Study participants (n = 43) consisted of 22 women with their husbands (21 men) and their specifications are presented in Table 1. The findings reflect the information, motivation, and behavioral skills of Iranian couples in the field of sexuality. The following general themes were derived from the interview data.
Information
The information construct in the IMB model is a basic background for the promotion of healthy sexual behaviors in couples.
Due to the predominant discourse of religion and the sexually conservative culture in Iran, sexual interactions are permitted exclusively within the family context and after marriage. In particular, girls are taught to have their first sexual experience with their future husband. N, 32 years old and a doctoral student, who had been married for 5 years said
"Because I grew up in a religious and traditional family, I saw sex only in the form of marriage. It was not that these relations existed outside of marriage. I myself adhered to it as my religion says it".
The culture of silence and the value of hijab and modesty, especially for women in Iranian culture, and lack of openness toward matters of sexuality, especially before marriage, make couples unlikely to neither seek any kind of sexual information nor be recognized as sexual beings in the society. Sh, 30 years old, master’s degree educated housewife who had been married for 1 year said she has never been looking for this information.
"I had no information before marriage; even I had not seen the male genitalia. There was a halo in my mind. Of course, I myself did not like to follow this information for a series of issues in society like Hijab and modesty and these things. There was a curtain between us and sex".
In the same vein, her husband (P, 28 years old, bachelor of chemistry, an educated man working in the non-governmental sector) expressed concern about the inactive role of responsible organizations of society for providing accurate and timely information to people.
"I have a concern for a long time, why sexuality shouldn’t be opened stealthy (behaving in a cautious and surreptitious manner)? I want to know that for me and when I was a teenager, why should not the organization that has an authority to train and talk about these things? Now, I do not say fully but start at school, for example, to tell these things. From childhood, these issues begin, and as one gets older, the problem gets clearer."
Despite the role of institutions such as families, schools, universities, health centers, and media in providing valid information on sexual issues, but all participants pointed to the inactive role of these institutions and their inefficiencies in providing relevant and timely sexual information and services.
In the expression of contributing couples, parents’ passivity in children’s sexual upbringing was characterized by silence and failure to address sexual issues, the absence of sex education at the age of adolescence and even at the time of marriage. S, 21-year-old undergraduate student, who had been married for 1 year, said that her mother had not talked about sex even during her marriage and wedding.
"Of course, this is a tradition in our family, for example, even when a girl wants to be a bride, someone else, for example, her aunt, is talking to her in this area, her mother does not go to talk".
Her husband (SH, 26-year-old man, food industry engineer and an employee) has a similar view in this regard:
"In our family, like most Iranian families, there was no talk about sexual issues. That is, both my parents and me were embarrassed to talk about these issues. Maybe we were afraid that our respect would be ruined".
Social learning theory and script theory suggest that people create and reserve “scripts” through observation of attractive and relevant models in both real life and the media that guide social behavior. Despite the lack of direct sexual education of parents to their children, participant couples said that they had modeled parents’ behaviors in the family context for their marital and sexual life indirectly in the field of mutual respect, expressing love and marital intimacy, maintaining privacy for themselves, and flexibility in their interrelationships. S, 26 years old, master of law, and housewife, pointed to this subject:
"I say that we did not receive any training or did not learn anything from family, but in the course of everyday life, I saw the life of my parents, I saw my aunt and saw my close relatives. I learned something from them. My parents, for example, always had privacy for themselves. Their room was surely separate and they devoted time to staying at home together or go out together".
Also, S, 25 years old, who works as a counselor in the care center of idle daughters, considers her flexibility in marital and sexual life as a result of her family’s upbringing.
"The flexibility I learned in marriage has come from my family. For example, I'll be having sex with my husband one night, even though I do not want to have sex for that night, it comes from the same flexibility that I learned in my family. Perhaps we do not receive directly education from the family, but family-based upbringing will affect our sexual life indirectly".
Many participants referred to the use of informal methods such as talking to friends and relatives, the experience of peers, jokes and metaphors, watching videos, social networking, and non-native media to get information. In fact, people filled out the deficiencies in formal education using these resources and mentioned it as the only way to meet their sexual needs. The major disadvantage of these methods is the mixing of accurate information with incorrect information and creating false beliefs and attitudes about sexual relationships in individuals that may harm their sexual life. H, 29 years old, an electrical engineer, who had been married for 1 year, pointed out the disadvantages of watching porn videos to gain information and skill:
"Unfortunately, due to the false culture that exists in the community, lack of sex education, the minds of teenagers and youth go to pornography and watch porn videos. After marrying, people realize that perhaps one percent of it can be implemented, but it does not work".
