"Smart boys" and "sweet girls - sex education needs in Thai teenagers: a mixed-method study

This study aimed to inform the redesign of sex education policy in Chiang Mai (Thailand) by exploring the knowledge and attitudes of teenagers, parents, teachers, and policy makers and placing these in the wider social, cultural, educational, and economic context of modern-day Thailand. Six selected secondary schools with diverse characteristics in socioeconomic and religious backgrounds and locations were studied. This mixed method study included: semi-structured interviews and narrative interviews with 18 key stakeholders; analysis of 2 key policy documents; a survey of 2301 teenagers; 20 focus groups of 185 teenagers; a survey of 351 parents; one focus group of 8 teachers; and two focus groups of 23 parents. Qualitative and quantitative data were assessed separately with thematic and statistical analysis, respectively, and outcomes were compared, combined and discussed. Results suggested: school-based sex education was biologically focused and inconsistently delivered. Chiang Mai teenagers showed a reasonable knowledge of biological issues around reproduction but were confused and uncertain about how to obtain or use contraception, avoid pregnancy and transmission of STIs, negotiate personal and intimate relationships and find sources of support and advice. Many parents and teachers lacked the knowledge, confidence, and skills to offer meaningful support to their children. Five important influences on Chiang Mai teenagers' sexual attitudes and behaviours were noted in this research: ambiguous social roles leading to confused identity, heightened sexual awareness and curiosity, critical gaps in knowledge and life skills, limited parental input, and an impulsive and volatile approach to intimate encounters. Results of this study suggest several possibility approaches that could be developed to improve sex education

Coital Experience Among Adolescents in Three Social-Educational Groups in Urban Chiang Mai, Thailand

This article compares coital experience of Chiang Mai 17–20-year-olds who were: (1) out-of-school; (2) studying at vocational schools; and (3) studying at general schools or university. Four-fifths, two-thirds and one-third, respectively, of males in these groups had had intercourse, compared to 53, 62 and 15 per cent of females. The gender difference for general school/university students, but not vocational school students, probably reflects HIV/AIDS refocusing male sexual initiation away from commercial sex workers. Vocational school females may have been disproportionately affected. Loss of virginity was associated, for both sexes, with social-educational background and lifestyle, and was less likely in certain minority ethnic groups. Among males, it was also associated with age and parental marital dissolution, and among females, with independent living and parental disharmony. Within social-educational groups, lifestyle variables dominated, but among general school/university students, parental marital dissolution (for males) and disharmony (for females) were also important, and Chinese ethnicity deterred male sexual experimentation

"Smart boys" and "sweet girls"--sex education needs in Thai teenagers: a mixed-method study.

BACKGROUND: In Thailand, rapid increases in economic prosperity have been accompanied by erosion of traditional cultural and religious values and by negative effects on sexual health of young people. We investigated knowledge, attitudes, norms, and values of teenagers, parents, teachers, and policymakers in relation to sex and sex education in Chiang Mai, Thailand, with a view to informing sex education policy. METHODS: We selected six secondary schools for maximum variation in socioeconomic background, religious background, and location. Methods were: narrative interviews with key stakeholders, and analysis of key policy documents; questionnaire survey of 2301 teenagers; 20 focus groups of teenagers; questionnaire survey of 351 parents; and two focus groups of parents. Qualitative and quantitative data were assessed separately with thematic and statistical analysis, respectively, then combined. FINDINGS: We noted five important influences on Thai teenagers' sexual attitudes and behaviour: ambiguous social roles leading to confused identity; heightened sexual awareness and curiosity; key gaps in knowledge and life skills; limited parental input; and impulsivity and risk-taking. Male teenagers aspire to be "smart boys", whose status depends on stories of sexual performance and conquests. Female teenagers, traditionally constrained and protected as "sweet girls", are managing a new concept of dating without their parents' support, and with few life skills to enable them to manage their desires or negotiate in potentially coercive situations. School-based sex education is biologically focused and inconsistently delivered. INTERPRETATION: Results of this large exploratory study suggest five approaches that could be developed to improve sex education: targeted training and support for teachers; peer-led sex education by teenagers; story-based scenarios to promote applied learning; local development of educational materials; and use of trained sexual health professionals to address learning needs of pupils, teachers, and parents

"Smart boys" and "sweet girls"--sex education needs in Thai teenagers: a mixed-method study.

BACKGROUND: In Thailand, rapid increases in economic prosperity have been accompanied by erosion of traditional cultural and religious values and by negative effects on sexual health of young people. We investigated knowledge, attitudes, norms, and values of teenagers, parents, teachers, and policymakers in relation to sex and sex education in Chiang Mai, Thailand, with a view to informing sex education policy. METHODS: We selected six secondary schools for maximum variation in socioeconomic background, religious background, and location. Methods were: narrative interviews with key stakeholders, and analysis of key policy documents; questionnaire survey of 2301 teenagers; 20 focus groups of teenagers; questionnaire survey of 351 parents; and two focus groups of parents. Qualitative and quantitative data were assessed separately with thematic and statistical analysis, respectively, then combined. FINDINGS: We noted five important influences on Thai teenagers' sexual attitudes and behaviour: ambiguous social roles leading to confused identity; heightened sexual awareness and curiosity; key gaps in knowledge and life skills; limited parental input; and impulsivity and risk-taking. Male teenagers aspire to be "smart boys", whose status depends on stories of sexual performance and conquests. Female teenagers, traditionally constrained and protected as "sweet girls", are managing a new concept of dating without their parents' support, and with few life skills to enable them to manage their desires or negotiate in potentially coercive situations. School-based sex education is biologically focused and inconsistently delivered. INTERPRETATION: Results of this large exploratory study suggest five approaches that could be developed to improve sex education: targeted training and support for teachers; peer-led sex education by teenagers; story-based scenarios to promote applied learning; local development of educational materials; and use of trained sexual health professionals to address learning needs of pupils, teachers, and parents