Sexual Intercourse Initiation and Adolescent Behaviors of Youth Living with Perinatal HIV Infection in Thailand

Abstract

Purpose: Today, youth living with perinatal HIV (YLPHIV) have grown-up receiving antiretroviral treatment. We determine the frequency of sexual intercourse initiation and associated factors among YLPHIV in Thailand. Methods: YLPHIV age between 15 and < 25 years were recruited from either HIV clinics or the community via youth networks from Dec 2017 to Feb 2018. Data were collected using a self-administered questionnaire on a mobile device. The questionnaire included demographic and socioeconomic background, their lifetime sexual and adolescent behaviors, reasons for not having sexual intercourse, and future plans for sexual intercourse. Comparisons between sexes, age groups, and sexual experiences were made; logistic regression was used to identify associated factors. Results: A total of 120 YLPHIV were enrolled; 58 (48%) were female. Their mean ± SD age and duration on ART were 20.3 ± 2.6 and 12.7 ± 3.0 years, respectively. Thirty-six (30%) reported having initiated sexual intercourse by the time of the study; 61 (51%) reported being in romantic relationships, and 58 (48%) reported having sexual contact. The only factor associated with sexual intercourse initiation based on the multivariate analysis was going out after midnight (odds ratio 3.968, 95% CI 1.540–10.226; p = 0.004). Among those who had not initiated sexual intercourse, the top three reasons for not initiating sexual intercourse were concern for their parents’ feelings (76%), not wanting to get sexually transmitted diseases (70%), and not wanting to spread HIV to others (62%). Half of YLPHIV who had not initiated sexual intercourse reported being uncertain whether, or when to have sex in the future. Conclusions: Sexual intercourse initiation and adolescent behaviors are part of growing-up for YLPHIV. Sexual education and HIV knowledge that are both age-appropriate and culturally appropriate should be included in HIV services, and counseling sessions to help these youths to plan for their future safely and responsibly.