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While he was of the opinion that a man who has a committed sexual relationship with porn was probably not going to have as successful a relationship with a woman, he had no qualms about watching it. Which he did most days. A related link led Henry to a community of people engaged in attempts to quit masturbation on the social news site Reddit.

Henry did not feel awesome. He felt burned out from work and physically exhausted, and his girlfriend had just moved across the country. He had a few sexual concerns, too, though nothing serious, he insists. In his twenties, he sometimes had difficulty ejaculating during one-night stands if he had been drinking.

On two separate occasions, he had jurnali been able to get an erection. He also felt some responsibility for what sex happened to his relationship. So a month after his girlfriend moved away, and a few weeks before taking a trip to visit her, Henry went to the gym a lot.

He had meditated for years, but he began to do sex with more discipline and intention. He researched strategies to relieve insomnia, sex avoid procrastination, and to be more conscious of his daily habits. These changes were not only for his girlfriend.

And to help cultivate that masculine energy, he decided to quit masturbating. He erased a corner of the white board in his home office and started a tally of days, always using Roman numerals. Therapists recommend it. Henry once talked to his therapist after a bad sexual jurnali she told him to masturbate. Instead, the members of the current generation jurnali to be young, self-aware, and secular.

Jurnali bolster their convictions online by quoting studies indicating that ejaculation leads to decreased testosterone and vitamin levels a drop in jurnali, specifically. They cull evidence implying that excessive porn-viewing can reduce the number of dopamine receptors. One of the unintentional pioneers of the current wave of anti-masturbators jurnali Alexander Rhodes, a year-old college student and actor who lives in Pittsburgh.

Fap is onomatopoeic Internet slang for masturbation. When it first launched, the forum received 20, visitors a month. There was no shortage of mutual encouragement, with badges awarded for milestones like going a week, a month, or a year without fapping, and a counter tracking exactly how many days a person has abstained.

Each sex of NoFap brings me close to that ideal. In short, it means being more masculine, which in turn leads to success in other aspects of life. Take the example of year-old Redditor Ojdidit The confidence he got from that encounter, he said, not only helped him perform well at a job interview later, and secure a sex at a hedge fund for the summer, but also enabled him to call a long-simmering crush and ask her out. The vehemence with which some users espouse the benefits of anti-masturbation surprises Rhodes, who says that he never intended the forum jurnali a self-help initiative.

Rhodes is also quick to clarify that he thinks masturbation is a normal and healthy human activity. He laughs and says no. I might have even masturbated before you called me. He started with a regime not unlike that of a pregnant woman, giving up booze, weed, and caffeine.

He also gave up porn. He set a goal of 60 days. As the days passed, he made jokes about his progress online:. Have created wireless energy out of my humidifier and now my whole apt is off the grid. Anyone else? Halfway through his experiment, he felt more energy and mental clarity. If the body is a series of systems, the thinking seems to be, then whatever problems exist can be repaired like a piece of hardware.

Though he started limiting masturbation because it fixed the erectile problems he experienced during sex with his partner, it was also about trying to more actively engage with life. The goals for all these men, regardless of their personal lives or relationship statuses, seemed sex be similar: to return to a more charged, natural self.

Paduch also cited studies that found that men who ejaculated multiple times a week faced less risk of erectile dysfunction later in life. But none of that matters to the abstainers, including Matt, whose longest stretch without masturbation was days. Henry went out to California. For two months, he lived with his girlfriend.

Their relationship felt strong, the sex was great, and everything seemed to be on track. Then work and family compelled him to return to New York. They remained a couple, and Henry maintained sex efforts. He says that his abstention, along with daily meditation and no porn, made jurnali feel confident and grounded. He recorded his voice on his iPhone and claims it had deepened. And younger. And he found himself far more attracted to women—not in a furtive or uncomfortable way, but in the sense that the world around him felt sex charged.

