1. Early Sexual Activity: Prevalence and Correlates Among School Adolescents in Rural Community, Central Thailand
Fifth year medical student, Phramongkutklao College of Medicine

2. Background
The prevalence of sexual activity of adolescents in urban areas were relatively higher than rural communities
Sexual activity in adolescents remains a major problem worldwide with its negative health outcomes

3. Average age of first SI throughout world
15 years
16 years
17 years
18 years
19 years
20 years
21 years
22 years
23 years
Thailand average 20 years
Ref: WHO 2011

4. Consequences of early sexual activities
Teenage pregnancy
Criminal abortion
STIs
Wellings K, Collumbien M, Slaymaker E, Singh S, Hodges Z, Patel D et al. Sexual behaviour in context: a global perspective. The Lancet. 2006;368(9548):

5. Percentage of condom used among Thai students
Department of Epidemiology of CDC in Year 2008, Ministry of Public Health

6. Incidence of STDs from unsafe sex in Thai teenagers (n=x/100,000)
Department of Epidemiology of CDC in Year 2007, Ministry of Public Health

7. Those who already had SI What did they answer?

8. Associated Factors
Individual Factors Individual sexual drive Desire for money as an exchange Environmental Factors Friends Media Couples Family
Ref: Prasartwanakit A. Sexual beliefs and patterns among Thai adolescents and youths in education ,Songkla Med J 2009;27(5): ,11

9. Environmental Factors
Ref: Prasartwanakit A. Sexual beliefs and patterns among Thai adolescents and youths in education ,Songkla Med J 2009;27(5): ,11

10. Objectives
To determine the prevalence of sexual activity among secondary school students in Chacheongsao and Sra-kaew provinces
To investigate the correlates leading to early sexual activity

14. Ethical consideration
Reviewed and approved by the Institutional Review Board (IRB) of the Royal Thai Army Medical Department

15. Results

16. General Characteristic description [N=702]
School A
chool B
Total
n(%)
Gender
Male
206(43.4)
91(40.1)
297(42.3)
Female
269(56.6)
136(59.9)
405(57.7)
Secondary school
Junior
262(55.2)
113(49.8)
375(53.5)
Senior
213(44.9)
114(50.2)
327(46.6)
Age (year)
mean±sd[min,max]
15.1±1.8[12,20]
15.1±1.8[12,19]
Parental status
Living together
313(65.9)
152(67)
465(66.2)
Another
162(34.1)
75(33)
237(33.7)

17. General Characteristic description [N=702]
School A
School B
Total
n(%)
Resident
Home
465(97.9)
221(97.4)
686(97.7)
Another
10(2.1)
4(1.7)
14(2)
Stay with
Parent
351(73.9)
152(67)
503(71.7)
124(26.1)
75(33)
199(28.3)
Income(bath)
0-499
110(23.2)
30(13.2)
140(19.9)
170(35.8)
88(38.8)
258(36.8)
≥1,000
195(41)
109(48)
304(43.3)
Grade
mean±sd[min,max]
2.7±0.6[1,4]
2.9±0.6[1,4]
2.8±0.6[1,4]

18. Prevalence of sexual activity in secondary school
Total SI = 183 (26.1%)
School A (29.8%)
School B 47(21.7 %)
Male
15(18.1%)
Female
32(23.9%)
Male
59 (30.4%)
Female 77(29.4%)

19. Prevalence of sexual intercourse of school A in each grade by gender

20. Prevalence of sexual intercourse of school B in each grade by gender

21. - Average age of first SI among secondary school students (School A and B) was 15 years old Average number of sexual partners was persons.

22. Used to have SI with any sex in early sexual activity (n=183)
Male
n(%)
Female
Heterosexual
61(92.4)
88(86.3)
Homosexual
4(6.1)
10(9.8)
Bisexual
1(1.5)
4(3.9)

23. Using drugs and substances before sex

24. Drug and substance types

25. Contraceptive methods

26. The usage of condoms in sexual intercourse

27. Knowledge of the source or condom distribution

28. Multivariate Analysis of risk factors in early sexual activity among secondary school students in rural area (n=327)
No Sexual intercourse
Sexual intercourse
Adjusted odds ratio
p-value 
n(%)
95%CI
Age* (yr)
15±2[12,18]
16±2[12,20]
1.86
( )
<0.001
Grade*
2.82±10.6[1.00,4.00]
2.70±0.61[1.00,3.80]
0.65
( )
0.016
Parents status
Living together
334(74.7)
113(25.3) 1
Others
156(69)
70(31)
1.57
( )
0.032
After adjusted for gender, wanted to have homosexual or heterosexual
*mean±sd[min,max]

29. Table**:Multivariate Analysis of risk factors in early sexual activity among secondary school students in rural area (n=327)
No Sexual intercourse
Sexual intercourse
Adjusted Odds ratio
p-value
n(%)
95%CI 
Seeing sexual intercourse of adult no
456(74.3)
158(25.7) 1
yes
15(44.1)
19(55.9)
2.35
( )
0.007
Early sexual intercourse of close friends No
283(73.9)
100(26.1)
23(38.3)
37(61.7)
3.28
( )
<0.001
Close friends substance abuse
294(71)
120(29)
Yes
12(41.4)
17(58.6)
3.04
( )
0.013

30. Discussion Literatures Review Our Research Study
Prevalence of early SI = 9.3%
Average age of first SI = 20 years
Some researches, indicating friends and substance use can both cause higher or lower prevalence of early sexual activity
Prevalence of early SI = 26.1%
Average age of first SI = 15 years
Correlates such as age, academic achievement, parental status, media, friends, and substance use shows an effect on having early sexual activity.

31. Conclusion
Prevalence of early sexual activity among secondary school students in a rural community is almost 3 times higher than generalization of students in Thailand
Average age of first sexual activity is now lower than before.

32. Conclusion Associated factors for early sexual intercourse Age
Academic achievement
Parental status
Pornography
Illegal drugs
Pressure from friends who already had early sexual activity

33. Conclusion
There are still sexually active students reported having multiple sex partners
Half of the participants reported a regular use of condoms

34. Limitation Social desirability bias
Self-report questionnaire might cause recall bias, attribution, exaggeration
Cross-sectional study can not determine temporal sequence between exposure and outcome

35. Recommendation
Interventions emphasising on the reduction of peer delinquency and substance use ought to be developed and implemented thereafter

36. Recommendation
Planning the education program and public policy for the solution of consequences of early sexual activity – teenage pregnancies, criminal abortions, and sexually-transmitted infections.

37. Thank you for your attention
adiós