Youth In Thailand Research Articles

Risk of Liver Fibrosis in Hepatitis B Virus and HIV Coinfected Youths Receiving Tenofovir-Containing Antiretroviral Regimen.

Background:Hepatitis B virus (HBV) and HIV coinfection is associated with risk of progression to chronic liver disease. We assessed liver stiffness in HBV-HIV coinfected youths.Methods:A cross-sectional study in HBV-HIV coinfected youths aged 18 to 25 years who received a tenofovir (TDF)-containing antiretroviral therapy regimen for >96 weeks. Measurements included HBV DNA level, HBV serology profiles, and transient elastography (TE). The cutoff for TE results included ≥5.9 kPa for F2-moderate fibrosis, ≥7.4 kPa for F3-severe fibrosis, and ≥9.6 kPa for F4-cirrhosis.Results:From March to December 2016, 15 HBV-HIV coinfected youths with a median duration on TDF-containing regimens of 3.3 years were enrolled. Five (33%) youths had significant liver fibrosis, 3 with F2-moderate, 1 with F3-advanced fibrosis, and 1 with F4-cirrhosis. Other 5 without liver fibrosis had hepatitis B surface e antigen (HBsAg) and hepatitis B surface e antigen (HBeAg) loss. Higher mean alanine transaminase (ALT) was observed among the group with F2-F4 when compared to those with F0.Conclusion:Liver fibrosis was evidenced in HBV-HIV coinfected youths in Thailand. Transient elastography might be considered for those who do not achieve HBsAg loss or have persistent ALT elevation while on treatment.

A cluster randomized trial of community mobilization to reduce methamphetamine use and HIV risk among youth in Thailand: Design, implementation and results

BackgroundUse of methamphetamines (MA) and other stimulants have consistently been associated with HIV/STI risk globally. We evaluated a community mobilization intervention (Connect to Protect, C2P®) to prevent MA use among youth and reduce HIV risk behaviors through community structural changes. DesignA community-randomized trial in northern Thailand with matched districts randomized to C2P intervention or a standard voluntary counseling and testing (VCT) control. Intervention districts formed stakeholders' coalitions to plan tailored local prevention programs. Two independent random household samples of youth aged 14–24 were surveyed in 2009 and 2012. Lifetime and recent MA use was modeled with multilevel logistic regression. ResultsIntervention initiatives included family-strengthening programs, school-based programs and opening a community drug treatment center. Control communities applied the government-led “war on drugs” approach in addition to youth and family programs. Baseline (N = 1077) and follow-up (N = 1225) samples included 47.5% females and 21.7% aged ≤16. Lifetime MA use in intervention districts reduced from 13.4% to 11.7% compared to reduction from 16.2% to 10.4% in the control districts (non-significant). In models, lifetime MA use was associated with: time (aOR = 0.6, 95%CI: 0.38–0.83), females (aOR = 0.2, 95%CI: 0.15–0.29), increasing age (aOR = 2.4, 95%CI: 1.40–4.20, ages 16–19; aOR = 3.5, 95%CI: 2.00–6.12, ages ≥20), and not being full-time students (aOR = 5.3, 95%CI: 3.77–7.37). Recent MA use showed similar results. Additionally, lifetime MA use was significantly associated with alcohol use, risky sexual behaviors and elevated depressive symptoms. ConclusionsDelay in developing and implementing specific prevention programs in the intervention districts slowed diffusion of the effect into the communities. Secular trends with contentious civil unrest and active drug-enforcement efforts in the control communities also contributed to the null intervention effect. Longer time and intensified efforts stressing a public health approach are needed to demonstrate the effectiveness of community mobilization in reducing substance use and HIV risk in this rural Thai community.

The relationships between sexual risk behaviors and general health risk behaviors among unmarried youth in Thailand.