His wife, R, 26 years old, computer engineer and employee, referred to the formation of misconceptions in herself as a result of inaccurate information:
"At the university, when I talked to my friends, I realized something about sex. Sometimes I saw the movie in dormitory. I thought, in terms of what I had heard from my friends and what I had seen in the movies that men get more pleasure in sex, and women were more likely to be harassed. It was the same in early marriage, because I had too much pain. I thought that sex is the same as women are a means to enjoy men. But after a few months my pain got better and my husband and I learned how to act in sex, I found that sexual pleasure is really two-way and could even be more for women".
Although married couples did not have much information before marriage, the marriage was a learning process for them, so that experience was the main source of information after marriage. During the marriage process, two people get to know each other well. This recognition helps them to improve their sexual life. M, 27 years old, bachelor of literature and housewife, referred to the importance of recognizing the needs of each other.
"After a while when couples get acquainted, a series of issues will be resolved spontaneously. For example, after some time, my husband and I learned that if we are bad, how we can make each other better, or what we like and what we do not like and this helped us to get better our marital relationships".
Similarly, her husband (A, 32 years old and a lawyer) points to the process of learning sex after marriage in this way:
"I did not know about sexual matters before marriage. Sex in early marriage, I was like an awkward driver who did not know how to drive, but I've found a lot of things with my wife. I think the great tools that affect sexual relationships are science and affection. The science of knowing what you should do, what you want and doing it with affection".
Motivation
Sexual motivation is a psychological construct that characterizes the driving force for sexual activity. Biological, social, and cultural factors affect sexual motivation [22]. The motivation construct in the IMB model includes the personal and interpersonal attitudes of couples to sexual relations, the sexual norms of society in the field of sexual relations, and the support of the family, friends, and community of the couples in order to improve their sexual life.
Sexual attitude
As mentioned in the previous section, couples did not have a proper attitude toward sexual relationships before marriage because of incomplete information, particularly women socialization prohibits them to be identified as a sexual being but looking for sex experience after marriage, their attitude changed and improved. M, a 34-year-old woman and beautician, said about her attitude change toward sexual matters before and after marriage:
"I did not think about sexual matters at all, that is, I did not even like to talk about it. If my friends talked about sexual issues, I would have left the group, but when I got married and experienced this relationship, I really saw this relationship as a need for both the woman and man that was very pleasing. Now that four years have passed since our marriage, every day, I find out more about the importance of this relationship in strengthening our marital life".
All couples had a positive attitude toward sexual interactions and referred to various motivations for sexual relationships. One of the main motivations of couples for sexual relationship was attention to sexual need. S, 27 years old, a master of industrial engineering woman who had been married for 4 years, considers that the motivation of herself and her husband for the sexual relationship is meeting the sexual need of each other and satisfying it through mutual love and interest.
"Our motivation is the sexual need. At times, we really see that we need it. I also want to keep him satisfied, and as soon as he addresses my need, we really want to make each other happy".
Her husband (K, 34 years old, bachelor of accounting and an employee) considers meeting sexual need as one of the most important motivations of sexual relations for couples.
"My motivation of sexual relationships is meeting a need, an intrinsic need that both the man and the woman must respond to it. I think 80% of people, especially men, marry to meet sexual need".
The most important motivation of all participants for having sex was love and affection to their husband/wife and getting closer through this relationship and increasing marital intimacy as a result. Z, 29 years old, bachelor of biology and a housewife, said in this regard:
"My husband and I have sex because of the love and affection that exists between us. It's a romantic game that is a pleasure of our life, enjoyment in a hug that my husband is trying to make me rejoicing. This intimacy brings us closer together".
Her husband’s motivation for sex was also expressing love and affection to his wife:
"I love my wife. My motivation of sexual relations shows my love and affection to her. When sex is based on love and affection, it leads to greater understanding, serenity and intimacy between couples. (F, 30 years old, diploma, mechanic)"
Some married women have sex to relieve themselves and their husbands of discomfort, tension, and fatigue and calm down. E, 24 years old and a self-employed woman who had been married for 5 years, used sex as a tool for relieving tension.
"When we crush together, one way to reconcile is to have sex. Now it’s either a suggestion or doing it, and really it happens. After sex, all the problems that exist disappear and calm down".
Most married women find sex as their duty and their motivation for establishing a relationship is obeying their husband. Sexual submission is considered a religious duty. It is also obligatory since they have signed the marital contract. M, a 26-year-old housewife, regards the acceptance of her husband’s sexual approach as the duty of the woman.
"Behold! This is something in our religion. It is the duty of the woman to obey. Because our religion teaches that we have to obey. If your husband asks you for sex, you must accept. If you do not want to, you should not marry".
