ANALYSIS OF ADOLESCENT REPRODUCTIVE HEALTH KNOWLEDGE ON PREMARITAL SEXUAL ATTITUDE

channel sexual urges in a healthy and responsible ABSTRACT Background : The lack of knowledge about adolescent reproductive health can affect adolescent attitudes about premarital sex which creates the risk of unhealthy sexual acts that affect reproductive health. This study aims to determine the effect of adolescent reproductive health knowledge on premarital sexual attitudes in 1 Sambit Senior High School, Ponorogo Regency. Method : This study used an observational analytic survey method with a cross sectional approach. The sample was taken using Proportional Random Sampling with a sample of 60 respondents, namely 21 students of class X, 17 students of class XI and 22 students of class XII, then analyzed using the Spearman Rank Test. Results : In this study, it was found that respondents who had knowledge about adolescent reproduction in the sufficient category mostly had positive attitudes towards premarital sexual attitudes, were 32 respondents (74.4%). The P-value is 0.021 < (α = 0.05), which means that there is a relationship between adolescent reproductive health knowledge and premarital sexual attitudes at 1 Sambit Senior High School, Ponorogo District. Conclution : Adolescents who have good knowledge about reproductive health will have a positive attitude in preventing teenage pregnancy which is included in premarital sexual attitudes


BACKGROUND
Adolescence is a period of transition, w here physical changes occur rapidly and sometimes are not balanced with mental changes (BKKBN et al., 2017). One of the problems faced during adolescence is premarital sexual behavior, where premarital sexual behavior in adolescents is all adolescent behavior that is driven by desire both with the opposite sex and the same sex that was carried out before an official relationship as husband and wife. The factors that cause premarital sexual behavior in adolescents are knowledge, increased libido, information media, religious norms, family, and increasingly free association. (Kemenkes RI, 2018;Sebayang et al., 2018) Low adolescent knowledge can affect adolescent attitudes in responding to premarital sex. Adolescents who have low knowledge about reproductive health and premarital sexual behavior tend to have unhealthy sexual acts which in turn bring them closer to the risk of being infected with various sexually transmitted diseases, including HIV and AIDS. (Nuraldila & Yuhandini, 2017). According to Ulfah's research (2018) knowledge about reproductive health has a direct effect on premarital sexual behavior. This is in line with Glanz's opinion in Ganela (2020) which states that one of the factors that influence behavior is cognitive factors, where adolescents who have experience correctly and proportionally about reproductive health tend to understand behavioral risks and alternative ways to use them correctly. channel sexual urges in a healthy and responsible manner (Ganela, 2020;Ulfah, 2018) The impact of premarital sexual behavior on adolescents can lead to the risk of unwanted pregnancy, dropping out of school, abortion, getting sexually transmitted diseases, psychosocial pressure that arises because of feelings of guilt for violating religious rules and fear of being known by parents and society. It is very important to provide adolescent reproductive health services, which aim to prevent and protect adolescents from risky sexual behavior that can affect reproductive health (Cahyani et al., 2019).
According to the World Health Organization (WHO) in 2020, especially in developing countries, it is estimated that 21 million girls between the ages of 15-19 are pregnant and around 10 million have unwanted pregnancies (WHO, 2020). The results of the 2018 Indonesian Adolescent Reproductive Health Situation Survey (SKRRI) stated that premarital sexual behavior in adolescents was reported as 4.5% in males and 0.7% in females aged 15 -19 years. Meanwhile, premarital sex behavior aged 20-24 years was 14.6% for men and 1.8% for women (Kementerian Kesehatan RI, 2015). Another survey show s that 5.26% of junior and senior high school students in Indonesia have had premarital sex (Nunik Kusumawardani et al, 2015). The results of the 2018 Basic Health Research (Riskesdas) show that 1.97% of adolescents aged 15-19 years and 0.02% of adolescents aged less than 15 years have been pregnant (Kemenkes RI, 2018b). According to data from the Ponorogo DPPKB, the number of marriages aged <20 years in 2021 is 534 (DPPKB Ponorogo, 2021 Ponorogo, 2021). There are several sexual activities that fall into the category of premarital sexual behavior, where sexual activity is defined as activities carried out to satisfy sexual desires or actions to obtain pleasure from the genitals or sexual organs through various behaviors, such as fantasizing, martubating, kissing, petting, and so on. intercrouse is an example of his behavior (Sebayang et al., 2018). There are several sexual activities that fall into the category of premarital sexual behavior, where sexual activity is defined as activities carried out to satisfy sexual desires or actions to obtain pleasure from the genitals or sexual organs through various behaviors, such as fantasizing, martubating, kissing, petting, and so on. intercrouse is an example of his behavior (Atik & Susilowati, 2021). Knowledge plays a role in early adolescent sexual behavior. Knowledge is one of the domains that shape a person's behavior. A person can perform an action because of the knowledge he has. This study aims to identify adolescent knowledge about reproductive health and premarital sexual attitudes in adolescents and analyze the influence of adolescent reproductive health knowledge with premarital sexual attitudes.