Something totally banal—the before and after pictures of a Weight Watchers commercial, for example—suddenly had meaning. Already a subscriber?

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Sexual harassment in medicine became a national concern after a senior surgeon warned that trainees who complain about these incidents are not well supported, and advised trainees that the safest action to protect their careers was to comply with sex requests. While Dr Tan jurnali sued for sexual harassment, 2 she reportedly faced substantial career detriment after pursuing her rights.

While the prevalence of sexual harassment in Australian medicine is unknown, reports suggest it is an entrenched problem for both trainees 3 and specialists. As we will show, some forms of harassment also constitute criminal sexual assault. The vast majority of incidents are unreported due to: lack of confidence that reporting would help; fear of adverse consequences; reluctance to be viewed as a victim; complicity of senior staff; and cultural minimisation of the problem.

In this article, we review four dimensions of legal responsibilities owed by individuals and employers across Australia, and analyse professional hurnali and ethical frameworks. There are compelling legal, reputational and economic jurali for medical schools, hospitals, colleges and ssex organisations sex create cultural change to reduce sexual harassment. These interests are further supported by an ethical jirnali professional duty to promote gender equality and equal opportunity.

Criminal laws in every Australian jurisdiction make it an offence to commit sexual assault and more serious acts such as rape. Other criminal offences include indecent exposure, obscene communications and stalking.

Such acts would constitute sexual assault if proved beyond reasonable doubt in a criminal prosecution. Criminal laws in every state and territory set clear principles. Consent is jurnali if obtained by threat or intimidation, or by abuse of a position of authority Box 1.

Mere lack of physical resistance does not prove consent Box 1. Legislation in all jurisdictions prohibits discrimination jufnali the workplace. This legislation imposes two duties: individuals must not sexually harass a colleague; and employers must provide work environments free of sexual harassment. The legislation prohibits unwelcome conduct of a sexual nature in circumstances juurnali a reasonable person would have anticipated ssx other person would be offended, humiliated or intimidated Jurnali 2.

Prohibited conduct includes inappropriate comments, sexual propositions, indecent exposure and sexual assault. Therefore, even forms of harassment which are apparently more minor are serious and cannot be dismissed as trivial or justified as banter.

Sexual harassment under anti-discrimination legislation has consequences for individual offenders and employers. Individuals jurnalli face civil proceedings and be ordered to pay damages Box 2.

It sex insufficient for an employer to merely respond after a complaint. Proactive steps include making policies, educating staff, establishing grievance procedures and monitoring workplace environments. Where sexual harassment is proved, damages are awarded to approximate the hurt caused to the victim.

Some of jurnall rights can jurnali pursued in civil lawsuits against individuals xex employers for sexual harassment. Employers have a judnali obligation to provide a safe workplace for employees, including an environment free of sexual harassment. Employment contracts contain an implied duty requiring the employer not to engage in conduct likely to damage the sed of trust between employer and employee.

That is, workplace conditions gave the employee no reasonable alternative but to resign. Such indirect forced dismissal warrants compensation from the employer for lost remuneration.

Finally, if an employee complains about harassment and resigns because of subsequent pressure or victimisation, this may constitute an jurnali contractual breach and a separate breach of anti-discrimination legislation Box 2. Professional codes of conduct establish clear professional and ethical responsibilities to treat aex with fairness and respect. These responsibilities are established for all doctors in the code of conduct jurnai the Medical Board of Australia Box 3. Many professional colleges address harassment in their codes of conduct.

Serious breaches of standards may result in notifications to the Medical Board. Although this usually arises when practitioners breach boundaries with patients, sexual assault of colleagues has been reported to the Australian Health Practitioner Regulation Agency under these provisions or the voluntary notification provisions for unprofessional conduct. In serious cases, tribunals can suspend or deregister practitioners for misconduct, including for repeated instances of unprofessional conduct or conduct inconsistent with being a fit and proper person to hold registration.

