Abstract
This paper examines factors that may place female Thai adolescents and young adults at risk for HIV, sexually transmitted diseases (STDs), and unintended pregnancies. A total of 832 female vocational students participated in a cross-sectional audio-computer-assisted self-interview (ACASI) survey after providing informed consent. The questionnaire covered: sociodemographic characteristics; knowledge, attitudes, and beliefs related to HIV and STDs; contraceptive practices; sexual experiences and behaviors; and drug use. Oral fluid was tested for HIV antibodies and urine was tested for illicit drugs and for the presence of gonococcal or chlamydial nucleic acids. A total of 359 women (43.1%) reported sexual intercourse history, with an average age at first sex of 17.6 years, and a 2.6 mean number of lifetime sex partners. Twenty-one percent of the entire sample reported coerced sexual contact or intercourse. Among those with sexual intercourse experience, 27.3% (n = 98) had been pregnant and the majority of their most recent pregnancies were terminated. Three tested positive for HIV antibodies. Sexually active young Thai women report behaviors or experiences that may expose them to HIV/STD infection and unintended pregnancy in the future. These include unprotected intercourse, sexual coercion, low levels of contraceptive use, and drug and alcohol use. Culturally appropriate interventions that increase their awareness of and ability to respond to these sexual health risks are needed.
Similar content being viewed by others
References
Allen, D. R. (2000). Learning the facts of life. Past and present experiences in a rural Tanzanian community. Africa Today, 47, 3-27.
Anonymous. (1997). Thai Ministry of Education, Educational Management Information System Centre.
Bond, K. C., Valente, T. W., and Kendall, C. (1999). Social network influences on reproductive health behaviors in urban northern Thailand. Social Science and Medicine 49, 1599-1614.
Boonmongkon, P., Nichter, M., Pylpa, J., and Kornkaew, C. (1998). Understanding women's experiences of gynecological problems: An ethnographic case study from northeast Thailand. Nakorn Pathom, Thailand: Center for Health Policy Studies, Faculty of Social Science and Humanities, Mahidol University.
Bunnell, R. E., Yanpaisarn, S., Kilmarx, P. H., Rhodes, P. H., Limpakarnjanarat, K., Srismith, R., Mastro, T. D., and St. Louis, M. E. (1999). HIV-1 seroprevalence among childbearing women in northern Thailand: Monitoring a rapidly evolving epidemic. AIDS, 13, 509-515.
Cash, K. (1995). Experimental educational interventions for AIDS prevention among northern Thai single female migratory workers (Women and AIDS Program Research Report Series No. 9). Washington, DC: International Center for Research on Women.
Cash, K., Sanguansermsri, J., Busayawong, W., and Chuamanochan, P. (1997). AIDS prevention through peer education for northern Thai single migratory factory workers (Women and AIDS Program Research Report in Brief). Washington, DC: International Center for Research on Women.
Celentano, D. D., Nelson, K. E., Beyrer, C., Eiumtrakul, S., Lyles, C., Go, V. F. L., Kuntolbutra, S., and Khamboonruang, C. (1998). Decreasing incidence of HIV and sexually transmitted diseases in young Thai men: Evidence for the success of the HIV/AIDS control and prevention program. AIDS, 12, F29-F36.
Craib, K. J., Weber, A. C., Cornelisse, P. G., Martindale, S. L., Miller, M. L., Schechter, M. T., Strathdee, S. A., Schilder, A., and Hogg, R. S. (2000). Comparison of sexual behaviors, unprotected sex, and substance use between two independent cohorts of gay and bisexual men. AIDS, 14, 303-311.
Fendrich, M., Johnson, T. P., Sudman, S., Wislar, J. S., and Spiehler, V. (1999). Validity of drug use reporting in a high-risk community sample: A comparison of cocaine and heroin survey reports with hair tests. American Journal of Epidemiology, 149, 955-962.
Feucht, T. E., Stephens, R. C., and Walker, M. L. (1994). Drug use among juvenile arrestees: A comparison of self-report, urine analysis and hair assay. Journal of Drug Issues, 24, 99-116.
Ford, N. J., and Kittisuksathit, S. (1994). Destinations unknown: The gender construction and changing nature of the sexual expression of Thai youth. AIDS Care, 6, 517-531.
Gray, A., and Punpuing, S. (1999). Gender, sexuality and reproductive health in Thailand (IPSR Publication No. 232). Nakorn Phathom, Thailand: Institute for Population and Social Research, Mahidol University.
Hanenberg, R. S., Rojanapithayakorn, W., Kunasol, P., and Sokal, D. C. (1994). Impact of Thailand's HIV-control programme as indicated by the decline of sexually transmitted diseases. Lancet, 355, 243-245.
Havanon, N. (1996). Talking to men and women about their sexual relationships: insights from a Thai study. In S. Zeidenstein & K. Moore (Eds.), Learning about sexuality: A practical beginning (pp. 110-118). New York: International Women's Health Coalition and Population Council.