Objectives:The prevalence and correlates of sexual risk behaviors among unmarried youth in Thailand are poorly documented. The objectives of this study were to compare the differences in sexual behaviors across age groups and gender and to identify the relationships between sexual risk behaviors and general health risk behaviors among unmarried Thai youth.Methods:A population-based, nationally representative, cross-sectional survey was conducted between January and March 2013. The Thai version of the Youth Risk Behavior Survey questionnaire was used to collect data from 800 unmarried Thai youth.Results:Majority of the respondents (65.9%) had not engaged in any sexual risk behavior, 18.7% had engaged in 2–3 sexual risk behaviors, and only 5.5% had engaged in a single sexual risk behavior. Current sexually active youth had higher risk of participating in physical fights (odds ratio = 3.41, 95% confidence interval = 1.53–7.57), smoking cigarette (odds ratio = 4.05, 95% confidence interval = 1.89–8.67), and drinking alcohol (odds ratio = 2.17, 95% confidence interval = 1.08–4.36).Conclusion:Thai youth were more likely to be involved in multiple sexual risk behaviors than a single sexual risk behavior. Physical fighting was the strongest general health risk behavior associated with the sexual risk behaviors, followed by substance abuse.

Investigation and recommendations on the promotion of sustainable consumption behavior among young consumers in Thailand

This study investigated sustainable consumption behavior (SCB) and its determinants among undergraduate youths in Thailand using the theory of planned behavior (TPB) as a theoretical framework. A multistage sampling technique was used to select 1,000 university students in Thailand. Data were collected using a self-administered questionnaire. Descriptive statistics and multiple regression analysis at the .05 level of statistical significance were used to analyze the data. The results showed that all three independent variables derived from TPB (Attitude toward the behavior, Subjective norm, and Perceived behavioral control) can co-predict the intention to perform SCB at 31.1 percent and sustainable consumption behavior at 22.3 percent. For intention, Perceived behavioral control had the most influence (β=.382), followed by Attitude toward the behavior (β=.302), and Subjective norm (β=.228), respectively. For sustainable consumption behavior, Perceived behavioral control also had the most influence (β=.389), followed by Attitude toward the behavior (β=.215), and Subjective norm (β=.133), respectively. The findings strongly suggested that these three independent variables should be considered in planning social marketing communication campaigns to increase effectiveness. “3-Alteration strategies” are described and recommended and a logic model is proposed for the promotion of sustainable consumption behavior among young consumers in Thailand for sustained success.

Cultural Adaptation of an Evidence-Informed Psychosocial Intervention to Address the Needs of PHIV+ Youth in Thailand

Globally, pediatric HIV has largely become an adolescent epidemic. Thailand has the highest HIV prevalence in Asia (1.2%), with more than 14,000 children living with HIV. There is growing demand for evidence-based psychosocial interventions for this population that include health and mental health support and sexual risk reduction, which can be integrated into HIV care systems. To address this need, a multidisciplinary team of Thai and US researchers adapted an existing evidence-informed, family-based intervention, The Collaborative HIV Prevention and Adolescent Mental Health Program + (CHAMP+), which has been tested in multiple global trials. Using community-based participatory research methods, changes to the intervention curriculum were made to address language, culture, and Thai family life. Involvement of families, youth, and stakeholders in the adaptation process allowed for identification of salient issues and of program delivery methods that would increase engagement. Participants endorsed using a cartoon-based curriculum format for fostering discussion (as in CHAMP+ South Africa) given stigma around discussing HIV in the Thai context. The Thai version of CHAMP+ retained much of the curriculum content incorporating culturally appropriate metaphors and story line. Sessions focus on family communication, coping, disclosure, stigma, social support, and HIV education. This paper explores lessons learned through the adaption process of CHAMP+ Thailand that are applicable to other interventions and settings. It discusses how culturally informed adaptations can be made to interventions while maintaining core program components.

Validating the Effectiveness Indicators of Social Marketing Communication Campaigns for Reducing Health-Risk Behaviors Among Youth in Thailand

This study aims to validate the effectiveness indicators of social marketing communication campaigns for reducing health-risk behaviors among Thai youth by using a quantitative research with 1,000 undergraduate students aged 18-24 years old in Thailand. A second-order confirmatory factor analysis was used to check compliance with empirical data at the .05 significance level. The findings showed that the effectiveness indicators of social marketing communication campaigns for reducing health-risk behaviors among Thai youth consist of forty-nine indicators from eight core components: 1) attitude toward health-risk behaviors reduction, 2) subjective norms, 3) perceived behavioral control, 4) intention to reduce health-risk behaviors, 5) practices for reducing health-risk behaviors, 6) knowledge in dangers and impacts of health-risk behaviors, 7) campaign brand equity, and 8) communication networks. These new developed effectiveness indicators should be taken into evaluating the effectiveness of social marketing communication campaigns for reducing health-risk behaviors among youtheffectively and efficiently for a sustained success both in Thailand and in international level.

