{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T09:36:35Z","timestamp":1773480995238,"version":"3.50.1"},"reference-count":45,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The National Research Council of Thailand and Mae Fah Laung University, Thailand","award":["06-2560"],"award-info":[{"award-number":["06-2560"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>\nBackground\n<\/jats:title>\n<jats:p>Early sexual initiation before the age of 15 years, prior to full physical and mental maturity, can lead to several problems, including sexually transmitted diseases. This study aimed to estimate the prevalence of and determine the factors associated with early sexual initiation among hill tribe youths in Thailand.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>\nMethods\n<\/jats:title>\n<jats:p>A cross-sectional study was conducted to gather information using a validated questionnaire from hill tribe youths aged 15\u201324 years living in 30 selected hill tribe villages in Chiang Rai Province, Thailand. Data were obtained using self-reports in a private and confidential room. Chi-square tests and logistic regression were used to detect associations between variables at a significance level of \u03b1=0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>\nResults\n<\/jats:title>\n<jats:p>A total of 1,310 hill tribe youths participated in the study: 60.8% were females, 59.0% were aged 15\u201317 years, 34.0% were Akha, and 90.1% had no income. Substance use was reported as follows: 22.2% used alcohol, 14.3% smoked, and 2.6% used methamphetamine. A large proportion (79.8%) had poor knowledge of safe sex, and 33.5% had poor attitudes toward early sexual behaviors and safe sex. One-fourth (24.1%) had sexual experience. Of these, 42.0% were males, and 53.0% were female. Among those who had sexual experience, 9.8% had their first sexual initiation before 15 years. Of these, 81.1% were males, and 18.9% were females. The overall age at first sexual initiation was 16.7 years. The minimum age at first sexual initiation was 12 years for males and 13 years for females. Sex and age, including smoking, amphetamine, and heroin use behaviors, were associated with early sexual initiation in the univariate model. In the multivariable model, sex and age remainedassociated with early sexual initiation. Males were 7.30 times (95% CI\u2009=\u20092.06\u201325.83) more likely to have experienced early sexual initiation than females were. Those aged 15\u201317 years were 8.31 times (95% CI\u2009=\u20091.68\u201341.07) more likely to have experienced early sexual initiation than those aged 21\u201324 years were.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>\nConclusions\n<\/jats:title>\n<jats:p>A large proportion of hill tribe youths have sexual experience, and one-tenth have experienced early sexual initiation before the age of 15 years. Specific knowledge on sexual education programs should be integrated into the high school study curriculum to protect early sexual initiation behaviors and safe sex, particularly for females. Family- and community-based interventions should also be strongly recommended for the implementation of sexual education training. The curriculum should focus on the impact of substance use and potentially early sexual initiation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0321083","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T17:45:41Z","timestamp":1744134341000},"page":"e0321083","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Factors influencing early sexual initiation among hill tribe youths in Chiang Rai Province, Northern Thailand: A community-based cross-sectional 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