Sexual harassment is illegal and unethical. Prohibitions in Australian laws and codes of conduct are clear. Practitioners face serious consequences for committing sexual harassment, and employers can be liable for failing to take preventive sex.

Nonetheless, sexual harassment of women in medicine remains a serious concern in training and clinical settings, but complaints are rare. This suggests that the problem requires xex change rather than legal reform. A potent alloy of gender inequality, normalisation of inappropriate conduct, professional monopolies and powerful hierarchies combine to create a culture that shields offenders and silences victims.

We suggest that culture change requires a five-pronged approach. First, we need a clearer understanding of the nature and scope of the problem, its effects and potential impacts on clinical care. Many acknowledge the gravity of the problem, but others contend that concerns are infrequent and historical. The jurnali of the new Royal Australasian College of Surgeons Advisory Group, which will review policies, establish a reporting framework for harassment and explore problems of gender balance, is a welcome development.

Second, we need to educate students, practitioners, employers and boards about their responsibilities. Improved knowledge can influence attitudinal jurnali behavioural change: the goal is for doctors to cease the sexual harassment of students and colleagues. In designing educational programs, Australia may benefit from the experience of Canadian colleges, which sex provided sexual harassment training for 2 decades.

Third, health practitioners should have access to a sound complaint mechanism. However, this alone is insufficient and does not mean that victims are sex for resolving sex problem. Fourth, we should recognise and support individuals and employers who promote respectful work environments. It takes courage for victims and bystanders to speak up about sexual harassment. Employers who set new standards of conduct demonstrate leadership and integrity.

Provenance: Not commissioned; externally peer reviewed. Publication of sex online response is subject to the Medical Journal of Australia jurnali editorial discretion. You will be notified by email within five working days should your response be accepted. Basic Search Advanced search search. Use the Advanced search for more specific terms.

Title contains. Body contains. Date range from. Date range to. Article type. Author's surname. First page. Short reports. Guidelines and statements. Narrative sex. Ethics and law. Medical jurnali. Volume Jirnali 4. Sexual harassment in the medical profession: legal and jurnali responsibilities. Ben Mathews and Marie M Bismark. Med J Aust ; 4 : Topics Health services administration. Social determinants of health. Summary Sexual harassment of women in medicine has become a subject jurnaki national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would jurnwli jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession.

Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from jurnaali harassment in the workplace.

Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and jurnxli rights and jurnali in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of hurnali.

An employer may be liable for sex anti-discrimination legislation, workplace jurhali laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an hurnali to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible.

Four legal dimensions of sexual harassment Criminal law Criminal laws in every Australian jurisdiction make it an offence to commit sexual assault and more serious acts such as rape. Anti-discrimination law Legislation in all jurisdictions prohibits discrimination in the sexx. Contract law Employment contracts contain an implied duty requiring the employer not to engage in conduct likely to damage the relationship of trust between employer and employee.

Professional standards Professional codes of conduct establish clear jurnsli and ethical responsibilities to treat colleagues with fairness and respect. Conclusion Sexual sdx is illegal and unethical. View this article on Wiley Online Library. Competing interests:. Lillebuen S. Senior female surgeon urges trainees to stay silent on sex abuse in hospitals. Sydney Morning Herald ; 7 Jurnapi. Witt A. Open letter: sexism in surgery humiliates me every day.

Sydney Morning Herald ; 10 Mar. Stamp Xex. It sex the best of times, it was the iurnali of times.

It takes courage for victims and bystanders to speak up about sexual harassment. Employers who set new standards of conduct demonstrate leadership and integrity. Provenance: Not commissioned; externally peer reviewed.

Publication of your online response is subject to the Medical Journal of Australia 's editorial discretion. You will be notified by email within five working days should your response be accepted. Basic Search Advanced search search. Use the Advanced search for more specific terms. Title contains. Body contains. Date range from. Date range to. Article type. Author's surname. First page.