METHODS
The type of this research is observational with analytical survey research method with cross sectional approach. The population of this study were students of SMA Negeri 1 Sambit, Ponorogo Regency as many as 358. The sample size in this study was 60 respondents with the proportional random sampling technique where the number of samples in each class was determined by determining the proportion according to the number of students in SMA Negeri 1 Sambit under study. This research was conducted from April to May 2022 at SMA Negeri 1 Sambit, Ponorogo Regency. The instrument used in this research is in the form of a questionnaire and the data will be analyzed using the Spearman Rank test. This research has passed the ethical test with the number 3004/KEPK/VI/2022.

P-value Correlation Coefficient
There is a relationship between adolescent reproductive health knowledge and premarital sexual attitudes at 1 Sambit Senior High School, Ponorogo District. .021 .298 * Based on Table 5, the results of data analysis on Adolescent Reproductive Health Knowledge with Premarital Sexual Attitudes at SMA Negeri 1 Sambit, Ponorogo Regency, the results of the Spearman's rho statistical test obtained a Pvalue of 0.021, because P-value < (α = 0.05) then H1 is accepted and H0 is rejected. which means that there is an influence of adolescent reproductive health knowledge on premarital sexual attitudes in SMA Negeri 1 Sambit, Ponorogo Regency. The results of the above analysis obtained the Correlation Coefficient of 0.298, which means the level of strength of the relationship (correlation) is low between the variable knowledge of adolescent reproductive health and the variable of premarital sexual attitudes. Thus the data means that the higher the knowledge of adolescent reproductive health, the more positive attitudes about premarital sex.

DISCUSSION
Based on the table of results of data analysis  of  Adolescent  Reproductive  Health  Knowledge with Premarital Sexual Attitudes at SMA Negeri 1 Sambit, Ponorogo Regency, the results of the Spearman's rho statistical test obtained a Pvalue of 0.002, because P-value < (α = 0.05) then H1 is accepted and H0 is rejected. it means that there is an influence of adolescent reproductive health knowledge on premarital sexual attitudes in SMA Negeri 1 Sambit, Ponorogo Regency, and based on table 4.10 shows that of the 60 respondents at SMA Negeri 1 Sambit Ponorogo who have knowledge about adolescent reproductive health in the category enough to have a positive attitude towards sexual attitudes premarital as many as 32 respondents (74.4%). The results of this study are in line with Mursit's research (2018) which states that there is a significant relationship between knowledge about reproductive health and attitudes towards prevention of teenage pregnancy at SMK N 1 Saptosari in 2018. If the attitude of adolescents is not good, it will affect deviations such as teenage pregnancy. which is increasing. So it is very important knowledge about reproductive health for adolescents as early as possible (Mursit, 2018). This is also supported by the research results of Rina et al. (2014) which also stated that there was a significant relationship between knowledge and adolescent attitudes towards premarital sex at SMA N 1 Cerenti. The results of the analysis in this study indicate that adolescents who have high knowledge about sex have 1,987 times the opportunity to be positive than adolescents who have low knowledge about sex (Rina et al., 2014). This is in accordance with Notoatmodjo's opinion, according to Notoadmodjo (2013), someone who has a good attitude (positive) usually has good knowledge. Meanwhile, someone who behaves badly usually has poor knowledge (Notoatmodjo, 2013). Thus it can be concluded that the results of this study are in line with the theory and previous research, where it was found that there was an influence of adolescent reproductive health knowledge with premarital sexual attitudes in students at SMA Negeri 1 Sambit, Ponorogo Regency, which means that students who have a positive (supportive) attitude towards sexuality premarital usually have good or sufficient knowledge about reproductive health. Meanwhile, students who have a negative attitude (not supportive) towards premarital sex usually have poor knowledge. Thus, students who have good or sufficient knowledge about reproductive health will have a positive attitude (support) in the prevention of teenage pregnancy which is included in premarital sexual attitudes. CONCLUSION Based on the calcilation results that the respondents have knowledge about adolescent reproductive health in the sufficient category, as many as 43 respondents (71.1%). The respondents have a positive attitude towards premarital sexual attitudes, as many as 49 respondents (81.1%). There is an influence of adolescent reproductive health knowledge on premarital sexual attitudes in SMA Negeri 1 Sambit, Ponorogo Regency, which is stated in the results of the Spearman's rho statistical test, the P-value is 0.002.