Changes in Sexual Behavior and Attitudes Across Generations and Gender Among a Population-Based Probability Sample From an Urbanizing Province in Thailand

Abstract

Thailand has undergone rapid modernization with implications for changes in sexual norms. We investigated sexual behavior and attitudes across generations and gender among a probability sample of the general population of Nonthaburi province located near Bangkok in 2012. A tablet-based survey was performed among 2,138 men and women aged 15–59 years identified through a three-stage, stratified, probability proportional to size, clustered sampling. Descriptive statistical analysis was carried out accounting for the effects of multistage sampling. Relationship of age and gender to sexual behavior and attitudes was analyzed by bivariate analysis followed by multivariate logistic regression analysis to adjust for possible confounding. Patterns of sexual behavior and attitudes varied substantially across generations and gender. We found strong evidence for a decline in the age of sexual initiation, a shift in the type of the first sexual partner, and a greater rate of acceptance of adolescent premarital sex among younger generations. The study highlighted profound changes among young women as evidenced by a higher number of lifetime sexual partners as compared to older women. In contrast to the significant gender gap in older generations, sexual profiles of Thai young women have evolved to resemble those of young men with attitudes gradually converging to similar sexual standards. Our data suggest that higher education, being never-married, and an urban lifestyle may have been associated with these changes. Our study found that Thai sexual norms are changing dramatically. It is vital to continue monitoring such changes, considering the potential impact on the HIV/STIs epidemic and unintended pregnancies.

Patterns of Sexual Behavior in Lowland Thai Youth and Ethnic Minorities Attending High School in Rural Chiang Mai, Thailand

“…These have been characterized by a decline in the age of sexual debut; a larger number of lifetime sexual partners, and a greater acceptance of adolescent premarital sex [5]. In the same study, younger generation of Thai had more positive attitudes toward women carrying condoms [5].…”

“…As described in detail elsewhere [4–9], sexual norms and traditional values of young people in Thailand are now undergoing rapid transformations- fueled by globalization and also by the increasing urbanization that the country has been witnessing over the past decades. These changes in sexual norms which include a decline in the age of sexual onset both in male and female Thai youth, a larger number of lifetime sexual partners, and a greater degree of acceptance of adolescent premarital sex [5], are also reflected in the increasing rates of unintended pregnancies and sexually transmitted infections (STIs) among Thai adolescents over the past 15 years [8, 9]. …”

Structural and Behavioral Correlates of HIV Infection among Pregnant Women in a Country with a Highly Generalized HIV Epidemic: A Cross-Sectional Study with a Probability Sample of Antenatal Care Facilities in Swaziland

“…A self-administered structured questionnaire was developed in English based on the review of Swazi and international literature [47]. To improve the initial draft [47], we conducted a preliminary qualitative study during February—March 2015 using semi-structured in-depth interviews among 37 pregnant women recruited through purposive sampling.…”

“…To improve the initial draft [47], we conducted a preliminary qualitative study during February—March 2015 using semi-structured in-depth interviews among 37 pregnant women recruited through purposive sampling. We recruited pregnant women in their 3 rd trimester to ensure that they would not be re-sampled for the current subsequent quantitative study.…”

“…Existing research has focused on men who have sex with men [37], sex workers [38], in-school youth [39] and the general population [40,41]. Studies on young women have either been qualitative [42–44] -which are suited to exploring risks at in-depth levels, but, fall short in quantifying risk- or sentinel surveillance studies using face-to-face interviews [45] which afford less privacy and anonymity and thus likely increase motivational bias [46,47]. This study aims to investigate HIV risk factors between HIV negative and HIV positive young women to provide empirical evidence specific to Swaziland.…”