Predictors of sexual behaviors among Thai young adults

Prevalence and factors associated with safe sex behaviors among adolescent vocational students in Nakhon Ratchasima Province, Thailand

Purpose

The purpose of this paper is to describe the prevalence and factors associated with safe sex behavior among vocational students in Nakhon Ratchasima Province, Thailand, and to determine the modifying factors listed as socio-demographic characteristic, the level of HIV and sexually transmitted infections’ knowledge, attitude toward reproductive health, and safe sex behavior among vocational students in Nakhon Ratchasima Province, Thailand.

Design/methodology/approach

A cross-sectional descriptive research was conducted from August to October 2018. The multistage stratified sampling, combined with purpose and random sampling, was used to select the participants. One vocational college with the highest number from urban, suburban and rural areas was purposely selected. The sample calculation by using Cochran’s formula, a random sampling by drawing from each college with male and female, was made to obtain the sample size of 355 students. Inclusion criteria included: vocational students, both male and female, aged between 15 and 19 years, resided in the study area, and volunteered to participate. Ethical consent including waiver of the parent’s consent for the participant aged under 18 years for this study was approved by the Institution Review Board for Human Research Ethics, Chulalongkorn University (Certification number JV 823/2561) A self-administered questionnaire was adapted by the principle researcher from the illustrative questionnaire for interview survey with young people (14), and The study of Prevalence of HIV, STD, Drug Use and Risk Behaviors in Adolescents and Young Adults, in Chaing Rai, Thailand (PRAYA) tool (15). All statistical analyses were performed by SPSS version 22.

Findings

The finding revealed that 332 participants were male (57.8 percent) and female (42.2 percent) with an average age of 16.8 years (±1.7). Approximately 60 percent of males and 50 percent of females had experience of sexual intercourse, with their first experience of sexual intercourse at the average age of 15. Most respondents 63.1 percent used a condom and 63.6 percent used contraception in their latest sexual intercourse. About 41.9 percent consumed alcohol and 15 percent reported substance abused. Sexual intercourse among adolescents vocational students were significantly associated with high knowledge of contraception (OR=0.30, 95%CI=0.10–0.82). Positive attitude toward reproductive health had a significant association with sexual intercourse (OR=0.17, 95%CI=0.05–0.58). Sexual intercourse among vocational students were also significant associated with low risk behavior (OR=0.45, 95%CI=0.22–0.91) and high risk behaviors (OR=0.24, 95% CI=0.10–0.59). Contraceptive used in the latest sexual intercourse had a significant association with cues to action (OR=0.43, 95% CI=0.22–0.86).

Research limitations/implications

This study used a self-reported questionnaire to collect information from participants about safe sex behaviors, which might contain bias data and socially desirable answers. The time for collecting data did not match vocational students’ schedule as they were about to have their final exams. An error in this questionnaire was the absence of condom use as one of the contraception methods.

Practical implications

The study showed that both male and female vocational students in Nakhon Ratchasima have a low level of knowledge of HIV, STIs and contraception. This study revealed that females have higher knowledge of all the factors more than males. Males usually received more harassment from peers for being sexually active than females do. Condoms and contraceptive used are inconsistent in all research conducted and have no common ground. Communication related to sex for those who have no partner was poor compared to students who have a partner. The four factors associated with safe sex behaviors should always be considered and surveyed among vocational students, as the study showed that all results vary for a future adolescence study.

Social implications

This research aims at government authorities. The policy makers should include reproductive health and rights in the curriculum. The Ministry of Public health and The Ministry of Education should provide training for the trainer program for teachers concerning safe sex behaviors. For future research, in-depth interview and qualitative study should be used to increase the reliability of the result of the inconsistency of using a condom and contraception. The researcher should do further studies into vocational college semester schedules before collecting data and should spend more time in the college, so the students become more acquainted to the researcher and give a more truthful answer. Moreover, condom use should be added as one of the contraception methods.

Originality/value

This is the first study among vocational students in Nakhon Ratchasima Province which emphasizes specifically on safe sex behaviors and factors related to it. Regarding the population of vocational students, this study covers almost 80 percent of the population. Sensitive questions for sexual activity status and sexually history were answered by a self-administered questionnaire in order to increase sincere answers on their experiences because participants were not shy to disclose their sexual experiences.

