Sexual behaviour of backpackers who visit Koh Tao and Koh Phangan, Thailand: a cross-sectional study

C. T. Lewis, G de Wildt

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


OBJECTIVES: To measure the proportion of backpackers engaging in unprotected sex while travelling in Thailand and to identify predictors of unsafe sexual behaviour.

METHODS: A cross-sectional study using an anonymous questionnaire was performed. English-speaking backpackers, excluding US and Thai citizens, were recruited while travelling through the piers of Koh Tao and Koh Phangan between 25 January and 13 March 2013.

RESULTS: 61.5% (1238/2013) respondents were travelling without a long-term sexual partner, of whom 39.1% (29.4% females; 51.9% males) reported intercourse with a new partner. 36.8% of these reported inconsistent/no condom use. Inconsistent condom use was independently associated with age <25 years, UK (vs Canadian) nationality and not bringing condoms from home. Backpackers who brought condoms from home were more likely to have sex with a new partner. Male gender and longer trip length increased the likelihood of new partner acquisition and overall risk of unsafe sex but were not associated with inconsistent condom use. New partners were most commonly backpackers from other countries. Men were more likely than women to have sex with a local person.

CONCLUSIONS: Backpackers visiting Thailand frequently report unsafe sex. Partner demographics demonstrate a mechanism of international sexually transmitted infection (STI) transfer. In an era of growing antibiotic resistance and continuing HIV transmission, targeting unsafe sex in backpackers has the potential to reduce STI incidence internationally. These data highlight the need for innovative public health intervention. To focus such measures, future research may elucidate why certain groups are at higher risk.

Original languageEnglish
Pages (from-to)410-4
Number of pages5
JournalSexually Transmitted Infections
Issue number6
Early online date6 Jun 2016
Publication statusPublished - Sept 2016


  • Adolescent
  • Adult
  • Condoms
  • Continental Population Groups
  • Cross-Sectional Studies
  • Female
  • Holidays
  • Humans
  • Internationality
  • Male
  • Middle Aged
  • Sex Factors
  • Sexual Behavior
  • Sexual Partners
  • Sexually Transmitted Diseases
  • Social Environment
  • Surveys and Questionnaires
  • Thailand
  • Travel
  • Unsafe Sex
  • Young Adult
  • Journal Article


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