Background: Teenagers are influenced by their surroundings, and this may also include their sexual behavior or societal responses to this type of behavior. It is important to understand the complexity of religious mandates and sociocultural disapproval of premarital sex from the perspectives of healthcare professionals.

Methods: This qualitative study aimed to explore the influence of religion on healthcare professional’s beliefs toward providing sexual and reproductive health information and treatment. An interview topic guide was used in the in-depth interview of 32 healthcare professionals in several health clinics in Malaysia. The data were transcribed and entered into the NVivo 11 software. Thematic analysis was used to evaluate the data.

Results: The findings show that some healthcare professionals positively incorporated Islamic beliefs into sexual health education session but excluded the contraception information. This study also highlights the strategies used by healthcare professionals (discourse on risk, being selective, maintaining their own honor) when providing sexual health services to teenagers.

Conclusion: These findings revealed how religion perpetuates a “moral” approach in the provision of sexual health services that potentially affects teenagers’ access to healthcare.


1. Adamczyk A, Hayes BE. Religion and sexual behaviors: Understanding the influence of Islamic cultures and religious affiliation for explaining sex outside of marriage. Am Sociol Rev. 2012;77:723–46.

2. Arousell J, Carlbom A. Culture and religious beliefs in relation to reproductive health. Best Pract Res Clin Obstet Gynaecol. 2016;32:77–87.

3. Husain F A. Reproductive issues from the Islamic perspective. Hum Fertil (Camb). 2000;3:124–8.

4. Rosenfield A. Reproductive health issues in Africa. Afr J Reprod Health. 1997;1:5–6.

5. Shaw SA, El-Bassel N. The influence of religion on sexual HIV risk. AIDS Behav. 2014;18:1569–94.

6. Lee LK, Chen PCY, Lee KK, Kaur J. Premarital sexual intercourse among adolescents in Malaysia: A cross-sectional Malaysian school survey. Singapore Med J. 2006;47:476–81.

7. Khalaf ZF, Low WY, Merghati-Khoei E, Ghorbani B. Sexuality Education in Malaysia: Perceived Issues and Barriers by Professionals. Asia Pac J Public Health. 2014;26:358–66.

8. Pekrun R, Elliot A, Maier M. Achievement goals and discrete achievement emotions: A theoretical model and prospective test. J Educ Psychol. 2006;98:583–97.

9. Musselwhite K, Cuff L, McGregor L, King KM. The telephone interview is an effective method of data collection in clinical nursing research: A discussion paper. Int J Nurs Stud. 2007;44:1064–70.

10. Carr ECJ, Worth A. The use of the telephone interview for research. Nurs Times Res. 2001;6:511–24.

11. Novick G. Is there a bias against telephone interviews in qualitative research? Res Nurs Health. 2008;31:391–8.

12. Opdenakker R. Advantages and disadvantages of four interview techniques in qualitative research [Internet]. Forum Qual Sozialforschung/Forum Qual Soc Res. 2006. [Cited 2018 Dec 15]. Available from: https://pure.tue.nl/ws/files/1948695/Metis202565.pdf.

13. Mays N, Pope C. Qualitative research in health care : Assessing quality in qualitative research service Assessing quality in qualitative research. BMJ. 2000;320

14. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.

15. Clarke V, Braun V. Successful qualitative research: A practical guide for Beginners. 2013. London, United Kingdom: SAGE publication Ltd.

16. Holloway I, Wheeler S. Qualitative Research in Nursing and Healthcare. 3rd ed. Hoboken, New Jersey: John Wiley & Sons; 2013. p. 25–100.

17. Silverman D. Doing Qualitative Research: A Practical Handbook. London, United Kingdom: SAGE Publication Ltd; 2018.

18. Landau L. Nursing Board Malaysia: Code of Professional Conduct for Nurses First Edition April 1998 [Internet]. [cited 2019 Feb 21]. Avaılable from: http://nursing.moh.gov.my/wp-content/uploads/2015/ 04/nursing_board_malaysia-code_of_professional_ conduct_1998.pdf.

19. Pound P, Denford S, Shucksmith J, Tanton C, Johnson AM, Owen J, et al. What is best practice in sex and relationship education? A synthesis of evidence, including stakeholders’ views. BMJ Open. 2016;7:e014791.

20. Arousell J, Carlbom A. Culture and religious beliefs in relation to reproductive health. Best Pract Res Clin Obstet Gynaecol. 2016;32:77–87.

21. Latifnejad Roudsari R, Javadnoori M, Hasanpour M, Hazavehei SMM, Taghipour A. Socio-cultural challenges to sexual health education for female adolescents in Iran. Iran J Reprod Med. 2013;11:101–10.

22. Wood K, Jewkes RK. Barriers and Scolding Nurses : to Blood Blockages Use in South Africa Adolescent Contraceptive. Reprod Health Matters. 2011;14:109–18.

23. Nalwadda G, Mirembe F, Tumwesigye NM, Byamugisha J, Faxelid E. Constraints and prospects for contraceptive service provision to young people in Uganda: providers’ perspectives. BMC Health Serv Res. 2011;11:220.

24. Olsson H. Openness and opposition: Sexuality education in Europe. In: Evid-Based Approaches Sex Educ Glob Perspect. 2016;292–314.

25. Wilson KL, Wiley DC, Rosen B. Texas Sexuality Education Instruction: Shame and Fear-Based Methodology. J Health Educ Teach. 2012;3:1–10.

26. Lederer A. An analysis of conflicting perspectives: The impact of exposing young people to graphic images of sexually transmitted infections in sexuality education [dissertation]. United States: Indiana University; 2016.

27. Santelli JS, Kantor LM, Grilo SA, Speizer IS, Lindberg LD, Heitel J, et al. Abstinence-only-until-marriage: An updated review of U.S. policies and programs and their impact. J Adolesc Health. 2017;61:273–80.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.