Older people and AIDS: quantitative evidence of the impact in Thailand.

Discussions of the AIDS epidemic rarely consider the impact on older people except as infected persons. Virtually no systematic quantitative assessments exist of the involvement of parents or other older generation relatives in the living and caretaking arrangements of persons with AIDS in either the West or the developing world. We assess the extent of such types of involvement in Thailand, a country where substantial proportions of elderly parents depend on adult children for support and where co-residence with an adult child is common. Interviews with local key informants in the public health system in rural and urban communities provided quantitative information on a total of 963 adult cases who either had died of AIDS or were currently symptomatic. The results indicate that a substantial proportion of persons with AIDS move back to their communities of origin at some stage of the illness. Two-thirds of the adults who died of an AIDS-related disease either lived with or adjacent to a parent by the terminal stage of illness and a parent, usually the mother, acted as a main caregiver for about half. For 70%, either a parent or other older generation relative provided at least some care. The vast majority of the parents were aged 50 or more and many were aged 60 or older. This extent of older generation involvement appears to be far greater than in Western countries such as the US. We interpret the difference as reflecting the contrasting epidemiological and socio-cultural situations in Thailand and the West. The fact that older people in Thailand, and probably many other developing countries, are extensively impacted by the AIDS epidemic through their involvement with their infected adult children has important implications for public health programs that address caretaker education and social and economic support.

Psychological well-being Asian style: the perspective of Thai elders.

Psychological well-being is an important aspect of life quality for older adults. Asian elders may have a distinctly different perspective from Westerners concerning the meaning of psychological well-being. Using qualitative research methods, this study focused on the views of Thai elders. In-depth interviews and focus group discussions were conducted with 67 Thai people aged 60 and over. Transcripts were content analyzed resulting in the identification of five dimensions of well-being: harmony, interdependence, acceptance, respect and enjoyment. When compared to research in the United States, some of the dimensions of psychological well-being were distinct while others were overlapping. Implications are discussed in relation to the development of culturally-relevant measures of well-being.

Respect for the elderly in Asia: stability and change.

This study analyzes data from seventy-nine focus groups conducted in the Philippines, Singapore, Taiwan, and Thailand. The research examined ways in which respect for the elderly is experienced in these four countries, the extent to which respect has changed over time, and the reasons for changes in respect for the elderly. Using qualitative analysis, five distinct dimensions of respect were identified: gestures and manners, tokens, customs and rituals, asking for advice, and obedience. Focus group discussions indicated that changes have occurred on most of these dimensions of respect. The changes were attributed to variations in family structure and function, education, income, and modernization. These findings are discussed in relation to changing definitions of respect and variations in the way in which respect for the elderly is expressed in Asia.

Studying living arrangements of the elderly: lessons from a quasi-qualitative case study approach in Thailand.

The present study explores aspects of living arrangements of the elderly in Thailand and how they relate to intergenerational support exchanges as revealed by a quasi-qualitative case study approach. The study describes some of the challenges this topic poses for measurement if surveys are used. These include difficulties in appropriately defining a household and identifying its members, treating coresidence as a continuum, taking account of the complex links to non-coresident children and kin, recognizing that similar living arrangements can have different meanings, viewing living arrangements as part of an evolving process, and recognizing the potential sensitivity of the topic to respondents. Careful and informed design of survey questionnaires can increase their ability to accurately reflect the underlying complex reality. However, there are also relevant critical issues for which surveys are not well suited. Although the study is specific to Thailand, many of the same issues are likely to arise in the research on elderly elsewhere as well.

Can prostitutes marry? Thai attitudes toward female sex workers.

This study explores popular attitudes towards female sex workers in Thailand by examining the general public's perceptions of a prostitute's ability to marry based on focus group data. The tentative conclusion emerging from our findings that the general public believes sex workers can marry is that a relative lack of severe or lasting social stigma is an important part of a Thai context that facilitates recruitment into prostitution and permits it to persist on a widespread scale. We interpret this conclusion in terms of the broader value system in Thai society. Although our findings are implicitly comparative in nature, a lack of comparable information from other countries on how those who provide commercial sex are viewed by the general population prevents a more definitive conclusion. There is an obvious need for research on this topic as well as on how sex workers view themselves, and how this translates into actual behavior. Data set used: focus group transcripts from the project "The influence of primary female partners and male peers on male extramarital sexual behavior in Thailand".

In the company of friends: peer influence on Thai male extramarital sex.

We explore some of the key social dynamics underlying patterns of male extramarital heterosexual behavior in Thailand. We analyze transcripts of focus group discussions and focused individual interviews conducted during 1993 and 1994 with married men and women living in both urban and rural areas of central Thailand. We discern several pathways of peer influence on extramarital commercial sex patronage that are common across our sites and interpret these peer effects in light of contemporary theories of social influence and sexual behavior.

Effect of birth spacing on infant survival in Thailand: two-stage logit analysis.

We formulated a two-stage causal model for infant survival and applied it to data drawn from the 1987 Thai Demographic and Health Survey covering the fate of 5,074 index children. The following six variables were considered as the explanatory variables: maternal age, maternal education, birth order, preceding birth interval, survival of the preceding child, and place of residence. The analysis suggests that the birth interval not only directly affected the chance of infant survival but it played the role of the filtering factor through which other variables indirectly operate on infant mortality. The effect of preceding child's death was very strong, the odds ratios for the following infant's death and short birth interval both exceeding three.