indicated that although the majority of youth abstain from sex before marriage, significant minorities are sexually active before marriage, with a huge heterogeneity based on gender and geographical region. A gender disparity is apparent in high-risk sexual behaviors. Multiple partners, inconsistent condom use, and younger age at sexual debut were more prevalent among men than women. There is a need to narrow gender disparities that expose young women to greater risks, expand health awareness and relevant skills, and enable access to SRH services. While the government has reaffirmed many commitments for young people’s wellbeing, policy development falls far short of realizing these commitments. Future success requires increased evidence on the SRH of youth as well as political will and strategic commitment to SRH for young people. The challenge is to develop comprehensive and culturally appropriate SRH education and confidential and nonjudgmental youth services. Due to the importance of families and parents, such programs need to engage families.

This paper describes perceptions of the societal acceptability and acceptability among peers of different types of premarital heterosexual relationships in Iran. Sources of variation in subjective norms are assessed. Results derive from a survey conducted in 2005 of a representative sample of 1743 female college students from four multidisciplinary universities in Tehran using two-stage random cluster sampling. An anonymous pilot-tested questionnaire was used. Respondents displayed remarkable heterogeneity and ambiguity concerning the social acceptability of premarital heterosexual friendship, dating and physical contact, but expressed greater certainty about the unacceptability of premarital sex. The majority (77.5%) reported that premarital sex was socially prohibited, while about one third (33.1%) were unsure about the social acceptability of having a boyfriend and dating before marriage. Peer norms were perceived to be more liberal but, nevertheless, very few peers were thought to be in favour of premarital intercourse. Older students, those with educated fathers and those studying in a mixed-sex university perceived norms to be more liberal than their counterparts. Access to satellite television, a major source of exposure to new information and values about sexuality, was a major predictor of liberal peer norms. It appears that a significant proportion of young people in Tehran have broken with tradition with regard to premarital social interaction and romantic friendships, but the majority still conforms to traditional cultural and religious values regarding abstinence before marriage.

Sexual and reproductive health (SRH) knowledge is an important predictor of an individual’s sexual behavior; however, little is known regarding this issue among Iranians. This study assessed sexual and reproductive health knowledge among men and women aged 15 to 49 years in Tehran. A total of 755 men and women aged 15 to 49 years were recruited using multistage, random cluster sampling in June 2014. An illustrative anonymous questionnaire endorsed by the World Health Organization (WHO) was used to collect the data. Bivariate and multivariate analyses were performed. The results showed that men and women were moderately knowledgeable about sexual and reproductive health (mean score of SRH knowledge = 39, range: 26 to 52); however, myths and misperceptions prevailed in different aspects of SRH. For example, only 45% of women and 38.7% of men accurately knew that a person infected with human immunodeficiency virus (HIV) can look healthy. Friends were identified as the primary or secondary source of knowledge about puberty and sex-related issues. A multivariate analysis showed that being female (coefficient = 0.139, p < 0.001) and being married (coefficient = 0.180, p < 0.001) were significant predictors of better SRH knowledge, while being young (age group 15 to 24) was a significant determinant of poor SRH knowledge (coefficient = −0.161, p < 0.001) when other influencing factors were controlled. Culturally appropriate and age-specific comprehensive education is recommended, particularly for men, the unmarried, and the younger generation in Iran.

Summary: Recent evidence indicates a rising trend in premarital sexual activity among young people in Iran. However, little is known about the extent to which young people’s sexual behaviours expose them to HIV and STI risks. This study aimed to assess HIV/STI-related sexual risk-taking behaviours (correlates and determinants) and HIV/STI risk perception among male university students in Tehran. A representative sample of male university students (N=1322) studying in government and private Tehran universities completed an anonymous questionnaire survey in 2013–14. Respondents were selected using two-stage stratified cluster sampling. About 35% of respondents had ever had premarital sex (n=462). The majority (about 85%) of the sexually experienced students reported having multiple sexual partners in their lifetime. More than half (54%) reported inconsistent condom use over the previous month. Despite this exposure to HIV/STI risk, the respondents had a very low level of HIV/STI risk perception. Only 6.5% were highly concerned about contracting HIV over the previous year, and an even lower percentage (3.4%) were concerned about contracting STIs in the near future. Early sexual debut (<18 years), studying in a private university, ever watching pornography and work experience were found to be significant predictors of having multiple sexual partners. Younger age at sexual debut, having one lifetime sexual partner and poor HIV knowledge were significant predictors of inconsistent condom use over the preceding month. HIV prevention programmes among Iranian youth need to focus on the postponement of first sex and enhancement of HIV/STI knowledge in the light of increasing access of young people to pornography.

Objectives To explore older (35 years +) primigravid women's knowledge of the risks of delayed childbearing and to identify the characteristics of those with limited knowledge. Methods A cross-sectional survey involving 675 primigravid women in Tehran, Iran, using a cluster random sampling method at the first prenatal visit. A validated questionnaire assessed the women's awareness of delayed-childbearing risks. Results Women variously identified conception difficulties, gestational diabetes, hypertension, multiple birth, caesarean section, preterm delivery, stillbirth, Down's syndrome, congenital abnormality, and low birth weight, as associated with delayed childbearing. Awareness of infant risks ranged between 10 and 72%. Awareness of maternal risks were independently related to the women’s educational levels (odds ratio [OR]: 1.95; 95% confidence interval [CI]: 1.12–3.38), planned pregnancy (OR: 1.87; 95% CI: 1.25–2.78) and maternal age ≥ 40 (OR: 1.24; 95% CI: 1.14–2.53). Women aware of infant risks were significantly likely to be aged ≥ 40 (OR: 1.87; 95% CI: 0.01–5.12), have post-graduate education (OR: 2; 95% CI: 1.90–4.42), and have a planned pregnancy (OR: 1.99; 95% CI: 1.03–5.12). Conclusion Women are largely unaware of the potential complications of delayed childbirth. Understanding the risks is important for reproductive healthcare providers and policy makers in providing appropriate information to enable women to make informed decisions on the timing of conception.