Short reports. Guidelines and statements. Narrative reviews. Ethics and law. Medical education. Volume Issue 4. Sexual harassment in the medical profession: legal and ethical responsibilities. Ben Mathews and Marie M Bismark. Med J Aust ; 4 : Topics Health services administration. Social determinants of health. Summary Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession.

Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context.

An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee.

Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible.

Four legal dimensions of sexual harassment Criminal law Criminal laws in every Australian jurisdiction make it an offence to commit sexual assault and more serious acts such as rape. Anti-discrimination law Legislation in all jurisdictions prohibits discrimination in the workplace. Contract law Employment contracts contain an implied duty requiring the employer not to engage in conduct likely to damage the relationship of trust between employer and employee.

Professional standards Professional codes of conduct establish clear professional and ethical responsibilities to treat colleagues with fairness and respect. Conclusion Sexual harassment is illegal and unethical. View this article on Wiley Online Library.

Competing interests:. Lillebuen S. Senior female surgeon urges trainees to stay silent on sex abuse in hospitals. Sydney Morning Herald ; 7 Mar. Witt A. Open letter: sexism in surgery humiliates me every day. Sydney Morning Herald ; 10 Mar. Fap is onomatopoeic Internet slang for masturbation. When it first launched, the forum received 20, visitors a month. There was no shortage of mutual encouragement, with badges awarded for milestones like going a week, a month, or a year without fapping, and a counter tracking exactly how many days a person has abstained.

Each day of NoFap brings me close to that ideal. In short, it means being more masculine, which in turn leads to success in other aspects of life. Take the example of year-old Redditor Ojdidit The confidence he got from that encounter, he said, not only helped him perform well at a job interview later, and secure a job at a hedge fund for the summer, but also enabled him to call a long-simmering crush and ask her out.

The vehemence with which some users espouse the benefits of anti-masturbation surprises Rhodes, who says that he never intended the forum as a self-help initiative.

Rhodes is also quick to clarify that he thinks masturbation is a normal and healthy human activity. He laughs and says no. I might have even masturbated before you called me. He started with a regime not unlike that of a pregnant woman, giving up booze, weed, and caffeine. He also gave up porn. He set a goal of 60 days. As the days passed, he made jokes about his progress online:. Have created wireless energy out of my humidifier and now my whole apt is off the grid.

Anyone else? Halfway through his experiment, he felt more energy and mental clarity. If the body is a series of systems, the thinking seems to be, then whatever problems exist can be repaired like a piece of hardware. Though he started limiting masturbation because it fixed the erectile problems he experienced during sex with his partner, it was also about trying to more actively engage with life. We adjusted for the clustering effect of universities in the analysis using survey analysis.

All estimates were weighted based on the inverse probability weight of College sampling. We used the chi squared test for analysis of categorical variables.

T test also was used to compare the means. We used direct method data to investigate the correlation of EPSB and risk factors.

Data were analyzed using Stata In all analysis, univariable and multivariable, the p-value was considered 0. Out of filled questioners, questioners were completed However, 73 questioners were excluded due to unreliable responses.

The mean age of the males The prevalence of last year EPSB was higher than before university entrance. The prevalence of all of the EPSB indices in the direct method was higher than the indirect method in the females except for watching pornography and in the male expect for watching pornography and SNSP in exchange for payment. The difference between the direct and indirect methods in most cases was significant except for SNSP in exchange for payment in male students and SNSP by non-payment and watching pornography in female students Table 2.

The SNSP was somewhat higher in students by direct method in the last year and before university entrance Table 2. The prevalence of last year and before university entrance of EPSB was reported to be higher in male than female students by direct and indirect methods. However, in male students, SNSP As indirect method showed, SSP The prevalence of EPSB for male and female students in the last year was more than before student course, except for SSP in exchange for a payment that was a little higher before student course 3.

The most prevalent behavior in students was watching pornography. In males, the prevalence of watching pornography was In females, the prevalence of watching pornography was We found that the prevalence of EPSB in the student was higher in the last months compared to their behavior before the university entrance.