A limited number of women have sex in order to keep their husband from extramarital relationships. They believe that men cannot control their sexual need and failure to meet their needs by their wives makes them seek these relationships outside marriage. Therefore, women are required to meet the sexual needs of their husbands in order to prevent them from extramarital relationships. A 29-year-old woman and autism coach despite confidence in her husband expressed her fears as follows:
"Well, “Adam” also fears of the stance of the society. Because you know that every moment ladies are ready to meet the needs of my husband. Of course, he's not like that, but it's always in my mind. If I do not respond to my husband's sexual need, he may be attracted to other women to meet his needs".
Sexual norms of society
Most cultures have social norms regarding sexuality. Social norms are structural factors that shape individuals’ perceptions of appropriate sexual behaviors for men and women [23]. Cultural scenarios are social determinants of sexual behaviors that recognize which behaviors are normal in any context and which ones are not [24]. The couples referred to the sexual norms of the Iranian community, including taboos surrounding sexuality, the prohibition of premarital sexual relations, the importance of preserving virginity for women, and sexual submission as factors affecting their sexual socialization.
Sexual issues are taboo
In Iran, as one of the traditional religious communities, the sex-based approach does not set a clear path to the sexual socialization of individuals, and sexuality is always in a state of ambiguity. Talking about sexual issues is a taboo. B, 29-year-old woman, bachelor’s degree in Persian literature and a housewife, stated if a woman has much to ask and answer in this regard, she is viewed differently and her modesty and chastity are questioned.
"You see, our country as it is, it did not give us any information. They all said from childhood that it was so bad, and the one who was talking about these things was a dirty person".
Prohibition of premarital sexual relations
Premarital sexual relationships are not religiously and socially acceptable in the Iranian culture and are considered unlawful and taboo. Most participants had a negative attitude toward sexual experience before marriage and considered it a temporary relationship to satisfy sexual needs. From a man’s viewpoint that was 27 years old, aerospace masters, having various sexual experiences before marriage leads a man to have various sexual interests. These varieties make him compare the current partner with formers, which weakens the foundations of marital life.
"I think that at least in our society, if there is sex before marriage, it will certainly affect the relationship after marriage, now I have no doubt about sin, paradise, and hell, but the various sexual interests of men makes it reopened again after marriage if they have experienced various relationships before marrying, and this is one reason for divorce".
In this regard, his wife (Y, 27-year-old woman, master’s degree in entrepreneurship management) stated that religious beliefs were an important factor for her in avoiding premarital sexual experience:
"I myself tried, at least for the sake of avoiding to be guilty, not to go to these issues. Premarital sexual relations, homosexuality and masturbating, are very ugly things from God’s eyes. Perhaps if I was born in another country and I was not a Muslim, I would easily go to these things, but when they said that from God's sake, that’s not the right thing, hence I did not go to this relationship, that’s the only reason".
The importance of preserving virginity for women
In Iranian culture, women’s sexual practices are organized based on shame, chastity, and honor, and emphasis is placed on preserving a women’s virginity. So, engaging in premarital sexual relationships and losing the symbol of virginity—the hymen—can cause the disrepute of a girl and her family and jeopardize her marital status and future. I, a 26-year-old man and marketer, said in this regard:
"If women have sex before marriage, their marriage process would be very difficult, and they will have difficulty to finding the right husband and if their husband finds it out after marriage then it’s too bad".
His wife, N, 22-year-old, student of handicrafts, said in this regard:
"Always we are told that after the first sexual intercourse you should bleed. Your curtain will be ripped off. If you do not get blood, you are not a good girl 100% and this means that you had sex before marriage. These issues were very important in the society and are still there".
Women’ sexual submission
Women’ sexual submission is one of the items of marital contract that is clearly described in the original Islamic sources such as the Quran. Almost all participating women believe that they should submit to their husbands’ sexual needs. T, 26 years old, master’s degree in medicinal plants and housewife, pointed to the necessity of sexual submission to her husband:
"When you get married, you have to obey, and whenever your husband asks you for sex, respond to his need".
Her husband (J, 29 years old, agricultural engineer) said in this regard:
"Some of my elder colleagues do not even know that the woman enjoys sexual relationship too. They use her as a tool and say it is her duty to do this. I also have the duty to work and pay for her. Their women also think so. They say my husband works and gives me and kids money, so I have to do sex. Of course, the new generation does not think so".
Social support
Couples’ understanding of social support will affect their sexual health behaviors. The existence of individuals or community support systems that can help couples to resolve sexual problems or promote their sexual health is important. According to the narratives of participating couples, parental conservatism in the sexual affairs of children in Iran has prevented couples from asking for parental help to resolve their sexual problems. However, couples have pointed to the use of other family members’ help in this regard. For example, S, a 25-year-old woman who was a psychology counselor, uses her sister’s help.
"Yeah, I talk about my sexual problems with my sister, who looks very similar in spirit and appearance to me, but not with my mother at all".
