The factors influencing HIV prevention and risk behaviors among the young population in Thailand: A review of the literatures (2000-2009)
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概要
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Background: Globally, young people contribute to approximately 50% of new HIV infections every year. In Thailand, the epidemic spread to adolescents and young adults in late 1990s. The prevalence of HIV among Thai people aged 22 years or younger had rose from 13% in 2003 to 22% in 2005.The number of new HIV cases and other sexually transmitted infections (STI) among adolescents have also been increasing.At the same time, the diversity of attitudes, beliefs, and lifestyles of the youth has been increasing. To tackle this situation, the government implemented a nationwide television campaign for young people in 2007. However, the campaign was forced to be closed because of strong criticism from the general public.Objectives: This study aimed to find useful information to improve the understanding how the recent HIV epidemic is gradually penetrating the youth population in Thailand.Study Design and Methods: A review of literatures was conducted using the Pub-Med database. The searching key words used in this study were: a) Thailand OR Bangkok, and b) adolescents OR young adults. In addition, a combination of the following terms was used: c) HIV, d) condom use, e) sexual behavior, and e) risk behaviors. The study selection was limited to English and Japanese language, and articles published between year of 2000 and 2009. Among 407 articles, 17 articles were selected for this study. Data extraction was based on two strategies as follows: a) assessing associations between predicted factors and HIV prevention and risk-taking behaviors, including attitudes, and b) reviewing the effects of educational interventions for HIV prevention programs conducted in Thailand.Results: Eleven studies reported the influences of individual attributes as a factor in HIV preventive and risky behaviors among youth. Factors such as age, gender, education, and sexual experiences such as condom use during first sexual encounter had significant associations with future condom use behaviors and other indirect HIV related preventive behaviors. At the same time, factors such as age, gender, predisposition status, knowledge of HIV, rape experiences, and substances use were significantly associated with unprotected sex and other indirect-HIV risk behaviors. Eight studies reported that the influence of socio-psychological factors on HIV prevention and risks. Factors such as a positive attitude toward condoms, condom use self-efficacy, high intention to use condoms, perception of the benefit of condom use, disagreement on barriers to condom use, and beliefs within the peer norms were significantly associated with HIV preventive behaviors. Similarly, factors of low self-efficacy and low communication skills, high perception of HIV risk, and weak relationships with their parents had significant association with high HIV-risk behaviors. Nine studies indicated the needs for improvement in the educational environment for the promotion of HIV prevention for youth in Thailand, and 5 studies conducted actual interventions in school settings. Health professional-led comprehensive sex education program and peerled sex education programs had significant influence on the improvement in young people's HIV prevention knowledge and attitudes.Conclusion: In conclusion, the influence of beliefs and perceptions on young people's HIV prevention and risk behaviors were reported in most of the selected articles covering the predicted factors. In actual interventions, the peer-led sex education programs and the health professional-led comprehensive sex education programs had significant effects on improving knowledge and attitudes. The peer-led education program had further effects on raising youth's self-efficacy and the sustainability of the lessons learned. These outcomes of peer education programs suggested that they might be an essential long-term educational strategy to prevent the spread of HIV in young people.
- 2011-10-00