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The Elephant in the Room: Adolescent Sex Education in Thaila

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Margaret Critchlow

on 19 September 2013

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Transcript of The Elephant in the Room: Adolescent Sex Education in Thaila

The Elephant in the Room: Adolescent Sex Education in Thailand
By Eryka Crittendon and Maggy Critchlow
The need for sex education
History of Sex Education
1938 - first government plan for sex education introduced, but not a subject in school until 1978
1974 - Mechai Viravaidya established the Population and Community Development Association (PDA)
Goal was family planning for Thailand's poor
Worked by destigmatizing condom use, making condoms as common as cabbages in villages
Program considered successful, with average family size decreasing from 7 in 1974 to less than 2 in 2005
1984 - first HIV case reported in Thailand
1990s - HIV prevention campaigns began, with public awareness media from Mechai's group, AIDS education in school, and education and condom distribution for CSWs
These measures were very successful, saving estimated millions of lives
Programs were also implemented to decrease vertical transmission of HIV
Awareness (and stigma) of the danger of HIV were very high
1999-2002 While HIV incidence has decreased significantly in the Thai population, it has increased 6% in youth in these three years
With increase in availability of ARVs, Thais live longer, making HIV seem like less of a risk
Other STI rates and unwanted pregnancies are high among adolescents, likely because of low rates of condom use
Presently, HIV rates are still high in young people, and they represent the majority of the new cases
However, risky behavior is still common, such as lower age for first intercourse (15, compared to 17-18 in earlier generations), as well as having multiple partners
Condom use remains low among adolescents
Cultural barriers
Impact on Health and Healthcare
Strategies for sex education
The US vs Thailand: Similarities
What's next?
concern that comprehensive sex education leads to increased sexual activity

heavy presence of sex in media, yet culturally conservative

high rates of STDs, unwanted pregnancy
strong emphasis on abstinence, some abstinence only

responsibility of schools and parents

abstinence based in religion
HIV/AIDS prevention is emphasized

responsibility of community, including NGOs, and parents

abstinence based in culture
United States
Test Your Knowledge: True/False
IV drug users are at the highest risk of HIV infection. T/F
Condom use in adolescents is around 50%. T/F
Parents are reluctant to talk to their children about sex, worrying that educating them will cause them to have sex earlier. T/F
Thailand has the highest prevalence of HIV in Southeast Asia. T/F
Adolescents are very knowledgeable about sex and don't believe many common myths about contraception or first times. T/F
Thailand's conservative culture makes many parents feel uncomfortable about discussing sex. T/F
Combining education with condom distribution has been very successful in both family planning and reducing HIV. T/F
Thailand has highest HIV prevalence in SE Asia, with adolescents and young adults currently the most at-risk
It has the second highest number of teen pregnancies worldwide
Median age of first intercourse is 15, with multiple partners becoming more common among youth
85% of men don't use condoms when having sex
Emergency contraception (EC) is a common form of birth control
Studies show much misinformation about sex, with many teens getting their information from friends and the media
HIV and other STDs place a significant financial burden on the universal healthcare system
Unwanted pregnancies can be physically and emotionally damaging, and can limit opportunity for adolescents, especially women
There are also social repercussions for some Thai women who are unwed mothers
Using media as main source of information leads to unrealistic and sometimes incorrect ideas of sex
Comprehensive sex education actually delays onset of sexual activity and increases safe sex practices
Goal: zero new infections for HIV by 2016 through better sex education
There is motivation among parents and educators for better sex education
More consistent condom use is essential for lowering rates of STDs, unwanted pregnancy
Giving teens the opportunity to have their questions answered from reliable sources is essential for stopping misinformation
Make safe sex the norm, and an expectation for adolescents
For Parents
Lacking in their own education, little knowledge of sexual health
Concerns of encouraging sexual activity
Generation gap - behavior has changed significantly recently
Feeling like it is not their responsibility
For Educators
Criticism from parents/community leaders for teaching comprehensive education
Cultural taboo causes discomfort in discussing sex
Mainly responsible for providing education
For Communities
For Adolescents
Changing society that is strongly influenced by Western culture
Children taught to respect and not question elders
Misinformation perpetuated by friends and media
Mixed messages from family, society and themselves
Considered taboo to talk about sex openly
Sexual attitudes have changed dramatically within last century
Increased gender equality over time
Elders must be respected and revered, under Buddhist culture
For Parents
For Educators
For Communities
For Adolescents
Health educators teach parents how to talk to their children about sex
In studies, parents expressed their desire to have honest communication with their children
Understand generational differences
Training programs ensure that educators are teaching correct information
Integrate into existing Family and Life Studies courses decreases controversy
Focus on importance of reducing HIV rates
Educate both teens and their parents
Host classes for both parents and adolescents
Increase access to condoms, educate on correct useage and ensure everyone understands
Work to make discussing sex less taboo
Understand changing culture
Peer education opportunities
Integrate parents with education
Provide accurate resources
Emphasize risks of unsafe sex
Boonmongkon, Pimpawun. "Sexuality Education in Thailand: How Far Do We Need to Go?" Arrows for Change (2009): n. pag. Web. 5 Sept. 2013.

Chaijitvanit, Somkid. "Talking about Sex in the Classroom." Bangkok Post [Bangkok] 4 Sept. 2007. Web. 5 Sept. 2013.

Fongkaew, Warunee, Kangwan Fongkaew, and Marjorie Muecke. "HIV/Sexual and Reproductive Health Program for HIV Prevention: The Youth/Adult Partnership with Schools Approach." Journal of Medical Association Thailand 89.10 (2006): 1721-732. Web. 19 Sept. 2013.

Hodal, K. (2012 March 20). Thailand struggles to teach the basics of sex education to students. The Guardian.

Sridawruang, C. (2011). The Involvement of Thai Parents in the Sex Education of their teenage children: A mixed methods study. Faculty of Health, School of Nursing and Midwifery, University of East Anglia

Sridawruang, C Pfeil, M & Croizer K. (2010, November). Why Thai parents do not discuss sex with their children: A qualitative study. Faculty of Health, School of Nursing and Midwifery, University of East Anglia.

Vuttanont, U. (2010, January). “Smart Boys” and “Sweet Girls” – Sex Education Needs in Thai Teenagers: A Mixed-Method Study. University College of London.
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