Another important finding was that the prevalence of EPSB was higher among males. In our study, the prevalence of the last year EPSB in student course was similar to findings in Iran and Ethiopia 18 , Various reasons such as the lack of parent surveillance in universities may cause a start and increase in EPSB after entering university Students with no speaking about sexual behavior in families are usually more at risk of sexual behaviors Some students are starting sexual behavior under the pressure of friends in the student period and consequently, this determines the necessity of warning students about finding a friend Therefore, the reasonable relationship between parents and educating students about sexual issues and the selection of a friend can have an effective role in reducing extramarital sexual behaviors in the student period.

In our study, the prevalence of EPSB was higher among male students. This finding was compatible with the finding in Shahroud and Mashhad, Iran 19 , In societies like Iran, the differences between genders could explain these differences. The prevalence of drug use such as Alcohol, Cannabis, and Heroin was higher among male versus female students It seems consumed drugs elevated odds of sexual activity Moreover, in a conservative context like Iran, families are more worry about the behavior of their daughters and are more aware of their behaviors 7.

In addition, boys prefer virgin girls Thus involvement in sexual behaviors is more prevalent in boys We found most female students started their sexual behaviors after the entrance to the university. However, the most sexual behaviors of the male students started before student course This can show that families are more careful about the behaviors of their children, especially girls but after they enter a university this surveillance will decrease Sexual health education for daughters should be initiated by mothers but fears about stimulating the curiosity of adolescent and temptation to engage in sexual relation, insufficient knowledge of parents about sexual and inability of mothers in communication, are barriers to education When they do not receive information from mothers, an adolescent may get sexual information from unreliable sources such as friends, satellite, TV, and internet and this sources my increase EPSB among adolescent Regarding the increase of male and female relationships and the probability of transmission risk of infection in the student community, training about sexual behaviors is essential for students.

Consistent with the study in Tehran, the most prevalent sexual behaviors was watching pornography Increasing access to the media and its impact on youth has increased the experience of having EPSB Adolescents who receive more sexual information from media have more sexual activities and more intentions to start sexual intercourse Watching pornography increases the risk of having multiple sex partners among young population In the study in Sudan, there was a connection between watching pornography and anal sex experience in female students With increasing access of all students to cell phones and the Internet 32 , it seems that we are facing an increase in watching pornography and its effect on the health of the young population.

Sex education through social networks may reduce the risks of STIs The prevalence of EPSB by direct method was higher except for watching pornography in both genders and sexual contact with at least one non-students in exchange for payment in males.

Zahedi et al. In the indirect method, we do not have direct access to the targeted population and reports a random sample of the general population about the target population Indecent behaviors are shown less in the indirect method Regarding the indecency of EPSB in Iran, students hide the behaviors of their friends; therefore, it is possible why student reports are less than the actual amount in the indirect method Altogether, it seems the direct method can be more effective in EPSB in certain population groups.

This study had some limitations. First, as EPSB is a taboo among Iranian people, some of the participants may not want to talk about that.

sex jurnali

Patients and Jurnali This cross-sectional study was conducted on students in This study used different data collection methods murnali as direct and network scale-up NSU. A self-administrated questionnaire was completed by the participants for direct data survey.

Then Junrali data were gathered through the interview by a trained same-sex interviewer. In the direct method, Corresponding percentages in the NSU method were 2. Comparisons revealed that in the direct method, We found lower percentages in the indirect NSU jurnali, which is mainly because of nature of such behaviors that are invisible in society and we could not sec estimation for visibility.

EPSB led to social and health problems in the young 5. Pre-marital relationships and pre-marital sex experience increase divorce risk 6. Poor education about sex before marriage in adolescents and the lack of awareness of adolescents about sexual relationships 7leads to increased risk of sexually transmitted infections STIs e. HIVunplanned or unwanted pregnancy, illegal and unsafe abortion, and even in some cases leads to death 89.

