Sexual risk behaviors and influencing factors among Muslim adolescents on southern border of Thailand

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_ijamh-2019-0221_abs_001_w2aab3b7b6b1b6b1aab1c12b2Aa"><jats:title>Objectives</jats:title><jats:p>To describe individual, interpersonal, and environmental factors and sexual risk behaviors among Thai Muslim adolescents.</jats:p></jats:sec><jats:sec id="j_ijamh-2019-0221_abs_002_w2aab3b7b6b1b6b1aab1c12b3Aa"><jats:title>Methods</jats:title><jats:p>We recruited adolescents from four schools and one vocational college on the Southern border of Thailand during October 2018 to January 2019. We used password-protected online questionnaires for each respondent to protect their privacy.</jats:p></jats:sec><jats:sec id="j_ijamh-2019-0221_abs_003_w2aab3b7b6b1b6b1aab1c12b4Aa"><jats:title>Results</jats:title><jats:p>We recruited N = 700 participants of which 9% were sexually experienced. Of those participants, many had never used a condom (41.3%) or considered taking contraceptive pills (71.4%). Moreover, 54% of them have had sexual intercourse more than once. Some had been infected with an STI (17.5%), and (14.3%) became pregnant more than once. Adolescents reported individual factors such as high religiosity (58.7%), and (47.6%) practiced Islam daily with no differences between boys and girls. Girls had significantly higher refusal of sex self-efficiency than boys (96 vs. 119.5, p &lt; 0.05). In the interpersonal factors, boys had more uninvolved parenting style, lower parental monitoring, higher parental approval of sex, and higher perceived peer norm than girls. The environmental factors besides cultural norms impacted girls and boys equally.</jats:p></jats:sec><jats:sec id="j_ijamh-2019-0221_abs_004_w2aab3b7b6b1b6b1aab1c12b5Aa"><jats:title>Conclusions</jats:title><jats:p>We showed low rates of sexual activity, but in those adolescents who were sexually active we showed high rates of lack of knowledge and higher rates of sexual risk behaviors. Individual, interpersonal, and environmental factors all influenced sexual risk behaviors. We recommend comprehensive sexuality education that includes Islamic context for adolescents and their parents embedded in policy, religious, and community cultural practices.</jats:p></jats:sec>

A Scoping Review of Knowledge, Awareness, Perceptions, Attitudes, and Risky Behaviors of Sexually Transmitted Infections in Southeast Asia

“…Based on the sex profile, most of the studies reported females to have higher levels of knowledge, awareness, attitude, and perception compared to males ( n = 7). It is to noted however that a fair comparison is not possible, as many of these studies had a skewed distribution whereby females outnumbered males [ 10 , 40 , 43 ]. Additionally, some of these studies also specifically targeted female participants [ 1 , 14 , 39 ].…”

“…Additionally, some of these studies also specifically targeted female participants [ 1 , 14 , 39 ]. Nevertheless, some of the reasons provided by researchers for a lower level of knowledge and awareness among males include having a more uninvolved parenting style or lower parental monitoring, as well as more sex approval (for younger males/boys), and thus there is a lack of responsible communication on STIs among this cohort [ 40 ].…”

“…For risky sexual behaviors, the two most prominent behaviors include having unsafe sex ( n = 15) and having multiple sexual partners ( n = 12), both of which were mainly reported by studies targeting vulnerable/high-risk cohorts, including (Y)MSM and transgender people [ 26 , 53 , 54 , 59 ], female sex workers (FSW) and their clients [ 50 , 55 , 56 ], adolescents [ 13 , 40 , 51 , 52 ], and HIV-positive individuals [ 57 , 58 ]. For instance, a study involving 506 HIV individuals in Vietnam found that 83.2% of participants engage in sex without using a condom, and 27.9% had multiple sex partners.…”

“…Interestingly, having unprotected sex and/or multiple sex partners were reported to be more common among male adolescents [ 40 , 52 ] and university students [ 8 ]. Such a tendency was particularly noted among boys with low parental control/monitoring [ 40 ] and male students who live away from their parents [ 8 ], thus suggesting that these individuals choose to engage in sexual risky behaviors due to a sense of freedom. Furthermore, this also provides an insight into a potentially risky environment in the community, particularly norms regarding males’ sexual behavior.…”

Risk of HIV/STIs among Muslim army conscripts in the three deep southern provinces of Thailand

“…A study conducted in USA found that more than half of US Muslim college students reported ever having had sexual intercourse, 30 while approximately 27.5% Muslim men in Ghana involved in high-risk sexual behavior. 18 In Thailand, a study in the southern border of Thailand (Muslim majority community) found that 9.0% schools and a vocational college students had experience of sexual intercourse 31 and 4.0% Muslim adolescent men in Ponok (private Islamic school) in Southern Thailand had premarital sexual intercourse. 20 The differences of the number observed among these studies may result from the local cultural influencing.…”