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.
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References
Agyemang, E. O., Dapaah, J. M., Osei, F. A., Appiah, S. C. Y., Mensah, N. K., Odoom, S. F., & Martyn-Dickens, C. (2020). Self-esteem assessment among adolescents living with HIV and seeking healthcare at Komfo Anokye Teaching Hospital-Kumasi, Ghana. Journal of the International Association of Physicians in AIDS Care, 19, 2325958220976828. https://doi.org/10.1177/2325958220976828
Albright, J. N., & Fair, C. D. (2014). Providers caring for adolescents with perinatally-acquired HIV: Current practices and barriers to communication about sexual and reproductive health. AIDS Patient Care and STDs, 28(11), 587–593. https://doi.org/10.1089/apc.2014.0162
Aurpibul, L., Puthanakit, T., Sudjaritruk, T., Oberdorfer, P., Chotecharoentanan, T., Taejaroenkul, S., & Sirisanthana, V. (2016). The 10-year effectiveness of combination antiretroviral treatment in perinatally HIV-infected children participating in Thailand’s National Access Program. Antiviral Therapy, 21(3), 261–265. https://doi.org/10.3851/IMP2978
Aurpibul, L., Tangmunkongvorakul, A., Musumari, P. M., Srithanaviboonchai, K., & Tarnkehard, S. (2016). Patterns of sexual behavior in lowland Thai youth and ethnic minorities attending high school in Rural Chiang Mai Thailand. PLoS ONE, 11(12), e0165866. https://doi.org/10.1371/journal.pone.0165866
Bauermeister, J. A., Elkington, K., Brackis-Cott, E., Dolezal, C., & Mellins, C. A. (2009). Sexual behavior and perceived peer norms: comparing perinatally HIV-infected and HIV-affected youth. Journal of Youth and Adolescence, 38(8), 1110–1122. https://doi.org/10.1007/s10964-008-9315-6
Bauermeister, J. A., Elkington, K. S., Robbins, R. N., Kang, E., & Mellins, C. A. (2012). A prospective study of the onset of sexual behavior and sexual risk in youth perinatally infected with HIV. Journal of Sex Research, 49(5), 413–422. https://doi.org/10.1080/00224499.2011.598248
Behulu, G. K., Anteneh, K. T., & Aynalem, G. L. (2019). Premarital sexual intercourse and associated factors among adolescent students in Debre-Markos town secondary and preparatory schools, north west Ethiopia, 2017. BMC Research Notes, 12(1), 95. https://doi.org/10.1186/s13104-019-4132-4
Brady, M. T., Oleske, J. M., Williams, P. L., Elgie, C., Mofenson, L. M., Dankner, W. M., & Pediatric, A. C. T. G. C. T. (2010). Declines in mortality rates and changes in causes of death in HIV-1-infected children during the HAART era. Journal of Acquired Immune Deficiency Syndromes, 53(1), 86–94. https://doi.org/10.1097/QAI.0b013e3181b9869f
CDC. (2020). HIV treatment as prevention. Retrieved from https://www.cdc.gov/hiv/risk/art/index.html
Chander, G., Lau, B., & Moore, R. D. (2006). Hazardous alcohol use: a risk factor for non-adherence and lack of suppression in HIV infection. Journal of Acquired Immune Deficiency Syndromes, 43(4), 411–417. https://doi.org/10.1097/01.qai.0000243121.44659.a4
Chiao, C., & Yi, C. C. (2011). Adolescent premarital sex and health outcomes among Taiwanese youth: perception of best friends’ sexual behavior and the contextual effect. AIDS Care, 23(9), 1083–1092. https://doi.org/10.1080/09540121.2011.555737
Elkington, K. S., Bauermeister, J. A., Robbins, R. N., Gromadzka, O., Abrams, E. J., Wiznia, A., & Mellins, C. A. (2012). Individual and contextual factors of sexual risk behavior in youth perinatally infected with HIV. AIDS Patient Care and STDs, 26(7), 411–422. https://doi.org/10.1089/apc.2012.0005
Ferrand, R. A., Corbett, E. L., Wood, R., Hargrove, J., Ndhlovu, C. E., Cowan, F. M., & Williams, B. G. (2009). AIDS among older children and adolescents in Southern Africa: Projecting the time course and magnitude of the epidemic. AIDS, 23(15), 2039–2046. https://doi.org/10.1097/QAD.0b013e32833016ce
Kimera, E., Vindevogel, S., Reynaert, D., Justice, K. M., Rubaihayo, J., De Maeyer, J., & Bilsen, J. (2020). Experiences and effects of HIV-related stigma among youth living with HIV/AIDS in Western Uganda: A photovoice study. PLoS ONE, 15(4), e0232359. https://doi.org/10.1371/journal.pone.0232359
Liu, A., Kilmarx, P., Jenkins, R. A., Manopaiboon, C., Mock, P. A., Jeeyapunt, S., & van Griensven, F. (2006). Sexual initiation, substance use, and sexual behavior and knowledge among vocational students in northern Thailand. International Family Planning Perspectives, 32(3), 126–135. https://doi.org/10.1363/ifpp.32.126.06
Lolekha, R., Boon-Yasidhi, V., Leowsrisook, P., Naiwatanakul, T., Durier, Y., Nuchanard, W., & Chokephaibulkit, K. (2015). Knowledge, attitudes, and practices regarding antiretroviral management, reproductive health, sexually transmitted infections, and sexual risk behavior among perinatally HIV-infected youth in Thailand. AIDS Care, 27(5), 618–628. https://doi.org/10.1080/09540121.2014.986046
