Cambodia Journal of Public Health (CJPH) of the School of Public Health at NIPH

Phearak Rin¹, Heng Sopheab¹, Sodara Chan¹

1. School of Public Health, the National Institute of Public Health, Ministry of Health, Phnom Penh, Cambodia

*Corresponding author: Phearak Rin, Email: phearakrin@gmail.com

THESIS ABSTRACT:

Introduction

Risky sexual behaviours play a significant role in devastating HIV epidemic. Young people’s lack HIV related knowledges are vulnerable to sexual risk behaviours and potentially lead to HIV infection among themselves and their sexual partners. Commonly, young men have greater intention of unsafe sexual practices and are more likely to have more sexual partners, use paid sex services and use condom inconsistently compared with young women. This study aimed to assess the trend of multiple sexual risk behaviours (HIV-SRB) and its determinants among young men aged 15‒24 in Cambodia.

Methods

This serial cross-sectional study used data from Cambodia Demographic and Health Survey (CDHS) 2005, 2010 and 2014 to analyse the trend of HIV SRB and its determinants. We used Stata V12 to manage and analyse the data. Sampling weight was used to compensate for the two-stage stratified cluster sampling. Chi-square test for trend was used to assess HIV SRB linear trend. Multivariable logistic regression was used to determine independent effects between HIV SRB and its predictors. Statistically significant level was set at p-value < 0.05.

Results

In total, there were 2884, 3265 and 1760 young men aged 15-24 from CDHS 2005, 2010 and 2014 respectively. At least 22.0% of young men reported sexually active across CHDS years. Young men reported decline of HIV SRB about half from 2005 (17.5%) to 2010 (9.5%), then levelling off at 9.3% in 2014 without further decline. Main determinants of HIV SRB were more likely to be non-married (AOR=4.8, 95% CI: 2.8–8.4), be in  high wealth index scores (AOR=2.0, 95% CI: 1.3–3.3), and have a history of mobility in the past 12 months (AOR=2.4, 95% CI: 1.5–3.8). Youth who reported more discriminatory attitude toward HIV patients was likely to reduce significantly their HIV SRB about 30.0% (AOR=0.7, 95% CI: 0.5–0.9).

Conclusions

An integrated HIV and sex education program should be conducted specifically among non-married  male youth, youth with history of mobility with the focus on knowledge, attitude and practice toward multiple sexual risk behaviours linked to HIV transmission. Program intervention on male youth should be prioritized based on these key determinants where feasible, given the limited national budget and other main priorities.  Future study should explore to confirm the future trend of HIV SRB and youth discriminatory behaviours when future CDHS data available.