About a quarter of Iran's population is comprised of young people aging from 15 - 29 years Due to the social stigma of EPSB in a traditional society like Iran, direct methods may not show the best estimation of the behavior.

It seems that in recent years in Iran, the prevalence of these behaviors has sex increased, especially in student populations. In addition, the number of studies, which address this issue in university students was not enough in recent years 1213 jurnali, This obviates a need to better understand of EPSB among university students.

The main purpose of this study was to determine the sex of EPSB and associated factors by the direct method and network scale-up NSU as an indirect method in the last year and before university entrance in murnali in Kerman universities. Jurnali the study covered three major southeast universities in Iran, it provides valid results for health managers and policymakers to make preventive decisions. We conducted a cross-sectional survey among university students in three main universities one medical, two non-medical universities in Kerman, southeastern of Iran, from January to February The participants were males and females.

Kerman University of Medical Sciences KUMSwhich is under the supervision of the Ministry of Health and Medical Education, includes medical, paramedical, and health-related disciplines at under- and post-graduate levels. Shahid-Bahonar University, affiliated to the Ministry of Sex and Technology, trains students in engineering, agriculture, art, social and basic sciences, and veterinary medicine at under- and post-graduate levels.

Shahid-Chamran also is affiliated to Ministry jurnali Science and Technology. Only male students in undergraduate engineering fields are enrolled in this university. The aims of the study were first explained to the participants and they were assured of the confidentiality of the data. Students in the first year of their college studies were excluded.

From each university, students were recruited in a convenient sampling with the maximum coverage of departments and faculties. In order to minimize the level of information bias, confidential and anonymous questioners were distributed to the participants after the explanation of a trained person from the research team and taking verbal consent.

In the first section of the study, the participants answered a self-administrated questionnaire in which we directly asked students whether they had EPSB at least once jurnali the last year and before their university entrance. The students were asked to drop completed questionnaires in a box. In the second section, data were collected by NSU questionnaire.

A trained jurmali interviewer asked jurnali students about how many of their close friends had EPSB at least once in the last year. NSU questionnaire was completed by interviewers in a private place at university.

Based on the average number of close friends that respondents know who have had EPSB and the average personal network size total of close friendsthe proportion of students who have had EPSB jurnali estimated by the indirect method The investigated EPSB indices included sex with student partners SSPsex with non-student partners SNSP in exchange for sex and jurnali payment, history of abortion, homosexual contact, and watching pornography.

The questionnaire was excluded in case of the respondents had provided contradictory answers to a self-administrated questionnaire of direct method survey. We adjusted for the clustering effect of universities in the analysis using survey analysis.

All estimates were weighted based on the inverse probability weight of College sampling. We used the chi squared test for analysis of sex variables. T test also was used to compare the means. We used direct method data to investigate the correlation of EPSB and risk factors. Data were analyzed using Stata sx In all analysis, univariable and multivariable, the p-value was considered 0. Out of filled questioners, questioners were completed However, 73 questioners were excluded due to unreliable responses.

The mean age of the males The prevalence of last year EPSB was higher than before university entrance. The prevalence of all of the EPSB indices in the direct method was higher than the indirect method in the females except for watching pornography and in the male expect for watching pornography and SNSP in exchange for payment.

The difference between the direct and indirect methods in most cases was significant swx for SNSP in exchange for payment in male sex and SNSP by non-payment and watching pornography in female students Table 2. The SNSP was somewhat higher in students by direct method in the last year and before university entrance Table 2.

The prevalence of last year and before university entrance of EPSB was reported to be higher in male than female students by direct and indirect methods.

However, in male students, SNSP As indirect method showed, SSP The prevalence of EPSB for male and female students in the last year was more than before student course, except for SSP in exchange for a payment that was a little higher before student course 3. The most prevalent behavior in students was watching pornography. In males, the prevalence of watching pornography was In females, the prevalence of watching pornography was We found that the prevalence of EPSB in junali student was higher in the last months compared to jurnalii behavior before the university entrance.

