<![CDATA[Premarital sexual activity among adolescents is an important public health concern because it may contribute to HIV/AIDS, sexually transmitted infections (STIs), and unintended pregnancy. Maliana, Timor-Leste, has reported increasing HIV/AIDS cases and a high rate of early pregnancy. This study analyzed factors associated with premarital sex prevention behavior among Grade XI students at Dom Martinho da Costa Lopes Senior High School, Maliana, Timor-Leste. A quantitative cross-sectional study was conducted among 234 Grade XI students selected through simple random sampling. Data were analyzed using univariate analysis, bivariate analysis with the Chi-square test, and multivariate logistic regression. Bivariate analysis found significant associations between premarital sex prevention behavior and attitude (p<0.001), family role (p=0.002), peer influence (p<0.001), and social media/internet use (p<0.001). Knowledge (p=0.107), sociocultural factors (p=0.110), and socioeconomic factors (p=0.545) were not significantly associated with prevention behavior. Multivariate analysis identified social media use as the dominant factor associated with premarital sex prevention behavior (OR=4.372). Students with inappropriate social media use were 4.372 times more likely to demonstrate poor premarital sex prevention behavior. Premarital sex prevention behavior among Grade XI students was associated with attitudes, family roles, peer influence, and social media/internet use. Social media use was the strongest associated factor. School-based sexual health education, parental involvement, positive peer support, and digital-health literacy interventions are recommended to strengthen adolescents’ preventive behavior.]]>
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