Victimization among high school students in Thailand

Victimization rates in home, school, and community were studied, among high school students aged 13–18, in three regions of Thailand: Bangkok (urban region), the West (rural region), and the South (Muslim region). The random sample consisted of 1305 high school students: 542 (41.5%) males and 763 (58.5%) females. Results indicated that the southern provinces had the highest victimization rates in all the studied categories. Males were victimized more than females. The reasons behind these results are being dealt with in light of the political and cultural characteristics of Thailand. Recommendations to ease the victimization rates of youth in Thailand are suggested.

Psychosocial needs of perinatally HIV-infected youths in Thailand: lessons learnt from instructive counseling

ABSTRACTIdentifying psychosocial needs of perinatally HIV-infected (pHIV) youth is a key step in ensuring good mental health care. We report psychosocial needs of pHIV youth identified using the “Youth Counseling Needs Survey” (YCS) and during individual counseling (IC) sessions. pHIV youth receiving care at two tertiary-care hospitals in Bangkok or at an orphanage in Lopburi province were invited to participate IC sessions. The youths’ psychosocial needs were assessed using instructive IC sessions in four main areas: general health, reproductive health, mood, and psychosocial concerns. Prior to the IC session youth were asked to complete the YCS in which their concerns in the four areas were investigated. Issues identified from the YCS and the IC sessions were compared. During October 2010–July 2011, 150 (68.2%) of 220 eligible youths participated in the IC sessions and completed the YCS. Median age was 14 (range 11–18) years and 92 (61.3%) were female. Mean duration of the IC sessions was 36.5 minutes. One-hundred and thirty (86.7%) youths reported having at least one psychosocial problem discovered by either the IC session or the YCS. The most common problems identified during the IC session were poor health attitude and self-care (48.0%), lack of life skills (44.0%), lack of communication skills (40.0%), poor antiretroviral (ARV) adherence (38.7%), and low self-value (34.7%). The most common problems identified by the YCS were lack of communication skills (21.3%), poor health attitude and self-care (14.0%), and poor ARV adherence (12.7%). Youth were less likely to report psychosocial problems in the YCS than in the IC session. Common psychosocial needs among HIV-infected youth were issues about life skills, communication skills, knowledge on self-care, ARV adherence, and self-value. YCS can identify pHIV youths’ psychosocial needs but might underestimate issues. Regular IC sessions are useful to detect problems and provide opportunities for counseling.

The study of ‘out-of-school’ children and youth situations for developing a lifelong education model for ‘out-of-school’ children and youth

According to UNESCO, the number of ‘out-of-school’ children and youth in Thailand is the fifth in Asia and second in ASEAN. Currently, the accumulated number is about 1.7 million people. The purposes of this research are to study ‘out-of-school’ children and youth situations and method of education provided for them from the related organizations and networks. The results of this study reveal that the problems of the ‘out-of-school’ children and youth include low quality of life, lack of life skills and social skills, and behavior problems. The causes are poverty, low achievement in school, and behavior issues which cause dismissal from school. What needs to be provided for them from related organizations are a suitable system of education and vocational skills training. The activities provided by related organizations can be categorized as 1) life skills, social skills and self-esteem enhancement activities 2) funding and resources, which help to open up educational opportunities, and 3) the development of local mechanism to develop them in each area.

Predictors of Intention to Use HIV Testing Service Among Sexually Experienced Youth in Thailand.

This study examined the predictors of intention to use HIV counseling and testing (HCT) services among those who had never used HCT services in a sample of 2,536 Thai youth in Bangkok (ages 15-24). Web-based questionnaires included assessments of HIV knowledge, HIV testing attitude, AIDS stigma, and youth-friendly HCT (YFHCT) service expectation. More than 80% of the sexually experienced youth had never used HCT services but among this group 74.06% reported having intentions to do so. The significant predictors consisted of favorable expectations of YFHCT services (p < .001), positive attitude toward HIV testing (p < .005), perceived high risk for HIV infection (p < .01), having multiple sex partners while also using condoms consistently (p < .01), willingness to pay (p < .001), and being informed about HCT and knowing service locations (p < .001). Policy makers, as well as health promotion program developers and researchers can use these findings to increase intention and use of HCT services among at-risk youth.

