Background and Objectives: Globally around half of new HIV infections occur in the age group 15-24. New reported cases of HIV/AIDS in Lebanon show that a younger age group (20-30) is being affected more than ever before. Lebanon is moving forward in implementing a national sexuality education curriculum in all public schools, as a mechanism for raising awareness and for preventing sexually transmitted infections (STI) including HIV among adolescents. However, little is known about adolescents' actual sexual behavior, the extent to which students are confident of their refusal skills, and the factors that determine these. Young adolescents, who have limited sexual knowledge and experience, may have difficulty in adopting the appropriate protective behavioral responses to prevent negative health outcomes including STI and HIV infection. Methods: This research identified the prevalence and risk factors for perceived sex refusal skills among Lebanese adolescents in grades 7-9 in public and private schools using the nationally representative Lebanon Global School Health Survey. Results: Results indicated that more than 40% (50.4% of boys and 34.8% of girls) of students did not feel confident that they could tell someone they did not want to have sexual intercourse with them. Multivariate logistic regression analysis indicated that being female, older and having close parental supervision predicted having perceived sex refusal skills among Lebanese adolescents. Moreover, having knowledge and/or education about risky behaviors was the strongest predictor for having perceived sex refusal skills among Lebanese adolescents. Conclusion: This study contributes to the limited literature on perceived sex refusal skills in Lebanon, the Middle East and North Africa. A number of recommendations for research and prevention programs can be drawn from this research. Advocacy efforts should target policy makers to ensure that policies are reviewed to support comprehensive sexuality education in Lebanese schools because of identified vulnerabilities of sexual violence, low levels of education or knowledge of risky behaviors including HIV risk, and low levels of perceived sex refusal skills.


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