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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†§

Sexually Transmitted Diseases: April 2003 - Volume 30 - Issue 4 - p 320-326
Articles

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.

This study describes the prevalence of chlamydial infection, gonorrhea, and HIV infection among adolescents and young adults in Thailand. Sexual behaviors among Thai youth were assessed with audio-computer-assisted self-interviews. Risk factors for chlamydial infection among males and females are described.

*Division of STD Prevention and Division of HIV/AIDS Prevention—Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention, and Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; and the §Thailand MOPH–U.S. CDC Collaboration, Nonthaburi, and Chiang Rai Public Health Office, Chiang Rai, Thailand

The authors thank the directors, staff, and students of three commercial and technical schools in Chiang Rai and the staff of the Thailand Ministry of Public Health–US CDC Collaboration, especially Dr. Khanchit Limpakarnjanarat, Chomnad Manopaiboon, and Supaporn Chaikummao.

Reprint requests: Frits van Griensven, PhD, MPH, HIV/AIDS Program, The Thailand MOPH - US CDC Collaboration, DMS Building 6, Ministry of Public Health, Nonthaburi 11000 Thailand. E-mail: fav1@cdc.gov

Received June 26, 2002,

revised October 2, 2002, and accepted October 17, 2002.

© Copyright 2003 American Sexually Transmitted Diseases Association