Advancing Sexual and Reproductive Health and Rights
 
International Perspectives on Sexual and Reproductive Health
Volume 36, Number 4, December 2010
DIGEST

In China, Sexual Debut Linked to Demographic And Social Factors

School type, socioeconomic status and family structure are important predictors of sexual debut among Chinese youth, according to a national survey.1 Five percent of youth in grades 10–12 had had sex, and a third of that group reported having had forced (or otherwise unwanted) sex. Youth who attended an ordinary or elite high school were less likely than those who attended a vocational school to have had sex (odds ratios, 0.4–0.6), while the odds of being sexually experienced were elevated among students living in a moderately or highly developed area rather than a developing one (1.1–1.4), and among those not living with both parents (1.7–3.1). These factors were also associated with sexual experience among college students.

The data are from the 2005 Chinese Youth Risk Behavior Survey, a randomized, multistage study conducted among urban adolescents in 18 of China's 31 provinces. The researchers collected information on social and demographic characteristics and sexual behaviors from 109,754 students in grades 10–12 and 33,653 college students. Participants had a median age of 18, and 53% were female. The investigators calculated descriptive statistics on respondents' experiences with sex, forced sex (defined as coerced, unwanted or forced sex) and, for college students, condom use at last sex and pregnancy. Predictors associated with these outcomes were identified through logistic regression.

About 5% of high school students reported having had sex. Males were more likely than females to be sexually experienced; among high school students 18 or older, for example, 11% of males and 4% of females had had sex. Sexual experience was more commonly reported by respondents in vocational schools than by those in other types of schools (7% vs. 4%).

One-third (33%) of sexually experienced high school students had had forced sex. This proportion was higher among females and younger respondents than among males and older respondents; it was highest among 15-year-old females (58%). Forced sex was more commonly reported by respondents in elite schools than by those attending other schools (37% vs. 31–33%), and by those living in developing rather than highly or moderately developed areas (37% vs. 31%).

One in nine college students (11%) reported having had sex, and the proportion was again higher among males than females. Sex that was forced, coerced or otherwise unwanted was more commonly reported by sexually experienced students at four-year colleges than among those at junior colleges (25% vs. 20%). Condom use at last sex increased with age among sexually experienced respondents, from 45% among females 18 or younger to 58% among those 22 or older, and from 35% to 51% among males in those age-groups. Depending on age, 22–31% of sexually experienced female college students had been pregnant, and 19–32% of sexually experienced males reported having impregnated a partner.

In the multivariate analysis, several factors were associated with sexual experience among high school students. Among both males and females, the odds of having had sex were lower among those who were attending an elite or ordinary high school rather than a vocational school (odds ratios, 0.4–0.6), and lower among those whose mother had not attended college than among those whose mother had at least a junior college education (0.7–0.8). The odds were higher among students who reported having a stepparent (2.1–3.1) or being raised by someone other than parents or grandparents (1.7–3.1) than among those living with both biological parents, and higher among youth living in a highly or moderately developed area than in a developing area (1.1–1.4). Males whose fathers had less than a junior college education had reduced odds of having had sex (0.8).

Among high school students of both genders, forced sex was positively associated with attending a nonvocational school (odds ratios, 1.3–1.5) and negatively associated with living in a moderately developed, as opposed to a developing, area (0.7–0.8). In addition, the odds of having experienced forced sex were reduced among females in highly developed areas (0.5) and among males with a high school–educated mother (0.6).

The findings were generally similar among college students: Having had sexual intercourse was positively associated with living in a one-parent household or with guardians other than parents or grandparents (odds ratios, 1.2–3.4), as well as with living in a moderately developed area (1.2–1.3); it was negatively associated with having a mother who had less than a college education (0.5–0.7). In addition, freshmen were less likely than seniors to have had sex (0.7 for both genders). Factors associated with sexual experience only among males were being a sophomore (0.8); having a father with a high school education rather than a higher educational level (0.8); and attending a junior rather than a four-year college (1.1). Female college students had elevated odds of having had sex if they had a stepparent (3.4) or lived in a moderately or highly developed area (1.2–1.3).

Among female college students, the likelihood of having experienced forced sex was elevated among freshmen (odds ratio, 2.3) and youth from a single-parent family (1.8). Females and males attending a junior rather than four-year college had reduced odds of forced sex (0.6–0.7). Among females, having not used a condom at last sex was positively associated with being a freshman (3.0), sophomore (2.7) or junior (1.8) rather than a senior; among males, it was associated with being a sophomore (1.5) and with living in a moderately developed area (0.7). Finally, the odds of having become pregnant (or of having impregnated a partner) were elevated among freshman and sophomore females (2.0–2.5), and reduced among members of both sexes whose mothers had not attended senior high school (0.5–0.6).

The researchers speculate that the lower likelihood of sexual experience among students at elite high schools might be related to the greater resources, more motivated student bodies and better learning environments at elite schools. They add that the inverse relationship between place of residence and sexual experience might be due to the more traditional beliefs (and thus more conservative sexual attitudes) among residents of less developed areas. Increased school-based sex education, they conclude, may help Chinese youth avoid unprotected sex as well as protect "themselves from being victims of high-risk sexual behaviors," such as unwanted sex.—H. Ball

REFERENCE

1. Song Y and Ji C-Y, Sexual intercourse and high-risk sexual behaviours among a national sample of urban adolescents in China, Journal of Public Health, 2010, 32(3):312–321.