Sexual risk behaviour and its correlates among adolescents in Indonesia, Laos, Thailand and Timor-Leste: results from national school surveys in 2015

Objectives: The study aimed to assess the prevalence and correlates of sexual risk behaviours among adolescents in four Southeast Asian countries.

Methods: In the cross-sectional "Global School-Based Student Health Survey (GSHS)", 24,423 adolescents (mean age 14.1 years, SD=1.7) from Indonesia, Laos, Thailand and Timor-Leste responded to a questionnaire in 2015.

Results: Overall, 8.5% of the students (11.0% males and 6.3% females) ever had sex, ranging from 5.3% in Indonesia to 26.4% in Timor-Leste. Among the sexually active, 49.3% (55.9% males and 36.8% females) had their first sexual intercourse before the age 14 years, ranging from 16.1% in Laos to 73.9% in Indonesia, 59.7% (62.6% males and 53.5% females) had multiple sexual partners, ranging from 55.5% in Timor-Leste to 63.4% in Indonesia, 46.9% (46.8% males and 46.5% females) did not use a condom at last sex, ranging from 37.0% in Thailand to 65.3% in Indonesia, 49.8% (53.7% males and 43.7% females) had not used or did not know of the use of birth control at last sex, ranging from 40.6% in Thailand to 61.5% in Timor-Leste, and 54.2% (54.9% males and 47.0% females) engaged in multiple sexual risk behaviour, ranging from 45.9% in Laos to 78.0% in Indonesia. In adjusted logistic regression analysis, male sex, older age, food insecurity, tobacco use, alcohol use, ever cannabis and/or amphetamine use, psychological distress, and school truancy were associated with two or more and/or multiple sexual risk behaviours.

Conclusions: A high proportion of students engaged in various sexual risk behaviours calling for a scale up comprehensive sexuality education and integration of substance use and mental health into such intervention programmes in this adolescent school population.