Laos Young Womens Sexual Behaviour
Reported, December 24, 2011
Lao PDR is currently considered to be a low HIV prevalence country, with 0.1% of adults aged 15-49 years estimated to be HIV infected in 2007 . However, Laos remains vulnerable to the spread of HIV as a result of a number of risk factors,including low condom usage and the country?s proximity to and interaction with other high prevalence countries in the region. By mid 2007, 2182 HIV infected persons,1347 AIDS cases and 731 HIV related deaths had been reported .Of the reported cases, 58% were men and 42% were women. Forty-three percent of infections were found in people aged 15 to 29 years and the majority (85%) was sexually transmitted.
The opening up of Lao PDR to the world has resulted in the country becoming increasingly mainstreamed into regional and international networks. Consequently, urban youth culture is rapidly evolving, influenced by continued exposure to a variety of foreign cultures. The evolving youth culture and its implications on the sexual behaviour of young people are poorly understood, and currently identified as an outstanding information gap.
At the same time, current surveillance data provide critical insights into the dynamics of the HIV epidemic. At the global level, HIV has been observed to be impacting more on women than men, a phenomenon now referred to as the feminization of HIV. Women account for a substantial proportion of HIV infections among young people between the ages of 15 to 24 years.
In 2004, Burnet Institute conducted a study on young men?s sexual behaviour in Vientiane, with support from The Royal Netherlands Embassy in Bangkok. One important finding was that most young, sexually active, unmarried men in Vientiane reported that they did not pay for sex. Nevertheless, they said that they were able to find female sex partners relatively easily. These findings emerged from both the quantitative survey and the focus group discussions held with young men. The implication was that a significant proportion of young women in Vientiane are having sex before marriage, and that these sexual relationships do not involve the exchange of money or favours.
The Government of Lao (GoL), and in particular the Centre for HIV, AIDS and STIs (CHAS) and the Lao Youth Union (LYU), found this study useful when it came to understanding male sexuality in Vientiane and designing national responses to the epidemic. Both CHAS and the LYU requested that the Burnet Institute conduct a similar study on the sexual behaviour of young women in Vientiane.
A study of urban young women?s sexual behaviour was therefore designed to contribute to the understanding of the nature and extent of young people?s high risk sexual behaviours. This study will also supplement data already generated by recent UNFPA reproductive health surveys. Moreover, the information will assist both governmental and non-governmental development partners to design, plan, and/or
strengthen interventions, specifically HIV, AIDS and sexual and reproductive health (SRH) activities, targeting young urban females.
Vientiane capital, located on the bank of the Mekong River, shares a border with Thailand to the west. It is the largest city in Laos, with a population of 695,473 (2005). Vientiane, the center of culture, commerce and administration in the Lao PDR, possesses a diversity of light industry including garment factories, is a
significant trading centre, and has an expanding service sector including restaurants and hotels. It is attractive not only to visiting foreigners, but also to young Lao who migrate to the city in search of work.
In total, 15 focus group discussions and 13 in-depth interviews were conducted, and observations undertaken of young women in entertainment venues and public parks.Twelve FGDs were conducted with general? young women: 3 with students (from school, college and university), 2 with beer-shop customers, 2 with garment factory workers, 2 with women recruited from public places (shopping centre and an outdoor
recreation area), 2 with hotel/entertainment venue staff, and 1 with women from the
military. In addition, 2 FGDs were undertaken with service women from small drinkshops, and 1 with self-identified lesbians.
Thirteen in-depth interviews were conducted. Of these, 6 interviews were undertaken with general young women; 2 with clients at beer-shops, 2 with university students, and 2 with garment factory workers. Of the remaining 5 interviews, 2 were conducted with service women at small drink-shops, 3 with mobile
service women, and 2 with lesbians.
During the quantitative data collection, a total of 1009 young women were approached by field researchers, of whom 832 (82.5%) agreed to participate in the survey. Reasons given by women for refusal included: not having sufficient time;shyness; and concern that the place of recruitment was too public. Of the 832
questionnaires collected, twenty were excluded from analyse because they were largely incomplete or because the participant was found to be ineligible. This left 812 questionnaires for analysis.
