| Summary: | This study aimed to inform the redesign of sex education policy in Chiang Mai (Thailand) by exploring the knowledge and attitudes of teenagers, parents, teachers, and policy makers and placing these in the wider social, cultural, educational, and economic context of modern-day Thailand. Six selected secondary schools with diverse characteristics in socioeconomic and religious backgrounds and locations were studied. This mixed method study included: semi-structured interviews and narrative interviews with 18 key stakeholders; analysis of 2 key policy documents; a survey of 2301 teenagers; 20 focus groups of 185 teenagers; a survey of 351 parents; one focus group of 8 teachers; and two focus groups of 23 parents. Qualitative and quantitative data were assessed separately with thematic and statistical analysis, respectively, and outcomes were compared, combined and discussed. Results suggested: school-based sex education was biologically focused and inconsistently delivered. Chiang Mai teenagers showed a reasonable knowledge of biological issues around reproduction but were confused and uncertain about how to obtain or use contraception, avoid pregnancy and transmission of STIs, negotiate personal and intimate relationships and find sources of support and advice. Many parents and teachers lacked the knowledge, confidence, and skills to offer meaningful support to their children. Five important influences on Chiang Mai teenagers' sexual attitudes and behaviours were noted in this research: ambiguous social roles leading to confused identity, heightened sexual awareness and curiosity, critical gaps in knowledge and life skills, limited parental input, and an impulsive and volatile approach to intimate encounters. Results of this study suggest several possibility approaches that could be developed to improve sex education.
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