Premarital sex and condom use among trainee healthcare workers: an exploratory study of selected healthcare training institutions in Enugu State, Nigeria

INTRODUCTION

To assess the prevalence and causes of premarital sex and condom use among trainee healthcare workers in selected healthcare institutions in Enugu State, Nigeria; and to proffer solution to challenges identified.

METHODS

We used a mixed study approach with qualitative and quantitative components. Informed consent was obtained from participants and data collected using self-administered structured questionnaires. Epi info® was used for data analysis.

RESULTS

A total of 362 respondents (309 unmarried) from four healthcare training institutions participated in the study. Among unmarried respondents, 141 (45.8%) were sexually active. Premarital sex was more common among Pentecostals and sexual activity increased with age (r=0.78; p <0.05). Premarital sexual activity was more common among males and trainee nurses (p <0.005). Although knowledge of condom use was high, actual use was poor (20.1%), with lowest rates among females, Catholics and age-group 30-35 years. Breakages, high failure rates and reduced sexual satisfaction were cited as major factors responsible for poor use. Use of non-specific terms such as "casual sex" and "casual or regular sex partners" hindered consistent, correct condom use.

CONCLUSION

There is a significant gap between knowledge of and actual use of condoms, despite high premarital sexual activity amongst healthcare workers. Furthermore, non-specific terminologies hinders appropriate condom usage. We propose the term: Committed Spousal Partner (CSP) defined as "a sexual partner who commits to fidelity (one sexual partner per time) and whose current HIV status is known through medical testing and is properly documented" in place of all non-specific terminology.

Attempted Suicide Triggers in Thai Adolescent Perspectives

The study goal was to describe attempted suicide triggers in Thai adolescents. A descriptive exploratory qualitative study approach was used utilizing in-depth interviews with twelve adolescents who had attempted suicide and six of their parents. Content analysis was conducted. Attempted suicide triggers were (1) severe verbal criticisms and expulsion to die by a significant family member, (2) disappointed and unwanted by boyfriend in first serious relationship, (3) unwanted pregnancy, and (4) mental illness leading to intense emotions and irresistible impulses. These attempted suicide triggers should be of concern and brought into suicide prevention management programs such as emotional management, effective communication for adolescents and family.

'The family is only one part …': understanding the role of family in young Thai women's sexual decision making

This study aims to understand young Thai women's perspectives about family influences on their sexual decisions with the goal of informing the future development of HIV programmes and interventions for young Thai women in urban areas. Eight focus groups were conducted with 40 young single women aged 18-25 years, recruited through a peer network of key informants from four sites across Bangkok: universities, government offices, slums and garment factories. Predetermined topics relating to family, sexual decisions and HIV were discussed with 4-5 participants in each group. Qualitative thematic and framework-analysis techniques were used to explore participants' narratives. Findings suggest that young Thai women's sexual decisions are complex and take place under a wide range of personal, familial and social influences. Parents were perceived as a barrier to parent-child communication about sex and HIV. Young women regarded mothers as more supportive and receptive than fathers when discussing sensitive topics. Young Thai women described a tension between having a strong sense of self and modern sexual norms versus traditionally conservative relational orientations. Future HIV interventions could benefit by developing strategies to consider barriers to parent-child communication, strengthening family relationships and addressing the coexistence of conflicting sexual norms in the Thai context.

Condom use and sexuality communication with adults: a study among high school students in South Africa and Tanzania

Background

Fostering adolescents’ communication on sexuality issues with their parents and other significant adults is often assumed to be an important component of intervention programmes aimed at promoting healthy adolescent sexual practices. However, there are few studies describing the relationship between such communication and sexual practices, particularly in sub-Saharan Africa. This study examined the relationships between adolescents’ communication with significant adults and their condom use in three sites in this region.

Methods

Data stem from a multi-site randomized controlled trial of a school-based HIV prevention intervention implemented in Cape Town and Mankweng, South Africa and Dar es Salaam, Tanzania. Only data from comparison schools were used. The design is therefore a prospective panel study with three waves of data collections. Data were collected in 2004 from 6,251 participants in 40 schools. Associations between adolescents’ communication with adults about sexuality issues and their use of condoms were analysed cross-sectionally using analysis of variance, as well as prospectively using multiple ordinal logistic regression analysis.

