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Background: Sexual attitudes and behaviors are important aspects of adolescent reproductive health because of the potential negative health consequences of having unsafe sex. Understanding the factors at the individual, partner, peer and family levels that influence the sexual attitudes and behaviors of youth will help us to design better health education programs for youth. Methods: A community-based cross-sectional study was conducted in 2002 among 1,200 (700 males and 500 females) young people in urban areas of Vientiane province. Both qualitative and quantitative methods were used to collect data. Focus group discussions were undertaken to explore reproductive health behavior and attitudes of unmarried youth and parent-youth connectedness and sexual communication. In total, eight focus groups with 64 participants were completed. Respondents in the survey included urban male and female youth aged 18 – 24 years selected through a multi-stage sampling design and interviewed face-to-face using a structured questionnaire. Data analysis was carried out using cross-tabulation, ANOVA, logistic regression, Cox Hazard regression and multiple linear regression. Results: Data was collected on sexual attitudes and behavior, and the socio-demographic, psychosocial and parental-interaction correlates of sexual attitudes and behavior. Key findings are highlighted below: -Less than half of male and about one-fifth of females was sexually experienced. The mean age at sexual debut was similar for males and females at 18.5 and 18.6 years respectively. .. Multiple partners and irregular condom use was reported. -Talking about sexual matters was more acceptable for males than for females. The majority of respondents held liberal sexual attitudes for males, agreeing that premarital sex is acceptable for young men in Lao society. -For males, age, attending school, education, feeling less happy and often feeling lonely were correlated with sexual attitudes and behavior, while for females, none of the socio-demographic background characteristics were correlated with sexual attitudes and behaviors. -There was a relationship between family structure variables (mother’s education, mother working, and mother living) and male sexual attitudes. None of the family structure variables were significantly related to the sexual attitudes and behavior of female youth. -There was a negative correlation between mother-son connectedness and sexual behavior; whereas for females, there was no relationship between parent-respondent connectedness and sexual attitudes and behavior. -There was a negative relation between mother-son general communication and sexual attitudes. -Father-son sexual communication was related to liberal sexual attitudes. None of parentdaughter sexual communication variables were significantly related to sexual attitudes. -There was only a negative relationship between father-son sexual communication and male youth sexual attitudes and behaviors. In contrast mother-son sexual communication was related to early onset of first sexual intercourse and a higher likelihood of having multiple sex partners. -Specific sexual communication about sexuality has more effect on behaviors such as age at first sexual intercourse and condom use then general communication. There was a significant positive relationship between father-son discussion about birth control and condom use, whereas mother-son discussion about birth control was associated with reduced odds of condom use. There was a positive association between mother-son discussions about when to start having sex and later age at first sexual intercourse. -For the set of perceived parental expectations regarding sex, only the negative correlation between perceived mother disapproval of sex and sexual attitudes of female youth was statistically significant. -Several factors of intimate relationships and peer influence were strong predictors of sexual attitudes and behavior for both males and females. The results of this study point to the complexity of parent-youth interaction and the interrelationship between parenting processes and youth sexual attitudes and behavior. The model incorporating the full range of variables was able to explain significantly more variation in sexual attitudes and behavior compared to more restricted models. Conclusion: The findings indicate that sex education needs to take into account the influence of gender norms on the attitudes and behaviors of boys and girls in terms of their relationships. A gender specific approach to sex education is needed because of the difference between boys and girls in sexual attitudes and behaviors. Recommendations are made for developing and implementing sex education programs by involving parents in the prevention programs, enhancing parent-youth connectedness, providing timely and accurate information to their children, promoting youth’s responsibility for their sexual health and helping the youth to build skills to protect their sexual health. |
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