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  • P. Salameh (a1) (a2), R. Zeenny (a2), J. Salamé (a3), M. Waked (a4), B. Barbour (a5), N. Zeidan (a5) and I. Baldi (a6)...


Sexuality is still a taboo in Middle Eastern countries, and Lebanon is no exception. This study’s objective was to evaluate attitudes towards sexuality and its practice among university students in Lebanon and assess their respective correlates. The cross-sectional study was carried out among students selected from seventeen universities across Lebanon. The participants received a self-administered standardized questionnaire that assessed their attitudes towards sexuality. It included questions on socio-demographic factors, risk-taking, risky behaviours and sexuality-related questions. Among 3384 students, 2700 (79.8%) answered the questions on sexuality. Around 15% had engaged in sexual activity, while 20% were regularly sexually active. Among males, 34.8% had never had sexual activity, 29.9% had tried it and 35.3% were regularly sexually active. Among females the results were respectively 85.1%, 5.3% and 9.6% (p<0.001). Only 36% regularly used condoms during their relationships. A liberal attitude towards sex, male sex, motives for risky behaviours, current cigarette smoking and problematic alcohol consumption were associated with sexual activity. Realizing that risky behaviours are dangerous, health concerns related to sexual relationships and a liberal attitude towards sex were associated with regular condom use. However, being bothered by condoms and female sex were inversely associated with condom use. Finally, participants who had motives for, and those who felt excited about risky behaviours, and those reporting current cigarette and waterpipe smoking and problematic alcohol consumption (β=0.600; p=0.002) embraced a more liberal attitude towards sex. Conversely, females (β=−7.58; p<0.001) and individuals who considered risky behaviours as dangerous reported an unfavourable attitude towards sexuality. A substantial proportion of Lebanese university students have regular sexual activity, but a low percentage use condoms for protection. Interventions are required among males in particular in view of these attitude and behavioural changes towards sexuality.


