Factors Associated with Risky Sexual Behavior among Unmarried Most-At-Risk Young People in Cambodia

Background: Recent surveys suggest that adolescents and young adults in Southeast Asian nations are at great risks of sexual reproductive health issues. This study explored factors associated with risky sexual behavior (RSB) among unmarried most-at-risk young people in Cambodia. Methods: A two-stage cluster sampling method was used to select 1,204 boys and 1,166 girls aged 10-24 from 252 hotspots in the capital city and seven provinces. A five-item scale was constructed to measure RSB. All variables were entered simultaneously in multivariate logistic regression models if they were significantly associated with RSB in bivariate analyses. Results: Of total, 37.7% of boys and 18.5% of girls had sexual intercourse in the past three months; of them, 69.6% of boys and 52.5% of girls were involved in commercial sex. Only 43.3% of boys and 6.5% of girls reported always using condom with unpaid regular partners in the past three months. Among sexually active girls, 43.5% reported having been pregnant and of them, 42.4% reported having induced abortion as a result of their most recent pregnancy. After adjustment, boys with higher levels of RSB were significantly more likely to live in an urban area, to have completed ≥ 9 years of formal education, and to be not currently living with parents. In contrast, girls with higher levels of RSB were significantly less likely to have completed ≥ 9 years of formal education and to have both parents alive. Both boys and girls with higher levels of RSB were significantly more likely to be in the age group of 20-24, to be not currently in school, to be employed, to be current alcohol drinkers, to be current heavy alcohol drinkers, to be current illicit drug users, and to have been tested for HIV. Conclusions: Unmarried young people in this study are exposed to several sexual reproductive health problems such as HIV and sexually transmitted infections, unwanted pregnancy, and unsafe abortion. These findings suggest the need for research and prevention programs for these key populations taking into account risk factors identified in this study

Youth Paying for Sex: What Are the Associated Factors? Findings from a Cross-Sectional Study in Cambodia

BACKGROUND: At-risk male youth in Cambodia who purchase sex are at greater risk for HIV compared to the general population. Factors associated with paying for sex among youth are poorly studied, both globally and in Cambodia. This study aimed to identify specific factors associated with transactional sex with women among most-at-risk male youth in Cambodia. METHODS: This cross-sectional questionnaire survey was conducted with 405 sexually active male youth aged 16-24 recruited at \u27hotspots\u27 in the capital city of Phnom Penh and seven provinces. We collected data on demographic factors, sexual behaviors, HIV testing and other potential factors. Multivariable logistic regression analysis was used to identify factors associated with transactional sex. RESULTS: In total, this study included 405 male youth with a mean age of 21.3 (SD = 2.2). Of the total respondents, 82.5% (n = 334) have ever paid for sex. After controlling for potential confounding, participants who purchased sex in the last 12 months remained significantly more likely to be older than 18 (AOR = 3.60, 95% CI = 1.26-10.62), reside in an urban area (AOR = 2.29, 95% CI = 1.24-4.20), never have been married (AOR = 9.58, 95% CI = 4.34-21.12), spend less than 2.55 USD per day (AOR = 2.22, 95% CI = 1.12-4.40), and have had more than 4.6 sexual partners in the past year (AOR = 16.73, 95% CI = 4.71-59.36). CONCLUSIONS: This study highlights the high proportion of Cambodian male youth who paid for sex and the potential challenges to addressing this issue. While the majority of HIV prevention interventions surrounding sex work are aimed at female sex workers themselves, targeting the demand side of sex work, particularly the local demand, may be an important next step towards a sustainable HIV prevention

Youth paying for sex: what are the associated factors? Findings from a cross-sectional study in Cambodia

10.1186/s12889-017-4999-8BMC PUBLIC HEALTH18

Youth paying for sex: what are the associated factors? Findings from a cross-sectional study in Cambodia

Abstract Background At-risk male youth in Cambodia who purchase sex are at greater risk for HIV compared to the general population. Factors associated with paying for sex among youth are poorly studied, both globally and in Cambodia. This study aimed to identify specific factors associated with transactional sex with women among most-at-risk male youth in Cambodia. Methods This cross-sectional questionnaire survey was conducted with 405 sexually active male youth aged 16–24 recruited at ‘hotspots’ in the capital city of Phnom Penh and seven provinces. We collected data on demographic factors, sexual behaviors, HIV testing and other potential factors. Multivariable logistic regression analysis was used to identify factors associated with transactional sex. Results In total, this study included 405 male youth with a mean age of 21.3 (SD = 2.2). Of the total respondents, 82.5% (n = 334) have ever paid for sex. After controlling for potential confounding, participants who purchased sex in the last 12 months remained significantly more likely to be older than 18 (AOR = 3.60, 95% CI = 1.26–10.62), reside in an urban area (AOR = 2.29, 95% CI = 1.24–4.20), never have been married (AOR = 9.58, 95% CI = 4.34–21.12), spend less than 2.55 USD per day (AOR = 2.22, 95% CI = 1.12–4.40), and have had more than 4.6 sexual partners in the past year (AOR = 16.73, 95% CI = 4.71–59.36). Conclusions This study highlights the high proportion of Cambodian male youth who paid for sex and the potential challenges to addressing this issue. While the majority of HIV prevention interventions surrounding sex work are aimed at female sex workers themselves, targeting the demand side of sex work, particularly the local demand, may be an important next step towards a sustainable HIV prevention

‘Fit for school’ – a school-based water, sanitation and hygiene programme to improve child health: Results from a longitudinal study in Cambodia, Indonesia and Lao PDR

Abstract Background The Fit for School (FIT) programme integrates school health and Water, Sanitation and Hygiene interventions, which are implemented by the Ministries of Education in four Southeast Asian countries. This paper describes the findings of a Health Outcome Study, which aimed to assess the two-year effect of the FIT programme on the parasitological, weight, and oral health status of children attending schools implementing the programme in Cambodia, Indonesia and Lao PDR. Methods The study was a non-randomized clustered controlled trial with a follow-up period of two years. The intervention group consisted of children attending public elementary schools implementing the FIT programme, including daily group handwashing with soap and toothbrushing with fluoride toothpaste, biannual school-based deworming; as well as construction of group handwashing facilities. Control schools implemented the regular government health education curriculum and biannual deworming. Per school, a random selection of six to seven-year-old grade-one students was drawn. Data on parasitological infections, anthropometric measurements, dental caries, odontogenic infections and sociodemographic characteristics were collected at baseline and at follow-up (24 months later). Data were analysed using the χ2-test, Mann Whitney U-test and multilevel logistic and linear regression. Results A total of 1847 children (mean age = 6.7 years, range 6.0–8.0 years) participated in the baseline survey. Of these, 1499 children were available for follow-up examination – 478, 486 and 535 children in Cambodia, Indonesia and Lao PDR, respectively. In all three countries, children in intervention schools had a lower increment in the number of decayed, missing and filled permanent teeth between baseline and follow-up, in comparison to children in controls schools. The preventive fraction was 24% at average. The prevalence of soil-transmitted helminth infection (which was unexpectedly low at baseline), the prevalence of thinness and the prevalence of odontogenic infections did not significantly differ between baseline and follow-up, nor between intervention and control schools. Conclusions The study found that the FIT programme significantly contributed to the prevention of dental caries in children. This study describes the challenges, learnings and, moreover, the importance of conducting real-life implementation research to evaluate health programmes to transform school settings into healthy learning environments for children. The study is retrospectively registered with the German Clinical Trials Register, University of Freiburg (Trial registration number: DRKS00004485, date of registration: 26th of February, 2013)