Knowledge, attitudes, and practices regarding antiretroviral management, reproductive health, sexually transmitted infections, and sexual risk behavior among perinatally HIV-infected youth in Thailand

More than 30% of perinatally HIV-infected children in Thailand are 12 years and older. As these youth become sexually active, there is a risk that they will transmit HIV to their partners. Data on the knowledge, attitudes, and practices (KAP) of HIV-infected youth in Thailand are limited. Therefore, we assessed the KAP of perinatally HIV-infected youth and youth reporting sexual risk behaviors receiving care at two tertiary care hospitals in Bangkok, Thailand and living in an orphanage in Lopburi, Thailand. From October 2010 to July 2011, 197 HIV-infected youth completed an audio computer-assisted self-interview to assess their KAP regarding antiretroviral (ARV) management, reproductive health, sexual risk behaviors, and sexually transmitted infections (STIs). A majority of youth in this study correctly answered questions about HIV transmission and prevention and the importance of taking ARVs regularly. More than half of the youth in this study demonstrated a lack of family planning, reproductive health, and STI knowledge. Girls had more appropriate attitudes toward safe sex and risk behaviors than boys. Although only 5% of the youth reported that they had engaged in sexual intercourse, about a third reported sexual risk behaviors (e.g., having or kissing boy/girlfriend or consuming an alcoholic beverage). We found low condom use and other family planning practices, increasing the risk of HIV and/or STI transmission to sexual partners. Additional resources are needed to improve reproductive health knowledge and reduce risk behavior among HIV-infected youth in Thailand.

The influence of family wealth on the educational attainments of youths in Thailand

This paper investigates the relative role of family wealth and other family characteristics in determining schooling decisions. Instead of employing a common approach that focuses on certain education levels, an alternative method is proposed that allows a study of the entire schooling attainment distribution for youths in different wealth quartiles. Even without access to a direct measure of scholastic ability, the study finds that differences in the “long-run” family factors perceived to be important in shaping cognitive ability account for the bulk of inequality in schooling attainment in the 1991 youth cohort. However, a decline in the relative importance of family backgrounds is observed in later cohorts. The surge in the relative importance of family wealth on college enrollment could be caused by either the increasing cost of college education or by the relatively rich and academically less able individuals taking a larger share of recent increases in college enrollment.

Gambling behavior Among A dolescent and youth in Thailand : A Case Study of Young People’s Gambling Behaviours in Bangkok Area

Gambling behavior Among A dolescent and youth in Thailand : A Case Study of Young People’s Gambling Behaviours in Bangkok Area

Smoking Beliefs and Behavior Among Youth in South Korea, Taiwan, and Thailand

Beliefs about smoking are important predictors of smoking behavior among adolescents, and adolescents who hold positive beliefs about the benefits of smoking are at an increased risk of smoking initiation. An alarming fact is the rising smoking prevalence in Asian countries, particularly the increasing trend in smoking during adolescence. This cross-sectional study examined smoking beliefs and behavior among a nationally representative sample of youth in South Korea, Taiwan, and Thailand. Descriptive statistics, linear regression, and logistic regression methods were used to analyze data from 13-15-year-old adolescents who participated in the 2005 Global Youth Tobacco Survey (GYTS) in South Korea (N = 4,765) and Thailand (N = 15,420) and the 2007 GYTS in Taiwan (N = 3,955). The rate of ever smoking among youth was similar in all three countries and ranged from 26.7 to 28.0 %. The prevalence of current smoking among youth in Thailand (11.4 %) was nearly double the prevalence in South Korea (6.6 %) and Taiwan (6.5 %). Pro-tobacco advertising exposure, as well as older ages, was a positive and significant predictor of positive beliefs about smoking among youth in all three countries. Additionally, youth who reported increased positive smoking-related beliefs, greater pro-tobacco advertising exposure, and were male were more likely to be current smokers in all three countries. Results suggest that greater attention be directed to understanding beliefs and attitudes about smoking among youth. Exploring the relationship between these factors and smoking behavior can provide a strong starting point in the development of effective smoking prevention interventions and tobacco control policies in this region.

