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"Remaja cenderung memiliki perilaku seksual berisiko yang dapat dicegah melalui program edukasi di sekolah. Model Ketahanan Remaja Tanpa AIDS/RaTnA merupakan edukasi berbasis sekolah dilengkapi keterampilan hidup untuk ketahanan remaja. Penelitian ini bertujuan menguji efektivitas Model Ketahanan RaTnA untuk meningkatkan perilaku pencegahan HIV dan AIDS pada siswa SMA. Penelitian ini menggunakan riset operasional melalui tiga tahap yaitu: studi cross-sectional, studi pengembangan model, dan studi quasi-experimental. Tahap pertama melibatkan 619 siswa yang diperoleh dengan teknik quota sampling, tahap kedua empat orang pakar dan tahap ketiga 114 siswa. Tahap pertama mengidentifikasi faktor risiko internal, faktor risiko eksternal, faktor proteksi individual, faktor proteksi sosiokultural, ketahanan remaja serta perilaku pencegahan HIV dan AIDS sebagai faktor kunci yang memengaruhi pengembangan Model Ketahanan RaTnA. Tahap kedua menghasilkan satu buku model dan kurikulum, tiga modul atau buku ajar, sembilan buku kerja, dan satu buku evaluasi sebagai perangkat Model Ketahanan RaTnA. Tahap ketiga menunjukkan bahwa setelah intervensi selama empat bulan, efek pemberian Model Ketahanan RaTnA di kelompok intervensi berdampak signifikan pada skor strategi koping, harga diri, kontrol diri, self-efficacy, pengetahuan tentang HIV dan AIDS, sikap terhadap pencegahan HIV dan AIDS, dan perilaku pencegahan HIV dan AIDS (p value < 0,001). Model Ketahanan RaTnA efektif meningkatkan skor harga diri, self-efficacy, pengetahuan-sikap-perilaku pencegahan HIV dan AIDS, strategi koping serta kontrol diri. Model Ketahanan RaTnA dapat diadopsi untuk asuhan keperawatan pada agregat remaja di komunitas.

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Adolescents tend to engage in risky sexual behaviors, which can be prevented through school-based educational programs. The Adolescent Resilience Without AIDS (RaTnA Resilience) Model is a school-based education program incorporating life skills to enhance resilience adolescent. This study aims to assess the effectiveness of the RaTnA Resilience Model in enhancing HIV and AIDS prevention behaviors among high school students. This operational research was conducted in three phases: a cross-sectional study, a model development study, and a quasi-experimental study. The first phase involved 619 students selected using quota sampling, the second phase involved four experts, and the third phase involved 114 students. The first phase identified key factors that shaped the development of the RaTnA Resilience Model, including internal risk factors, external risk factors, individual protective factors, sociocultural protective factors, adolescent resilience, and HIV and AIDS prevention behaviors. The second phase resulted in the creation of one model handbook and curriculum, three teaching modules or textbooks, nine workbooks, and one evaluation book as supporting materials for the RaTnA Resilience Model. The third phase revealed that after four months of intervention, the RaTnA Resilience Model significantly influenced coping strategies, self-esteem, self-control, self-efficacy, knowledge of HIV and AIDS, attitudes toward HIV and AIDS prevention, and preventive behaviors in the intervention group (p value < 0,001). The RaTnA Resilience Model effectively improves self-esteem, self-efficacy, HIV and AIDS knowledge, attitudes, and prevention behaviors, as well as coping strategies and self-control. The RaTnA Resilience Model can be adopted as a nursing intervention for adolescent populations in community settings."

"Masa remaja merupakan masa transisi dari masa anak-anak menuju dewasa, ditandai dengan percepatan perkembangan fisik, mental, emosional dan sosial. Semakin muda umur remaja melakukan hubungan seksual, semakin besar resiko terjadinya penularan penyakit-penyakit infeksi menular seksual, kehamilan tak diinginkan, dan aborsi. Data SDKI 2012 menyatakan umur remaja Indonesia yang telah melakukan hubungan seksual pranikah berkisar antara 9 - 24 tahun. Prevalensi remaja yang belum menikah yang telah melakukan hubungan seksual sebesar 8,3 % laki-laki dan remaja perempuan sebesar 1%. Suwarni (2009) menyatakan bahwa 14,7% remaja SMA di Pontianak telah melakukan intercourse (hubungan seks) pranikah dan proporsi remaja yang melakukan hubungan seksual di Semarang sebesar 12,1% (Azinar, 2013). Penelitian ini bertujuan mengetahui determinan ketahanan remaja untuk tidak melakukan hubungan seksual pranikah. Proporsi kumulatif ketahanan remaja sebesar 92,6% dengan rata-rata usia pertama kali melakukan hubungan seksual pranikah 15,8 tahun. Determinan ketahanan remaja meliputi perilaku rangsang seksual (AHR: 7,7; 95% CI: 5,2 - 11,3), perilaku mabuk karena alkohol (AHR: 1,5; 95% CI: 1,1 - 2) dan perilaku berciuman. Hubungan antara perilaku berciuman dengan ketahanan remaja berbeda tiap satuan waktu. Diperlukan upaya penyuluhan kesehatan reproduksi yang lebih dini bukan hanya di lingkungan sekolah, namun juga di lingkungan keluarga dan komunitas remaja agar perilaku hubungan seksual pranikah dapat dicegah.

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Adolescent is a transition period from childhood to adulthood, signed by rapid development in physical, mental, emotional and social. Earlier sexual initiation by adolescent, increasing risk to get sexual transmitted diseases, unmeet need, teen’s pregnancies, and unsafe abortion. According to data DHS 2012, adolescent in Indonesia had have premarital sexual on 9 - 24 years old. Prevalence of unmarried boys who had have sex are 8,3 % and girls are 1%. Suwarni (2009) announced that 14,7% of high school students in Pontianak had have premarital sex. Meanwhile, based on Azinar (2013) study in Semarang, about 12,1% adolescents had it.

This study aim to know determinants of adolescent’s survival not to have premarital sex. The results show that adolescent’s survival cumulative proportion is about 92,6% and age mean of sexual debut is 15,8 years old. Factors associated with adolescent’s survival not to have premarital sex are sexual arrousal behavior (AHR: 7,7; 95% CI: 5,2 - 11,3), ever drunk by alkohol (AHR: 1,5; 95% CI: 1,1 - 2) and kissing. The association between kissing and adolescent’s survival rate is difference in each time unit (year). Need enforcements to give earlier education about adolescent’s health reproduction, not just as formal education in high school, but also in the family and adolescent’s community to prevent premarital sex among adolescents."