Effects of Health Counseling on the Level of Knowledge and Attitudes Regarding Sexual Health in AL-Huda MTs Students

Abortion, pregnancy and sexually transmitted diseases are also a problem of adolescent sexual health in the world (WHO, 2015). This data shows that the number has increased every year. Increased sexual health problems also occur in cases of abortion, pregnancy and sexually transmitted diseases. The importance of knowledge about reproductive health, adolescents need to get enough information, so that they know what should be done and which should be avoided. Besides, with a good knowledge of sexual health, will form a positive attitude towards sexual health. This study aims to determine the effect of health education on the level of knowledge and attitudes about sexual health in MTs AL-Huda students. One group pretest-posttest design research design is the pre-experimental design type. A total population of 128 with a sample of 97 respondents employing purposive sampling and research instruments was a questionnaire. The results of univariate studies before health education for knowledge were 24 good (24.7%), 39 adequate (40.2%), 34 poor (35.1%) and attitudes of 36 positive (37.1%) and 61 negative ( 62.9%). After health education for knowledge, 62 were good (63.9%), 33 were sufficient (34.0%) and 2 were less (2.1%) while for attitudes namely, 78 were positive (80.4%) and 19 were negative (19, 6%), bivariate results with the Wilcoxon test (ρ = 0,000 <α = 0.05), it was concluded that there were significant differences between knowledge and attitudes before and after health education. It is recommended to improve the knowledge and attitudes of adolescents through health education, especially in maintaining and maintaining reproductive/sexual health.


INTRODUCTION
Indonesian adolescents are currently experiencing increased vulnerability to various health risks, especially those related to sexual and reproductive health, including increased threats from HIV / AIDS. Adolescent sexuality and reproductive health are defined as the physical and psychological well-being of an adolescent, including conditions free from unwanted pregnancy, unsafe abortion, sexually transmitted diseases (STDs) including HIV / AIDS, and all forms of sexual violence and coercion. Adolescent reproductive health is a healthy condition that involves the reproductive systems, functions and processes possessed by adolescents. Understanding Public understanding of sexuality is still lacking until now. This lack of understanding is very clear, namely the existence of various ignorance that exists in society about sexuality that should be understood. Some people still believe strongly in myths, which is a misconception about sex. An understanding of adolescent sexual behavior is an important thing to know because adolescence is a transition period from sexual behavior of children to adult sexual behavior (Endarto, 2014). Adolescent reproductive health (KRR) is a healthy condition that involves the reproductive systems, functions and processes possessed by adolescents. The needs and types of reproductive health risks faced by adolescents have different characteristics from children or adults.
Types of reproductive health risks faced by adolescents include pregnancy, abortion, sexually transmitted diseases (STDs), sexual violence, and the problem of limited access to information and health services. This risk is influenced by various interrelated factors, namely demands for young marriage and sexual relations, access to education and employment, gender inequality, sexual violence and the influence of the mass media and lifestyle (Nugrahaeni, 2015).
According to the World Health Organization (WHO) in 2015 the number of AIDS sufferers in the world was 33,300,000 and in Asia there were 4,900,000 cases. As many as 53% of AIDS sufferers are teenagers. Besides, abortion, pregnancy and sexually transmitted diseases are also a problem of adolescent sexual health in the world (WHO, 2015 This study uses a one group pretest-posttest design research design that is the type of pre-experimental design is done in a way before the treatment / variable treatments are observed or measured first (pretest) after which the treatments are carried out. And after treatment, obesity measurement (postest) is carried out (Hidayat, 2009). The population in this study were all students of MTs Al-Huda Gattareng Village, Gantarang District, Bulukumba Regency as many as 128 people. The sample is part of the population to be studied or part of the number of characteristics possessed by the population (Hidayat, 2009     The first test is done by testing the knowledge of respondents before and after counseling. In this study analyzed using the Wilcoxon test with a value of ρValue 0.00 <α = 0.05, which means that there are significant differences between knowledge before and after health education. The difference in the average value of knowledge before and after counseling is 0.72. Wilcoxon test with a value of ρValue 0.00 <α = 0.05, which means that there are significant differences between knowledge before and after health education. After conducting health education there were still respondents who lacked years of age due to the very young age of the respondents and the time spent distributing questionnaires that were too long to make respondents forget about the information provided besides that some respondents just answered without thinking whether this was the right answer or not. The difference in the average value of knowledge before and after counseling is 0.72. Knowledge is the result of knowing someone about objects through their senses. By itself, at the time of sensing to produce knowledge is strongly influenced by the intensity of attention and perception of the object. Most of one's knowledge is obtained through the sense of hearing and vision (Notoatmodjo, 2011). Many factors influence knowledge including education, experience, age, information. Mass media, social culture and economy, environment. Health education is an important aspect in increasing family knowledge, using health education means that health workers help families in efforts to improve health status (Djay, 2014). Besides, health education is also an educational activity carried out by disseminating messages, instilling confidence, so that people are not only aware, know and understand, but also want to get accustomed to doing suggestions that have to do with health (Maulana, 2012).
One of the steps in health education is to assess the needs of the community such as counseling on reproductive health in adolescents who will enter the world of puberty which will undergo many changes including the reproductive organs. The results of a study conducted by Massolo (2015) that there is an influence of reproductive health education on the knowledge and attitudes of adolescents about premarital sex in SMAN that there is a relationship between the level of knowledge about reproductive health and risky sexual behavior in adolescents of SMK Negeri 4 Yogyakarta.
Based on the researchers' assumptions that increasing knowledge through health education is very necessary for example in terms of increasing adolescent / student knowledge about reproductive health. Adolescents in this case who will enter their new world must be equipped with sufficient knowledge to avoid unwanted things such as early marriage, pregnancy outside marriage, free sex and the use of illegal drugs both from adolescence and from family. Factors that influence attitudes can be divided into internal and external factors.
Internal factors include gender, age, education, and experience. By looking at the sample of researchers who are all teenagers with relatively young age is one of the causes there are still 19 respondents who are still being negative about sexual health even though health counseling has been given while in terms of gender, men are more dominant negative than women. This happens because in the context of reproductive health the most widely discussed is women and the most disadvantaged from reproductive health itself is women. The difference in the average value of attitude before and after counseling is 0.33.
Attitude is a reaction or response of someone who is still closed to a stimulus or object (Notoatmodjo, 2011 directly or indirectly. Adapt directly asked how the respondent's opinion or statement of an object. Besides aiming to increase knowledge, health education can also influence the attitude of someone who receives information from health education. This is in line with research conducted by Nugrahaeni (2015) which states that there is an influence of adolescent reproductive health counseling on adolescent sexual knowledge and attitudes (study at SMAN 1 Margahayu Bandung). These results are also supported by research conducted by Wijaya (2015)