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Al-Shdayfat, N. M. & Green, G. (2012) Reflections on sex research among young Bedouin in Jordan: risks and limitations. Cultural Health & Sexuality 14(1), 101111.
Alkaiyat, A., Schaetti, C., Liswi, M. & Weiss, M. G. (2014) Condom use and HIV testing among men who have sex with men in Jordan. Journal of the International AIDS Society 17, 18573.
AlQuaiz, A. M., Kazi, A. & Al Muneef, M. (2013) Determinants of sexual health knowledge in adolescent girls in schools of Riyadh-Saudi Arabia: a cross sectional study. BMC Women’s Health 13, 19.
Amazaki, M. & Shimizu, Y. (2008) Relationship between awareness of STDs and condom use by University students: development of an awareness scale for prediction of condom use. Nippon Koshu Eisei Zashi 55(5), 306317.
Askun, D. & Ataca, B. (2007) Sexuality related attitudes and behaviors of Turkish university students. Archives of Sexual Behavior 36, 741752.
Awwad, J., Nassar, A., Usta, I., Shaya, M., Younes, Z. & Ghazeeri, G. (2013) Attitudes of Lebanese university students towards surgical hymen reconstruction. Archives of Sexual Behaviour 42(8), 16271635.
Barbour, B. & Salameh, P. (2009) Knowledge and practice of university students in Lebanon regarding contraception. East Mediterranean Health Journal 15(2), 387399.
Bergamini, M., Cucchi, A., Guidi, E., Stefanati, A., Bonato, B., Lupi, S. & Gregorio, P. (2013) Risk perception of sexually transmitted diseases and teenage sexual behaviour: attitudes towards in a sample of Italian adolescents. Journal of Preventive and Medical Hygiene 54(2), 114119.
Brakel, K. (2008) Studies on Youth Policies in the Mediterranean Partner Countries: Palestinian Occupied Territories EuroMed Youth III Programme. Euromed, Ramallah. URL:
Carvalho, K., Sant’Anna, M. J., Coates, V. & Omar, H. A. (2008) Medical students: abuse of psychoactive substances and sexuality aspects. International Journal of Adolescent Medicine and Health 20(3), 32328.
Center for Disease Control (2012) Epi Info™ software, version URL:
Center for Educational Research and Development (2009) [List of Universities in Lebanon]. Beirut, Lebanon. URL:
Coker, A., Richter, D., Valois, R., McKeown, R., Garrion, C. & Vincent, M. (1994) Correlates and consequences of early initiation of sexual intercourse. Journal of School Health 64, 372377.
Fernández, A. M., Celis-Atenas, K., Córdova-Rubio, N., Dufey, M., Corrêa Varella, M. A. & Benedetti Piccoli Ferreira, J. H. (2013) Youth sexuality: behaviors, attitudes and differences by sex and personality variables in Chilean university students [in Spanish]. Revista médica de Chile 141(2), 160166.
Hiltabiddle, S. (1996) Adolescent condom use, the health belief model, and the prevention of sexually transmitted disease. Journal of Obstetric Gynecology and Neonatal Nursing 25(1), 6166.
Hoque, M. & Ghuman, S. (2012) Contraceptive practices in the era of HIV/AIDS among university students in KwaZulu-Natal, South Africa. SAHARA Journal 9(1), 1519.
Ismael, A. S. & Sabir Zangana, J. M. (2012) Knowledge, attitudes and practice of condom use among males aged (15–49) years in Erbil Governorate. Global Journal of Health Science 4(4), 2736.
Kabiru, C. & Orpinas, P. (2009) Factors associated with sexual activity among high-school students in Nairobi, Kenya. Journal of Adolescence 32(4), 10231039.
Kloep, M., Guney, N., Cok, F. & Simsek, O. F. (2009) Motives for risk-taking in adolescence: a cross-cultural study. Journal of Adolescence 32, 135151.
Lally, K., Nathan-V., Y., Dunne, S., McGrath, D., Cullen, W., Meagher, D., Coffey, J. C. & Dunne, C. (2014) Awareness of sexually transmitted infection and protection methods among university students in Ireland. Irish Journal of Medical Science 184(1), 135142.
Mantzouranis, G. & Zimmermann, G. (2010) Taking risks, worth it? Risk behaviours and perceiving their risks among adolescents. Neuropsychiatrie de L’enfance et de L’adolescence 58, 488494.
Moore, M. J., Barr, E. M. & Johnson, T. M. (2013) Sexual behaviors of middle school students: 2009 Youth Risk Behavior Survey results from 16 locations. Journal of School Health 83(1), 6168.
Nemcic, N., Novak, S., Maric, L., Novosel, I., Kronja, O., Hren, D., Marušic, A. & Marušic, M. (2005) Development and validation of questionnaire measuring attitudes towards sexual health among university students. Croatian Medical Journal 46(1), 5257.
Nkomazana, N. & Maharaj, P. (2013) The prevalence of condom use among university students in Zimbabwe: implications for planning and policy. Journal of Biosocial Science 45(5), 643659.
O’Hare, T. (2001) Substance abuse and risky sex in young people: the development and validation of the risky sex scale. Journal of Primary Prevention 22(2), 89101.
Primack, B. A., Switzer, G. E. & Dalton, M. A. (2007) Improving measurement of normative beliefs involving smoking among adolescents. Archives of Pediatric and Adolescent Medicine 161(5), 434439.
Quadrel, M. J., Fischhoff, B. & Davis, W. (1993) Adolescent (in)vulnerability. American Psychology 48(2), 102116.
Rahamefy, O., Rivard, M., Ravaoarinoro, M., Ranaivoharisoa, L., Rasamindrakotroka, A. J. & Morisset, R. (2008) Sexual behaviour and condom use among university students in Madagascar. SAHARA Journal 5(1), 2835.
Rosenthal, A., Elinav, H., Ramlawi, A., Shasha, D., Olshtain-Pops, K., Korem, M. et al. (2011) HIV/AIDS among Palestinians: detection, clinical presentation, prognosis and HIV testing patterns, 1994–2010. International Journal of Infectious Disease 15(6), e377e381.
Salamé, J., Barbour, B. & Salameh, P. (2013) Do personal beliefs and peers affect practice of alcohol consumption in Lebanon university students? Eastern Mediterranean Health Journal 19(4), 340348.
Salameh, P., Jomaa, L., Issa, C., Farhat, G., Zeghondi, H., Gerges, N. et al. (2012) Assessment of health risk behaviours among university students: a cross-sectional study in Lebanon. International Journal of Adolescence and Youth 1, 114.
Salameh, P., Salamé, J., Waked, M., Barbour, B., Zeidan, N. & Baldi, I. (2014) Risk perception, motives and behaviours in university students. International Journal of Adolescence and Youth 19(3), 279292.
Shapiro, R., Siegel, A. W., Scovill, L. C. & Hays, J. (1998) Risk-taking patterns of female adolescents: what they do and why. Journal of Adolescence 21, 143159.
Shirazi, K. K. & Morowatisharifabad, M. A. (2009) Religiosity and determinants of safe sex in Iranian non-medical male students. Journal of Religious Health 48(1), 2936.
Shrestha, R. M., Otsuka, K., Poudel, K. C., Yasuoka, J., Lamichhane, M. & Jimba, M. (2013) Better learning in schools to improve attitudes toward abstinence and intentions for safer sex among adolescents in urban Nepal. BMC Public Health 13, 244.
Siegel, A. W., Cousins, J. H., Rubovits, P., Parsons, J. T., Lavery, B. & Crowley, C. L. (1994) Adolescent perceptions of the benefits and risks of their own risk taking. Journal of Emotional and Behavioral Disorders 2, 8998.
Sibai, T., Tohme, R. A., Beydoun, H. A., Kanaan, N. & Sibai, A. M. (2009) Violent behavior among adolescents in post-war Lebanon: the role of personal factors and correlation with other problem behaviors. Journal of Public Health (Oxford) 31(1), 3946.
Vivancos, R., Abubakar, I. & Hunter, P. (2008) Sex, drugs and sexually transmitted infections in British university students. International Journal of STD and AIDS 19(6), 370377.
Wilson, K. L., Smith, M. L. & Menn, M. (2013) Abstinence-related word associations and definitions of abstinence and virginity among Missouri high school freshmen. Journal of School Health 83(11), 787794.
Wong, L. P. (2012) An exploration of knowledge, attitudes and behaviours of young multiethnic Muslim-majority society in Malaysia in relation to reproductive and premarital sexual practices. BMC Public Health 12, 865.
World Health Organization (2010) Validation of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and Pilot Brief Intervention: A Technical Report of Phase II Findings of the WHO ASSIST Project. URL: (accessed August 2014).
World Health Organization (2013) Sexually Transmitted Infections (STIs). The Importance of a Renewed Commitment to STI Prevention and Control in Achieving Global Sexual and Reproductive Health. URL: (accessed August 2014).
Zhang, D., Pan, H., Cui, B., Law, F., Farrar, J. & Ba-Thein, W. (2013) Sexual behaviors and awareness of sexually transmitted infections among Chinese university students. Journal of Infection in Developing Countries 7(12), 966974.
Zou, Y., Yan, H., Wu, H., Chen, R., Huang, D. & Li, S. (2013) Female undergraduate fine arts students: a high-risk population for multiple sexual partners, unwanted pregnancy and sexually transmitted infections in China. European Journal of Contraception and Reproductive Health Care 18(2), 127136.


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