Liu Alice, Kilmarx Peter, Jenkins Richard A, Manopaiboon Chomnad, Mock Philip A, Jeeyapunt Supaporn, Uthaivoravit Wat, van Griensven Frits
Stanford University School of Medicine, Stanford, CA, USA.
Int Fam Plan Perspect. 2006 Sep;32(3):126-35. doi: 10.1363/3212606.
Thailand has undergone dramatic social changes in the last two decades, yet little is known about factors related to sexual initiation among adolescents.
A survey using the audio computer-assisted self-interviewing method was conducted to assess social and demographic characteristics, substance use, sexual behavior, and knowledge of HIV and STIs among 1,725 vocational school students aged 15-21 living in northern Thailand. Gender differences for these factors were evaluated using chi-square and Mann-Whitney U tests. Multivariate survival analysis using Cox proportional hazards models assessed associations between these variables and sexual initiation for each gender.
Males initiated sexual intercourse at an earlier age than females (median ages of 17 and 18, respectively). At any given age, sexual initiation was associated with having a nonagricultural background and using alcohol or methamphetamine (adjusted rate ratios, 1.3-2.9). For males, initiation was also associated with having parents who did not live together, having a friend as a confidant, tobacco use, high perceived risk for HIV and high STI knowledge (1.3-1.7). For females, other factors associated with earlier initiation were younger age at interview, living away from family, lacking a family member as a confidant, high perceived risk for STIs and ever having smoked marijuana (1.3-2.4).
Interventions to ameliorate the adverse consequences of early sexual initiation need to address social influences such as parents and peer groups. Programs should identify and target high-risk subgroups, such as those who are sexually experienced at an early age and those engaged in patterns of generalized risk-taking.
泰国在过去二十年经历了巨大的社会变革，但对于青少年性初次行为相关因素却知之甚少。
采用音频计算机辅助自我访谈法进行了一项调查，以评估1725名年龄在15 - 21岁、居住在泰国北部的职业学校学生的社会和人口学特征、物质使用情况、性行为以及对艾滋病毒和性传播感染的知晓情况。使用卡方检验和曼 - 惠特尼U检验评估这些因素的性别差异。使用Cox比例风险模型进行多变量生存分析，评估这些变量与每种性别的性初次行为之间的关联。
男性开始性行为的年龄早于女性（中位数年龄分别为17岁和18岁）。在任何给定年龄，性初次行为都与非农业背景以及使用酒精或甲基苯丙胺有关（调整后的率比为1.3 - 2.9）。对于男性，性初次行为还与父母不住在一起、有朋友作为知己、吸烟、认为感染艾滋病毒的风险高以及性传播感染知识丰富有关（1.3 - 1.7）。对于女性，与较早开始性行为相关的其他因素包括访谈时年龄较小、离家居住、缺乏家庭成员作为知己、认为感染性传播感染的风险高以及曾经吸食过大麻（1.3 - 2.4）。
改善过早性初次行为不良后果的干预措施需要解决父母和同龄人群体等社会影响因素。项目应识别并针对高危亚组，例如那些过早有性经历的人和那些有普遍冒险行为模式的人。
