Socio-cultural Context of Adolescent Sexuality of Perinatal HIV-Infected Adolescents in the Central Part of Thailand: Sexual Experience and Reproductive Health Problems

Abstract

Since HIV infection in a culturally conscious Thai population leads to social stigma and peer pressure, perinatal HIV-infected adolescents (PHIVA) form an especially vulnerable minority. Little is known about the sexuality of PHIVA in Thailand. A total of 102 PHIVA aged 15–19 years were enrolled in this cross-sectional study. Demographic, sexuality, and sociocultural context were acquired from face-to-face semi-structured interviews. Social indicators, including level of schooling, frequency of orphancy/foster care home and self-determination/right to privacy, showed that PHIVA are structurally disadvantaged in Thai society. More than 50% of PHIVA in this study have had romantic relationships. Around 30% of PHIVA had already experienced sexual intercourse. Regarding sexually active female PHIVA, 16% reported to be rape victims. Over 40% of the sexually active male and female PHIVA had a history of STDs with the majority of them showing no adequate coping strategy. The majority of sexually active PHIVA engaged in risky sexual behaviour with 60% reporting to stop antiretroviral therapy during sexual relationships and more than 50% not using a condom. At the same time 75% of PHIVA reported to prefer HIV-negative partners. In the female cohort, a history of 8 pregnancies under the age of 20 were observed, with almost 90% being unwanted. While two pregnancies were terminated by abortion, 3 out of the 6 born children to female PHIVA were HIV-positive. Thai PHIVA suffer from social discrimination and are particularly vulnerable in society. This study suggests that sexuality desire and emotional needs of PHIVA are no different from HIV-negative adolescents. However, they will need more support in reproductive health information and empowerment. Youth interventions and sexual education classes aiming specifically at the needs of PHIVA should be established.