Havanon, N., Bennett, A., and Knodel, J. (1993). Sexual networking in provincial Thailand. Studies in Family Planning, 24, 1-17.
Heise, L., and Elias, C. (1995). Transforming AIDS prevention to meet women's needs: A focus on developing countries. Social Science and Medicine, 40, 931-943.
Hemarajata, C. (1989). The narcotics problem: A study and analysis of its legal aspects. (Chulalongkorn University Research Report Series No. 4). Bangkok: Chulalongkorn University Research Dissemination Project.
Jenkins, R. A., Mason, C. J., Torugsa, K. Jamroenratana, V., Lalang, C., Nitayaphan, S., and Michael, R. A. (1999). Dynamics of HIV risk behavior among young Thai men. AIDS and Behavior, 3, 335-346.
Kilmarx, P., Supawitkul, S., Wankrairoj, M., Uthaivoravit, W., Limpakarnjanarat, K., Saisorn, S., and Mastro, T. D. (2000). Explosive spread and effective control of human immunodeficiency virus in northernmost Thailand: The first decade of the epidemic in Chiang Rai province, 1988–99. AIDS, 14, 2731-2740.
Kitsiripornchai, S., Markowitz, L. E., Ungchusak, K., Jenkins, R. A., Leucha, W., Limpitaks, T., and Sangkharomya, S. (1998). Sexual behavior of young men in Thailand: Regional differences and evidence of behavior change. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 18, 282-288.
References in post-transition Thailand: Implications for the future course of fertility (Population Studies Center Research Report No. 96-369). Ann Arbor, MI: Population Studies Center, University of Michigan.
Knodel, J., VanLandingham, M., Saengtienchai, C., and Pramualratana, A. (1996b). Thai views of sexuality and sexual behaviour. Health Transition Review, 6, 179-201.
Mason, C. J., Markowitz, L. E., Kitsiripornchai, S., Jugsudee, A., Sirisopana, N., Torugsa, K., Carr, J. K., Michael, R. A., Nitayaphan, S., and McNeil, J. G. (1995). Declining prevalence of HIV-1 infection in young Thai men. AIDS, 9, 1061-1065.
Mastro, T. D., and Limpakarnjanarat, K. (1995). Condom use in Thailand: How much is it slowing the HIV/AIDS epidemic? AIDS, 9, 523-525.
Miller, K. S., Clark, L. F., and Moore, J. S. (1997). Sexual initiation with older male partners and subsequent HIV risk behavior among female adolescents. Family Planning Perspectives, 29, 212-214.
Mills, S., Benjarattanaporn, P., Bennett, A., Pattalung, R., Sundhagul, D., Trongsawad, P., Gregorich, S. E., Hearst, N., and Mandel, J. S. (1997). HIV risk behavioral surveillance in Bangkok, Thailand: Sexual behavior trends among eight population groups. AIDS, 11(Supplement 1), S43-S51.
Nelson, K. E., Celentano, D. D., Eiumtrakul, S., Hoover, D. R., Beyrer, C., Suprasert, S., Kuntolbutra, S., and Khamboonruang, C. (1996). Changes in sexual behavior and a decline in HIV infection among young men in Thailand. New England Journal of Medicine, 335, 297-303.
Nishimo, Y., and Schnuck, M. (1997). Single Thai women's interpersonal communication and mass media reception on AIDS. AIDS Education and Prevention, 9, 181-200.
Nopkesorn, T., Mastro, T. D., Sangkharomya, S., Sweat, M., Singharaj, P., Limpakarnjanarat, K., Gayle, H. D., and Weniger, B. G. (1993). HIV-1 infection in young men in northern Thailand. AIDS, 7, 1233-1239.
Paz-Bailey, G., Kilmarx, P. H., Supawitkul, S., Limpakarnjanarat, K., Young, N. L., Manopaiboon, C., Mock, P., Korattana, S., and van Griensven, G. J. P. (2001). Risk factors for sexually transmitted diseases in adolescents: An audio-computer self-interviewing survey with noninvasive specimen collection in Chiang Rai, Thailand [Abstract]. International Journal of STD and AIDS, 12(Supplement 2), 171.
Phongpaichit, P., Piriyarangsan, S., and Treerat, N. (1998). Guns, girls, gambling, ganja: Thailand's illegal economy and public policy. Kuala Lumpur: Oxford University Press, 1998.
Podhisita, C., and Pattaravanich, U. (1995). Youth in contemporary Thailand: Results from the family and youth survey (IPSR Publication No. 197). Nakorn Phathom, Thailand: Institute for Population and Social Research, Mahidol University.
Raffaelli, M., and Pranke, J. (1995). Women and AIDS in developing countries. In A. O'Leary and J. S. Jemmott (Eds.), Women at Risk: Issues in the Primary Prevention of AIDS (pp. 219-236). New York: Plenum Press.
