Background: Methamphetamine (MA) is a commonly used substance among youths, particularly those who are living in poor economic conditions with low levels of education and who have had bad childhood experiences. The Akha and Lahu hill tribe youths living on the Thailand-Myanmar-Laos Republic border are identified as the group most vulnerable to MA use in Thailand. The study aimed to estimate the prevalence of MA use and determine its associations with childhood experiences among Akha and Lahu youths aged 15-24 years in northern Thailand. Methods: A cross-sectional study was conducted to estimate the prevalence of MA use and determine its association with childhood experiences among Akha and Lahu youths living in northern Thailand. Validated and sealed questionnaires were used to gather information from participants after obtaining the informed consent form. Questionnaires were completed by participants and their parents at home. Logistic regression was used to identify the associations between variables at the α=0.05 level. Findings: A total of 710 participants participated in the study: 54.2% were Akha, 52.5% were females, 50.6% were aged 15-17 years (mean=18.1, SD=2.7), and 11.4% did not have Thai ID cards. The prevalence of MA use at least once among Akha and Lahu youths was 14.5%. In multivariate analysis, eight variables were found to be associated with MA use among Akha and Lahu youths in northern Thailand: sex, age, a family member who uses MA, smoking, a close friend who uses alcohol, highly confident personality, history of physical assault from a family member at an age of 0-5 years, and history of physical assault from a family member while aged 6-14 years. Males had a 4.97-fold (95% CI=2.08-10.23) greater likelihood of MA use than females. Participants aged 18-20 years and 21-24 years had a 1.96-fold (95% CI=1.03-3.71) and 2.50-fold (95% CI=1.23-5.10) greater likelihood of MA use than those aged 15-17 years, respectively. Those who had a family member who used MA had a 5.80-fold (95% CI=1.99-16.91) greater risk of MA use than those who did not. Those who smoked had a 8.9-fold (95% CI=4.88-16.29) greater likelihood of MA use than those who did not. Those who had a close friend who used alcohol had a 2.21-fold (95% CI=1.17-4.18) greater risk of MA use than those who did not. Those who had a highly confident personality had a 2.08-fold (95% CI=1.07-4.06) greater risk of MA use than those who did not. Those who had been physically assaulted by a family member while aged 0-5 years had a 2.37-fold (95% CI=1.18-5.21) greater chance of MA use than those who had not, and those who had been physically assaulted by a family member while aged 6-14 years had a 3.28-fold (95% CI=1.38-7.77) greater risk of MA use than those who had not. Interpretation: All relevant government and nongovernment agencies together with the Ministry of Public Health Thailand should address MA use among Akha and Lahu youths by properly developing a community health intervention that is focused on improving family relationships, male youths, smoking, and individuals with a highly confident personality. Funding Statement: This project was supported by the National Research Council of Thailand, Mae Fah Luang University, and The Center of Excellence for the Hill Tribe Health Research. TA was awarded the research grant from the National Research Council of Thailand (NRCT) (Grant No. 29/ 2561). Declaration of Interests: Authors declare no competing interests. Ethics Approval Statement: All research concept, procedures, and instruments were approved by the Mae Fah Luang University Research Ethic Committee on Human Research (REH-60141).
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