The development of HIV/AIDS preventive model in Akha hill tripe people in Thailand

INTRODUCTION:  HIV/AIDS has been identified as a major health problem in Thaliand for a triple of decades. The main route of tramsmission is unprotected sexual intercourse. In 2012, the youths have been reported as the highest of risk populations. Akha is one of the hilltribe people who were migrated from south China duirng last 150 years, with almost 1,600,000 people in 2013. They are living with unavailability to access public services such as educational and health systems. This reasech aimed to assess the risk behaviors and to develop the apporpriate preventive model among Akha youths in the communitu level.

METHODS: This operational research was conducted and divided into two phases: the first phase aimed to determine the risk behaviors used a cross-sectional study design, following by the community participatory research design to develop the HIV/AIDS preventive model among the Akha youths. The instruments were composed of completed questionnaires and assessment forms that were tested for validity and reliability before use. Study setting was Jor Pa Ka and Saen Suk Akha villages, Mae Chan District, Chiang Rai, Thailand. Study sample were the Akha youths lived in the villages. Means and Chi-square test were used for the statistical testing. 

RESULTS:

Akha youths in the population mobilization villages live in agricultural families with low income and circumstance of narcotic drugs. The average age was 16 (50.00%), 51.52% Christ, 48.80%completed secondary school, 43.94%had annual family income 30,000-40,000 baht. Among males, 54.54%drank, 39.39%smoked, 7.57% used amphetamine, first sexual intercourse reported at 14 years old, 50.00%had 2-5 partners, 62.50%unprotexted sex (no-condom). Reasons of unprotected sex included not being able to find condoms, unawareness of need to use condoms, and dislike. 28.79% never been received STI related information, 6.06 % had STI. Among females, 15.15% drank, 28.79% had sexual intercourse and had first sexual intercourse less than 15 year old. 40.00% unprotected sex (no-condom), 10.61%never been received STI related information, and 4.54% had STI. The HIV/AIDS preventive model contained two components. Peer groups among the youths were built around interests in sports. Improving knowledge would empower their capability and lead to choices that would result in HIV/AIDS prevention. The empowering model consisted of 4 courses a. Human reproductive system and its hygiene, b. Risk-avoid skills, family planning, and counseling techniques, c. HIV/AIDS and other STIs, d. Drugs and related laws and regulations. The results of the activities found that youths had a greater of knowledge and attitude levels for HIV/AIDS prevention with statistical significance (2-test = 12.87, p-value= 0.032 and 2-test = 9.31, p-value<0.001 respectively). 

CONCLUSIONS:

A continuous and initiative program development for supoort youths' capability is the appropriate process to reduce the spread of HIV/AIDS, particularly in the population who have the specific of language and culture.