The difference in sexual expectations and sexual style of new couples with their parents was one of the obstacles to seeking help from them. B, 23-year-old woman, an employee of a tourism institution who has been married for 2 years, said:
"Our sexual relationship is very different from our parents. For example, my husband and I, in some nights, see films together up to half the night. Of course, not a porn movie, romantic movies that may have sexy scenes. It’s very exciting for us. Or, for example, oral sex, which is fun for both of us. But I’m sure it’s not interesting in my parent’s opinion, so how can I get help from them?"
Support from friends and colleagues are also helpful in solving couples’ sexual problems. Sh, 29 years old, an electrical engineer man, referred to his colleagues’ support to address each other’s problems.
"For example, with my co-worker, there were issues that when we had a sexual problem we talked together. Where did you go, what doctor you went to? What did you do? It is 100% helpful".
Community support systems such as schools, universities, workplace, health centers, and the official media are passive in sex education because of sexual taboos and synonyms of sexuality education by promoting unrestrained behaviors in the society. The lack of specialized and clinical counseling system for sexual problems of couples was identified as one of the weaknesses of the official health system in Iran.
N, a 28-year-old man and accountant, said pre-marital classes as the only formal education in sexual matters did not have the necessary effects.
"In pre-marital classes at the health center, which in my opinion do not teach a lot, because of a number of limitations".
His wife (A, 28 years old and a nurse) had a similar view:
"Sex education for couples in official media and health centers is only about preventing unwanted pregnancies and preventing sexually transmitted diseases. I think there should be valid counseling centers that provide comprehensive information to couples in health centers. So, couples can use this service at a low cost; because the cost of sexual counseling in the private sector is high and most couples cannot afford for this fee".
Behavioral skills
The behavioral skills construct in the IMB model is an essential determinant that includes objective skills of individuals to improve sexual life and self-efficacy or believe in their ability to implement sexual enhancement behaviors.
The dominant behavioral skills which were expressed by most couples include applying methods to increase intimacy in marital life as creating a sincere environment, expressing love physically like caressing, kissing, hugging. M, 26 years old, diploma and industrial worker man, describes his sexual skills as such:
"I try to do what my wife likes and draw her attention to me. Everyone knows what his wife’s disadvantage is, how you can attract her to yourself. When she is sad, I try to get her heart by talking, a surprise, a gift, a flower bunch or touching, kissing and hugging".
In contrast, his wife (E, 21 years old, art student) refers to the use of her elegance and femininity skills. Like most Iranian women who do not directly ask their husbands for sex, she refers to the exchange of nonverbal messages between her and her husband using femininity skills.
"Sometimes before my husband comes home, I cook his favorite food, decorate the salad, wear a pretty and seductive dress, makeup, I use a good perfume, or, for example, I would play the song that we listened to at the time of the engagement, sometimes dance, my husband who comes home, finds out that we should do something tonight. He cannot withstand despite being fatigued".
Sexual interactions without learning communication skills will not be a complete experience. Participating couples referred to verbal and written communication skills such as talking about sexual thoughts, beliefs, feelings, tendencies, and expectations, as well as happy communication such as posting jokes, romance messages, defining and praising of the spouse that leads to increased forgiveness, compatibility, cooperation, commitment, support, and intimacy in their marital life. S, 27-year-old woman, industrial engineer, who has been married for 4 years said:
"We had a lot of problems early in our lives. We are now forgiving the mistakes of each other, rather than disturbing each other; we share our wishes together and solve our problems by speaking. We forgive each other most of the time. In the past four years we have come to the conclusion that we can’t change each other, so whenever I’m upset, my husband jokes with me, trying to make me laugh and mollycoddle me to make me feel good".
Differences of generations in sexual behaviors
Sexual behavior varies between different ages and cultural, social, and economic groups. In recent years, some social traditions have changed in the Iranian society. Factors like westernization and modernity, access to communication technology, and social media played an important role in these cultural changes. So, the predominant pattern of sexual behaviors among Iranian young people has faced serious change. On the other hand, the rapid technological advancement has led to newer and more diverse demands of individuals, and welfare, freedom, tranquility, and pleasure have become more important. M, 29 years old, bachelor of chemistry and a self-employed man, pointed to the differences in generations in accepted patterns of sexual behaviors.
"Women need to learn about up-to-date sex, to have sexual relations in accordance with the sexual needs that are currently being promoted in the world. Sexual relationships in our era differ from the sex of my grandparents. They must understand this difference".
In the same vein, his wife (Z, 26-year-old woman and English translator) compared the sexual behavior of the new generation with their parent’ behaviors.
"Our mother and father did not like some of sexual behaviors that occurs between husbands and wives nowadays, like the oral relationship or a lot of relationships before having sex (foreplay). They do not like these behaviors and only know intercourse about sex. For example, having anal sex in today’s young people is very common especially among men that I think is the result of seeing porn movies".