Questionnaire participants were recruited from homes, dormitories and villages (20.8%); garment factories (14.2%); other workplaces (3.7%); restaurants (13.8%);the boat racing festival (11.5%); shops, markets or shopping centres (10.1%); parks and other public places (8.0%); schools and colleges (9.5%); entertainment venues (8.3%) and other places (0.2%). Eighty-eight percent of participants self-administered the questionnaire; the remaining questionnaires were interviewer administered.
Sexual experiences
A total of 26.5% of the survey participants reported having had sex (either vaginal sex with a man or sex with a woman). Sexual experiences were not confined to married respondents; 19.2% of unmarried young women reported having had sex, thus indicating that a significant proportion of young women in Vientiane do engage in pre-marital sex.
The proportion of young women who reported having had vaginal sex did not differ significantly when living arrangements were compared; 17.4% of young women living with their families as compared to 17.6% of young women either living alone or shared accommodation with friends or hostels.
As might be expected, the proportion of females who reported sexual experience increased with age. Nonetheless, it was also found that younger women were engaging in sex. Of participants aged 15-19 years, 13% reported having had vaginal sex, as compared to 36.5% of 20-24 year olds.
Nature of sexual practices
Among survey participants, vaginal sex was the most commonly reported sexual practice (25% of all women surveyed. However, women also reported a variety of other sexual practices, most commonly touching a partners genitals or being touched on the genitals (18.1% and 18.6% respectively). Sex between the
thighs (11.5%), and giving and receiving oral sex (6.4% and 7.1%, respectively) were less commonly reported, while anal sex (2.3%) was only reported occasionally.
However, it is of note that any non-penetrative sexual experience (apart from kissing) was only rarely reported by survey participants who had not also had either vaginal sex or sex with another female. Genital touching and giving oral sex were reported by only 1.5% and 0.2% of women who had not also engaged in vaginal sex or sex with another woman.
These quantitative findings were in accordance with the qualitative findings. During the Focus Group Discussions, women reported that vaginal intercourse (front door sex) is the most common sexual practice. They said that vaginal sex indicates mutual respect as it is soft and not violent. FGD participants explained that when they first meet a sexual partner, most women will only have vaginal sex, primarily because
they are shy about doing anything else. They also reported concerns about how new partners might perceive them if they engaged in anything other than vaginal sex.
One young woman made the following comment: I only had vaginal sex with my partner because I had no experience and was very shy. Also, if I practiced several styles of sexual activity he might think that I was sexually active and had had multiple sexual partners and then he would avoid me and not marry me.
However, during the discussions the young women did say that, after having known their partners for some time, they would be more likely to engage in longer sessions of sexual activity and to perform other sexual acts, including oral sex, anal sex (back door), and sex between the thighs. They young women was explained that these days young people learn new styles of sexual activity from pornographic films as well
as from their peers.
Focus group discussion participants noted that as women become more sexually experienced, they would be more likely to have anal or oral sex, in an effort to increase their own pleasure as well as their partners, and also to avoid pregnancy.
The women commented that oral sex can be pleasurable and is often used, either as the principal form of sexual expression or as part of foreplay. Some women said that when oral sex is performed on a man by a woman on her knees, there is a feeling of domination by the man, which some of them claimed to enjoy. They also believed that oral sex provides more enjoyment to a man because the mouth is tighter than
the vagina. Participants said that almost all men would use their fingers to stimulate the sexual organs of women. Some of the women mentioned a belief that if a woman swallows semen it would make her appear younger.
During the focus group discussion conducted with service women, many participants reported having performed oral sex, particularly with older clients, when oral sex, touching and kissing are used as techniques to stimulate erections. Following this, normal vaginal sex would usually follow.
Sexual partners
In total, 25.8% of survey participants reported having had a sexual partner in the last six months. For the group of married, separated or divorced women, this figure was 100%; for unmarried women it was 18.9%. The proportion of young women living with their families who had had a male partner in the previous six months (15.9%) was similar to that of young women who lived either alone or in shared
accommodation (17.2%). Among the sexually active unmarried women in the sample, 52.4% of those living alone or in shared accommodation (22 out of 42 women) reported having had more than one male partner in the previous six months,while only 27.4% (23 out of 84 women) of those living with their families had had
more than one partner in the same time period.
More Information at:
http://countryoffice.unfpa.org/lao/drive/
FinalReportYoungWomensSexualBehaviourStudy.pdf
Credits:
The Department of Health of Vientiane Capital (PCCA) in collaboration with the Burnet Institute and UNFP