Sexual risk behaviors among Muslim adolescents on the southern border provinces of Thailand

Abstract

Engagement in sexual risk behaviors is related to higher rates of unintended pregnancies and sexually transmitted infections (STIs), which threaten the health of adolescents in Thailand. At present, there is little knowledge concerning the sexual risk behaviors and consequences of engaging in sexual behaviors among Thai Muslim adolescents. Therefore, this study explored the sexual risk behaviors and related factors that could explain sexual risk behaviors to guide future prevention efforts. The aims of this cross sectional descriptive study were to describe sexual risk behaviors and examine the individual, interpersonal, and environmental factors among Thai Muslim adolescents. Participants were recruited by a convenience sampling technique from four schools and one vocational college at the southern border area of Thailand from October 2018 to January 2019. Password protected online questionnaires were given to each respondent to protect their privacy. Data were analyzed using descriptive statistics as well as ordinal and binary logistic regression. Of the 1200 participants, 700 provided complete information and were included in the analysis. The majority indicated low pre coital behaviors (86.9%) and low sexual behaviors (92.0%). Of those participants, 9% had previous experiences with sexual intercourse, and the proportion of sexually active males was higher than for females. Many had never used a condom (41.3%) or contraceptive pills (71.4%). Moreover, 54% of those had had sexual intercourse more than once. Some had been infected with an STI (17.5%) and became pregnant more than once (14.3%). Ordinal logistic regression results for the individual factors showed that sexual risk behaviors prevention knowledge was protective and increased age was a predictive factor for higher sexual risk behaviors, while gender was not a predictor. For the interpersonal factors, parental approval of sex (OR 1.46; 95% Cl [1.23; 1.74]) and peer norms (OR 1.09; 95% Cl [1.05; 1.12]) were predictive factors for higher sexual risk behaviors, while more parental monitoring (OR 0.93; 95% Cl [0.87; 0.99]) was a significant factor for lower sexual risk behaviors. In terms of environmental factors, cultural norms were a significant protective factor, while neighborhood disorganization was a predictive factor for higher sexual risk behaviors. In conclusion, there were low rates sexual intercourse among those adolescents. For those adolescents who were sexually active, however, the results showed high rates of sexual risk behaviors. Individual, interpersonal, and environmental factors influenced sexual risk behaviors. Therefore, further studies are recommended that include all stakeholders within Muslim communities to create comprehensive sex education for students, recommendations for parents, and community guidance appropriate for Muslims.