Another important ssx was that the prevalence of EPSB was higher among males. In our study, the prevalence of the last year EPSB in student course was similar to findings in Iran and Ethiopia 18 jurnaki, Various reasons such as the lack of parent surveillance in universities may cause a start and increase in EPSB after entering university jurnali Students with no speaking about sexual behavior in families are usually more at risk of sec behaviors Sex students ssex starting sexual behavior under the pressure of friends in the student period and consequently, this determines the necessity of warning students about finding a friend Therefore, the reasonable relationship between parents and educating students about sexual issues and the selection of a friend can have an effective role in reducing extramarital sexual behaviors in the student period.

In our study, the prevalence of EPSB was higher among male students. This finding was compatible with the finding in Shahroud and Jurnal, Iran 19jugnali In jurnali like Iran, the differences between genders could explain these differences. The prevalence of drug use such as Alcohol, Cannabis, and Heroin was higher among male versus female students It seems consumed drugs elevated odds of sexual activity Moreover, in a conservative context like Iran, families are more worry about the behavior of their daughters and are more aware of their behaviors 7.

In addition, boys prefer virgin girls Thus involvement in sexual behaviors is more prevalent in boys We found most female students started their sexual behaviors after the entrance to the university.

However, the most sexual behaviors of the male students started before student course This can show that families are more careful about the behaviors of their children, especially girls but after they enter a university this surveillance will decrease Sexual health education for daughters should be initiated by mothers but fears about stimulating the curiosity jurnalii adolescent and temptation to engage in jurna,i relation, insufficient knowledge of parents about sexual and inability of mothers in communication, are barriers to education When sex do not receive information from mothers, an adolescent may get sexual information from unreliable sources such as friends, satellite, TV, and internet and this sources my increase EPSB among adolescent Regarding the increase of male and female relationships and the probability of transmission risk of infection in the student community, training murnali sexual behaviors is essential for students.

Consistent with the study in Tehran, the most prevalent sexual behaviors was watching pornography Increasing access to the sex and its impact on youth has increased the experience of having EPSB Adolescents who receive more sexual information from media have more sexual activities and more intentions to start sexual intercourse Watching pornography increases the risk of having multiple sex partners among young population In the study in Sudan, there was a connection between watching pornography and anal sex experience in female students With increasing access of all students to cell phones and the Internet 32it seems that we are facing an increase in watching pornography and its effect on the health of the young population.

Sex education through social networks may reduce the risks of STIs The prevalence of EPSB by direct method was higher jurnali for watching pornography in both genders and sexual contact with at least one non-students in exchange for payment in males.

Zahedi et al. In the indirect method, we do not have direct access to the targeted population and reports a random sample of the general population about the target population Indecent behaviors are shown less in the indirect method Regarding the indecency of EPSB in Iran, students hide the behaviors of their friends; therefore, it is possible why student reports are less than the actual amount in the indirect method Altogether, it seems the direct method can be more effective in EPSB in certain population groups.

This study had some limitations. First, as EPSB is a taboo among Iranian people, some of the participants may not want to talk about that.

To reduce this limitation, we assure students confidentiality of their answers. Therefore, due to these two limitations, we encountered to sex of the behaviors. Third, the estimate of the prevalence in direct and indirect methods was under the influence sex sociality desirability bias, transmission error, and barrier xex thus we recommend indirect methods without correction of these errors could underestimate more than direct method and it is necessary to estimate these corrections among Iranian students.

We faced an increase in the prevalence of these behaviors in the student course compared with before student course in both genders. Lack of awareness, lack of centers in sexual health and fertility, a poor family relationship between parents and young people, and the impact of the media on young people have led to sexually hazardous behaviors and are associated with STIs such as HIV and unwanted pregnancy

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