Results

Cross-sectional analyses showed that consistent condom users had significantly higher mean scores on communication (across topics and communication partners) than both occasional users and never-users, who had the lowest scores. After controlling for condom use at the first data collection occasion in each model as well as for possible confounders, communication scores significantly predicted consistent condom use prospectively in all three ordinal logistic regression models (Model R² = .23 to .31).

Conclusion

The findings are consistent with the assertion that communication on sexuality issues between adolescents and significant adults results in safer sexual practices, as reflected by condom use, among in-school adolescents. The associations between communication variables and condom use might have been stronger if we had measured additional aspects of communication such as whether or not it was initiated by the adolescents themselves, the quality of advice provided by adults, and if it took place in a context of positive adult-adolescent interaction. Studies with experimental designs are needed in order to provide stronger evidence of causality.

Elevated alcohol and sexual risk behaviors among young Thai lesbian/bisexual women

BACKGROUND

Little empirical data have been published about drinking or sexual behaviors among Thai lesbians. We examine the association of sexual identity with established indicators of alcohol- and sexual-related health behaviors among female bar patrons.

METHODS

We conducted a cross-sectional study among women (N=121) aged 18-24 who frequented popular drinking establishments in Chiang Mai, Thailand. We used general linear modeling techniques to estimate associations between sexual identity and positive alcohol expectancy, harmful drinking, age at sexual debut, and number of lifetime sexual partners.

RESULTS

Nearly one-third of women aged 18-24 recruited from Chiang Mai drinking venues identified as lesbian/bisexual. As compared to their heterosexual counterparts, lesbian/bisexuals reported higher positive alcohol expectancy scores, more harmful drinking, earlier age at sexual debut, and higher number of lifetime sexual partners. In adjusted models, lesbian/bisexual identity was associated with higher positive alcohol expectancy (β=1.94 points; 95% CI: 0.75, 3.13), earlier age at sexual debut (β=-0.85 years; 95% CI: -1.46, -0.23), and higher number of lifetime sexual partners (rate ratio=1.70; 95% CI: 1.22, 2.37).

CONCLUSION

Lesbian/bisexual women in this study engaged in multiple behaviors that are potentially harmful to health, which may in turn place this group at heightened risk for alcohol abuse and sexually transmitted infections in Thailand. The clustering of alcohol- and sexual-related risk behaviors, and its consequences for health outcomes in this population, should be explored in future research and may be an important point of intervention.

Coital Experience Among Adolescents in Three Social-Educational Groups in Urban Chiang Mai, Thailand

This article compares coital experience of Chiang Mai 17-20-year-olds who were: (1) out-of-school; (2) studying at vocational schools; and (3) studying at general schools or university. Four-fifths, two-thirds and one-third, respectively, of males in these groups had had intercourse, compared to 53, 62 and 15 per cent of females. The gender difference for general school/university students, but not vocational school students, probably reflects HIV/AIDS refocusing male sexual initiation away from commercial sex workers. Vocational school females may have been disproportionately affected. Loss of virginity was associated, for both sexes, with social-educational background and lifestyle, and was less likely in certain minority ethnic groups. Among males, it was also associated with age and parental marital dissolution, and among females, with independent living and parental disharmony. Within social-educational groups, lifestyle variables dominated, but among general school/university students, parental marital dissolution (for males) and disharmony (for females) were also important, and Chinese ethnicity deterred male sexual experimentation.

Thai men's health and sexual attitude

Men's health awareness, including the research and study of quality of life, sexual desires and risk factors, has increased worldwide. In Thailand, this advancement is made possible by cooperation, research and sponsorship from the local Thai community. This article aims to illustrate the sexual attitudes of Thai people, to determine the degree of erectile dysfunction (ED) and to investigate how to manage and cope with ED in a Thai community. We reviewed the relevant literature from Thai-based articles and surveys in regard to men's health, sexual attitudes, the prevalence of ED and common risk factors in the Thai community. The primary risk factor for ED in Thai men was age-related health decline and the presence of vascular disease. Most Thai men will seek consultation from their partner in regard to ED. The main presentation of metabolic disease in Thai patients was dyslipidemia. New selective serotonin reuptake inhibitors are not available for premature ejaculation in Thai communities. The debate in regard to malpractice compensation is an issue that should be closely monitored. There is currently a shortage of home care for the elderly in Thailand. The insights provided by the articles helped recruit the study patients and in turn, helped us gain knowledge that can be translated into improved men's health care in Thailand.