title: Risk factors for sexually transmitted diseases in northern Thai adolescents: an audio-computer-assisted self-interview with noninvasive specimen collection.
abstract: BACKGROUND
  Previous studies of sexual behavior and sexually transmitted diseases (STDs) in Thai adolescents may have been limited by participation bias and underreporting of stigmatized behaviors.
  
  
  OBJECTIVE
  The goal was to increase knowledge about risk behaviors and STDs among youths in Thailand.
  
  
  METHODS
  Students aged 15 to 21 years completed an audio-computer-assisted self-interview. Oral fluid was tested for HIV antibodies and urine was tested for Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acids with polymerase chain reaction.
  
  
  RESULTS
  Of 1736 invited students, 1725 (99.4%) agreed to participate. Overall, C trachomatis infection was detected in 49 (2.8%), and there were five cases (0.3%) each of infection with N gonorrhoeae and HIV. Among those who reported sexual intercourse, the prevalence of chlamydial infection was 3.7% among men and 6.1% among women. Logistic regression analysis showed age-adjusted factors associated with chlamydial infection among men to be parents' occupation in agriculture, having sold sex, having a sex partner who had been pregnant, and the number of casual sex partners during lifetime. Among women, age-adjusted factors were parents' occupation in agriculture, number of casual partners during lifetime, having an older sex partner, and perception of higher HIV infection risk.
  
  
  CONCLUSIONS
  These adolescents had high rates of unprotected intercourse and are at risk for STDs. Prevention programs should emphasize use of effective contraceptive methods, including condom use; reducing the number of sex partners (stressing the risk a partner of older age may pose to female adolescents); and reducing engagement in commercial sex.
authors.affiliation: Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Bailey
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kilmarx
authors.forename: Somsak
authors.initials: S
authors.lastname: Supawitkul
authors.forename: Thanyanan
authors.initials: T
authors.lastname: Chaowanachan
authors.forename: Supaporn
authors.initials: S
authors.lastname: Jeeyapant
authors.forename: Maya
authors.initials: M
authors.lastname: Sternberg
authors.forename: Lauri
authors.initials: L
authors.lastname: Markowitz
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Mastro
authors.forename: Frits
authors.initials: F
authors.lastname: Van Griensven
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D000328:Adult; D000367:Age Factors; D001296:Audiovisual Aids; D003201:Computers; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D012309:Risk-Taking; D012731:Sex Counseling; D012737:Sex Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D013048:Specimen Handling / Q000379:methods; D011795:Surveys and Questionnaires; D013785:Thailand / Q000453:epidemiology