Louthrenoo, O., Aurpibul, L., Oberdorfer, P., & Sirisanthana, V. (2018). Family functioning in adolescents with perinatal HIV infection. Journal of the International Association of Physicians in AIDS Care, 17, 2325958218774782. https://doi.org/10.1177/2325958218774782
Mellins, C. A., Brackis-Cott, E., Leu, C. S., Elkington, K. S., Dolezal, C., Wiznia, A., & Abrams, E. J. (2009). Rates and types of psychiatric disorders in perinatally human immunodeficiency virus-infected youth and seroreverters. Journal of Child Psychology and Psychiatry, 50(9), 1131–1138. https://doi.org/10.1111/j.1469-7610.2009.02069.x
Mellins, C. A., Tassiopoulos, K., Malee, K., Moscicki, A. B., Patton, D., Smith, R., & Pediatric, H. I. V. A. C. S. (2011). Behavioral health risks in perinatally HIV-exposed youth: Co-occurrence of sexual and drug use behavior, mental health problems, and nonadherence to antiretroviral treatment. AIDS Patient Care and STDs, 25(7), 413–422. https://doi.org/10.1089/apc.2011.0025
Merzel, C., VanDevanter, N., & Irvine, M. (2008). Adherence to antiretroviral therapy among older children and adolescents with HIV: a qualitative study of psychosocial contexts. AIDS Patient Care and STDs, 22(12), 977–987. https://doi.org/10.1089/apc.2008.0048
Phaileeklee S, Thaikla K., Dithisawadvet S., Chareonrat S., Tantirangsi N., Chindej A., & Seeuparat N. (2015). Alcohol, tobacco, substance use and health-risk behaviors among high school students in Thailand.
Ross, J. L., Teeraananchai, S., Lumbiganon, P., Hansudewechakul, R., Chokephaibulkit, K., Khanh, T. H., & Kerr, S. J. (2019). A longitudinal study of behavioral risk, adherence, and virologic control in adolescents living with hiv in Asia. Journal of Acquired Immune Deficiency Syndromes, 81(2), e28–e38. https://doi.org/10.1097/QAI.0000000000002008
Sohn, A. H., & Hazra, R. (2013). The changing epidemiology of the global paediatric HIV epidemic: Keeping track of perinatally HIV-infected adolescents. Journal of the International AIDS Society, 16, 18555. https://doi.org/10.7448/IAS.16.1.18555
Sridawruang, C., Pfeil, M., & Crozier, K. (2010). Why Thai parents do not discuss sex with their children: A qualitative study. Nursing & Health Sciences, 12(4), 437–443. https://doi.org/10.1111/j.1442-2018.2010.00556.x
Srijaiwong, S., Sindhu, S., Ratinthorn, A., & Viwatwongkasem, C. (2017). Factors influencing sexual behaviors among Thai adolescents. Journal of Population and Social Studies, 25(3), 171–193. https://doi.org/10.25133/JPSSv25n3.002.
Steele, R. G., Nelson, T. D., & Cole, B. P. (2007). Psychosocial functioning of children with AIDS and HIV infection: Review of the literature from a socioecological framework. Journal of Developmental and Behavioral Pediatrics, 28(1), 58–69. https://doi.org/10.1097/DBP.0b013e31803084c6
Tangmunkongvorakul, A., Carmichael, G., Banwell, C., Seubsman, S. A., & Sleigh, A. (2010). Intimate relationships among adolescents in different social groups in northern Thailand. The Southeast Asian Journal of Tropical Medicine and Public Health, 41(6), 1475–1493. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21329326
Techasrivichien, T., Darawuttimaprakorn, N., Punpuing, S., Musumari, P. M., Lukhele, B. W., El-Saaidi, C., & Kihara, M. (2016). Changes in sexual behavior and attitudes across generations and gender among a population-based probability sample from an urbanizing province in Thailand. Archives of Sexual Behavior, 45(2), 367–382. https://doi.org/10.1007/s10508-014-0429-5
Tulloch, T., & Kaufman, M. (2013). Adolescent sexuality. Pediatrics in Review, 34(1), 29–37. https://doi.org/10.1542/pir.34-1-29 quiz 38.
Unicef. (2020). UNAIDS 2020 estimates; global and regional trend. Retrieved from https://data.unicef.org/topic/hivaids/global-regional-trends/
Wellings, K., Collumbien, M., Slaymaker, E., Singh, S., Hodges, Z., Patel, D., & Bajos, N. (2006). Sexual behaviour in context: A global perspective. Lancet, 368(9548), 1706–1728. https://doi.org/10.1016/S0140-6736(06)69479-8
WHO. (2015). Global standards for quality health care services for adolescents. Retrieved from https://www.who.int/maternal_child_adolescent/documents/global-standards-adolescent-care/en/
Acknowledgements
We thank all youth and their caregivers for their willing cooperation in this study. We also would like to thank the study team and hospital staff who coordinated study activities and routine services for our participants throughout the study period.
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Aurpibul, L., Chotecharoentanan, T., Khampun, R. et al. Sexual Intercourse Initiation and Adolescent Behaviors of Youth Living with Perinatal HIV Infection in Thailand. Sex Res Soc Policy 19, 433–441 (2022). https://doi.org/10.1007/s13178-021-00557-y
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DOI: https://doi.org/10.1007/s13178-021-00557-y