Rojanapithayakorn, W., and Hanenberg, R. (1996). The 100% condom program in Thailand. AIDS, 10, 1-7.
Rumakom, P., Guest, P., Chinvarasopak, W., Utarmat, W., and Sontanakanit, J. (2000). Obtaining accurate responses to sensitive questions: A comparison of two data collection techniques. Unpublished manuscript, Horizons, Population Council, Bangkok.
Siriwasin, W., Shaffer, N., Roongpisuthipong, A., Bhiraleus, P., Chinayon, P., Wasi, C., Singhanati, S., Chotpitayasunondh, T., Chearskul, S., Pokapanichwong, P., Mock, P., Weniger, B. G., and Mastro, T. D. (1998). HIV prevalence, risk, and partner serodiscordance among pregnant women in Bangkok. Journal of the American Medical Association, 280, 49-54.
Sittitrai, W., Phanuphak, P., Barry, J., & Brown, T. (1992). Thai sexual behavior and risk of HIV infection: A report of the 1990 survey of partner relations and risk of HIV infection in Thailand. Bangkok: Program on AIDS, Thai Red Cross Society, and Institute of Population Studies, Chulalongkorn University.
Soonthorndhada, A. (1996). Sexual attitudes and behaviours and contraceptive use of late female adolescents in Bangkok: A comparative study of students and factory workers (IPSR Publication No. 202). Nakorn Phathom, Thailand: Institute for Population and Social Research, Mahidol University.
Thongkrajai, E., Thongkrajai, P., and Stoeckel, J. E. (1996). Algorithm development and STD incidence in northeast Thailand and intergrated RH programme into existing FP, MCH program in northeast Thailand. Unpublished report for World Health Organization, Geneva.
van Griensven, F., Supawitkul, S., Kilmarx, P. H., Limpakarnjanarat, K., Young, N. L., Manopaiboon, C., Mock, P. A., Korattana, S. and Mastro, T. D. (2001). Rapid assessment of sexual behavior, drug use, HIV, and sexually transmitted diseases in northern Thai youth, using audio-computer assisted self-interviewing and noninvasive specimen collection. Pediatrics, 108, e118[Available at http://www.pediatrics.org/cgi/content/full/108/1/e13].
van Griensven, G. J. P, Surasiengsunk, S., and Panza, A. (1998). The use of mortality statistics as a proxy indicator for the impact of the AIDS epidemic on the Thai population (IPS Publication No. 267/98). Bangkok: Institute of Population Studies, Chulalongkorn University.
VanLandingham, M. J., Suprasert, S., Sittitrai, W., Vaddhanaphuti, C., and Grandjean, N. (1993). Sexual activity among never-married men in northern Thailand. Demography, 30, 297-313.
VanLandingham, M., Saengtienchai, C., Knodel, J., and Pramualratana, A. (1995). In the company of friends: Peer influence on Thai male extramarital sex (Population Studies Center Research Report No. 96-360). Ann Arbor: MI: Population Studies Center, University of Michigan.
Weiss, E., and Gupta, G. R. (1998). Bridging the gap: Addressing gender and sexuality in HIV prevention. Findings from the Women and AIDS Research Program. Washington, DC: International Center for Research on Women.
Weiss, E., Whelan, D., and Gupta, G. R. (1996). Vulnerability and opportunity: Adolescents and HIV/AIDS in the developing world. Findings from the Women and AIDS Research Program. Washington, DC: International Center for Research on Women.
Weniger, B. G., Limpakarnjanarat, K., Ungchusak, K., Thanprasertsuk, S., Choopanya, K., Vanichseni, S., Uneklabh, T., Thongcharoen, P., and Wasi, C. (1991). The epidemic of HIV infection and AIDS in Thailand. AIDS, 5, S71-S85.
World Health Organization (1997). Abortion: A tabulation of available data on the frequency and morbidity of unsafe abortion, 3rd ed. Geneva: Author.
Xenos, P., Pitaktepsombati, P., and Sittitrai, W. (1993). Partner patterns in the sexual behavior of unmarried, rural Thai men. Asian and Pacific Population Forum, 6, 104-117.
Xu, F., Kilmarx, P. H., Supawitkul, S., Yanpaisarn, S., Limpakarnjanarat, K., Manopaiboon, C., Korattana, S., Mastro, T. D., and St. Louis, M. E. (2000). HIV-1 seroprevalence, risk factors and preventive behaviors. Journal of Acquired Immune Deficiency Syndromes, 25, 353-359.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Allen, D.R., Carey, J.W., Manopaiboon, C. et al. Sexual Health Risks Among Young Thai Women: Implications for HIV/STD Prevention and Contraception. AIDS Behav 7, 9–21 (2003). https://doi.org/10.1023/A:1022553121782
Issue Date:
DOI: https://doi.org/10.1023/A:1022553121782