Sexually Transmitted Diseases

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Risk Factors for Sexually Transmitted Diseases in Northern Thai Adolescents: An Audio-Computer-Assisted Self-Interview With Noninvasive Specimen Collection

PAZ-BAILEY, GABRIELA MD, MSc*‡; KILMARX, PETER H. MD*§; SUPAWITKUL, SOMSAK MD∥; CHAOWANACHAN, THANYANAN MSc†§; JEEYAPANT, SUPAPORN MSc§; STERNBERG, MAYA PhD*; MARKOWITZ, LAURI MD*; MASTRO, TIMOTHY D. MD†; VAN GRIENSVEN, FRITS PhD, MPH†§

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Abstract

Background: Previous studies of sexual behavior and sexually transmitted diseases (STDs) in Thai adolescents may have been limited by participation bias and underreporting of stigmatized behaviors.

Goal: The goal was to increase knowledge about risk behaviors and STDs among youths in Thailand.

Study Design: Students aged 15 to 21 years completed an audio-computer-assisted self-interview. Oral fluid was tested for HIV antibodies and urine was tested for Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acids with polymerase chain reaction.

Results: Of 1736 invited students, 1725 (99.4%) agreed to participate. Overall, C trachomatis infection was detected in 49 (2.8%), and there were five cases (0.3%) each of infection with N gonorrhoeae and HIV. Among those who reported sexual intercourse, the prevalence of chlamydial infection was 3.7% among men and 6.1% among women. Logistic regression analysis showed age-adjusted factors associated with chlamydial infection among men to be parents’ occupation in agriculture, having sold sex, having a sex partner who had been pregnant, and the number of casual sex partners during lifetime. Among women, age-adjusted factors were parents’ occupation in agriculture, number of casual partners during lifetime, having an older sex partner, and perception of higher HIV infection risk.

Conclusion: These adolescents had high rates of unprotected intercourse and are at risk for STDs. Prevention programs should emphasize use of effective contraceptive methods, including condom use; reducing the number of sex partners (stressing the risk a partner of older age may pose to female adolescents); and reducing engagement in commercial sex.

© Copyright 2003 American Sexually Transmitted Diseases Association

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