Transtheoretical model and risky sexual behaviour in HIV + youth in Thailand

The purpose of the study was to determine the applicability of the Transtheoretical Model for predicting unprotected intercourse in HIV+ Thai youth. Questionnaires and interviews about sexual behaviour, readiness to change, self-efficacy, substance use, emotional distress and social support were obtained from 70 HIV+ Thai youth (ages 17 to 25). Path analysis suggested the model was an excellent fit with the data. Readiness to change but not self-efficacy was directly related to unprotected intercourse acts. This differed from HIV+ youth in the US where self-efficacy fully mediated the relationship between readiness to change and condom use. In the Thai sample, social support and self-efficacy were indirectly related to unprotected intercourse through stage of change. Substance use was unrelated to unprotected intercourse, but rates of use were low. Potential cultural differences in the construct of self-efficacy and its relationship to risky behaviours in Thailand require further study. However, results highlight the potential of prevention interventions that increase readiness to change through boosting self-efficacy and social support specific to practicing safer sex while addressing mental health concerns.

Transgendered Youth in Thailand

Transgendered Youth in Thailand

Modification and Translation of the Thai Version of the Youth Risk Behavior Survey

The Youth Risk Behavior Survey (YRBS) has been used as a standard and updated as required for 15 years to measure risk behavior among American youth. This article discusses the modification and translation of the YRBS to be used to measure risk among youth in Thailand. The steps involved included not only modification and translation but also testing of cross-cultural equivalences (semantic, content, and conceptual) and assessment of feasibility and acceptability of the modified survey among adolescents in Thailand. The process is described and findings discussed.

Health Risk Behaviors among HIV-Infected Youth in Bangkok, Thailand

Purpose To describe health risk behaviors, including sexual risk, alcohol/substance use, and medication adherence in HIV-infected youth in Bangkok. Despite the high burden of HIV in developing countries compared with developed countries, considerably more information is available in the latter compared with the former regarding adolescent health risk behaviors. Currently there is no information on health risk behaviors among HIV-infected youth in Thailand. Methods HIV-infected Thai youth 16–25 years of age were enrolled. Participants were seen at a baseline visit and a 3-month visit to assess health risk behaviors. The interviews were completed at both visits. Results There were 29 men and 41 women. Twenty-eight participants (40%) were on antiretroviral therapy at baseline visit. Mean adherence was 94.3–98.2% over the past month and 90.9–96.3% over the past 3 months, though up to one-third reported less than 95% adherence. The proportion of youth with consistent condom use in the previous 30 days at baseline (55.6%) was comparable to the proportion at 3-month visit (58.3%) ( p = 1.0). Men were more likely to have a partner with unknown human immunodeficiency virus (HIV) status and were less likely to disclose HIV status to their partners. Forty-nine youth (70.0%) had used alcohol in the past 12 months; nine (12.9%) had used more than 20 times. Approximately 1/4 had used alcohol in the previous 30 days at baseline and at 3-month visit. Substance use besides cigarettes was uncommon. Conclusion Levels of treatment adherence were high among Thai youth receiving antiretroviral therapy. Alcohol use was prevalent, though other drug use was not. Sexual acts without a condom in both genders and nondisclosure among males were concerning. Interventions focusing on sexual risk reduction for HIV-infected youth are needed and must be scaled up in Thailand.

Changing Patterns of Drug Use among Thai Youths 1972 – 1976

This study examines changes in rates and types of drug used by youths in Thailand. It reports information collected in two separate studies, one of which was conducted in 1972 and the other, in 1976. This research met the challenge set to serious investigators by informal estimates of increasing drug use among Thai youths that were reported in the mass media. The author and his colleagues undertook to investigate systematically the magnitude of drug usage among two specific populations, students and youthful workers. A survey instrument was administered to a carefully selected sample in order to learn about their degree of personal experience with illicit drugs, their reasons for initiating experience with drugs, their knowledge about the availability of illicit drugs, the types of drugs used, the age at which young people initiate drug use, the circumstances underlying illicit drug use, and youths' reasons for not using drugs. The author has examined the social factors associated with drug use. It is concluded that drug abuse reflects manifold factors in the larger society and cannot be seen solely as a problem of youth. As a consequence, drug abuse prevention and control measures that only address a youthful audience are likely to be ineffective. Although changing patterns of drug use can be observed among Thai youths, the nature of these changes and the direction of trends do not suggest that drug abuse per se is likely to diminish.