Objective To examine sexual and reproductive health related knowledge, attitude and behaviors among adolescent students in China and to provide evidences for promoting reproductive health education in schools and universities.
Methods We conducted a cross-sectional survey from June to August 2017 among 1 840 students recruited with convenient sampling from 22 senior high schools and 21 universities in 11 provinces and municipalities of China. A self-designed questionnaire was adopted in the study and totally 1 355 participants completed the survey via paper work or using mobile phone application anonymously.
Results Of all the participants, 53.28% were scored with a pass mark of ≥ 60 out of 100 for sexual and reproductive health knowledge; only 25.98% (352/1 355) considered that one should not have sex before marriage, indicating an open attitude towards sexual behavior. Among the participants, sexual experience was reported by 8.98% (52/579) of those under the age of 18, 10.85% (83/765) of senior high school students, and 26.61% (157/590) of the college students; the senior high school students reported significantly higher sexual behaviors and calling someone for sex after alcohol drinking during previous one year than the college students ( χ 2 = 7.888 4 and χ 2 = 10.382 7, both P < 0.05). The proportions of having sexual experiences and browsing pornographic materials were significantly higher among the male participants than among the female participants ( χ 2 = 34.529 2 and χ 2 = 237.760, both P < 0.001). For all the participants, 36.16% (490), 70.26% (952), and 39.78% (539) did not reported having education program on AIDS, maternity and sexually transmitted diseases, and physical health in the schools.
Conclusion Among senior high school and college students in China, sexual and reproductive health knowledge is generally at a low level but the attitude towards sexual behavior is relatively open and sexual behavior tends to be prevalent in younger students, especially among male students; the results suggest that education programs on sexual activity and reproductive health and the accessibility of relevant health services need to be promoted among the students.
【摘 要】 目的 了解 11 省市青少年性与生殖健康相关知识、态度和行为现状，为促进学校生殖健康教育提供数据支持。 方法 于 2017 年 6 — 8 月，在中国 11 省市便利抽取 22 所高中和 21 所大学的 1 355 名学生，采用自行设计的健康问卷开展横断面调查。 结果 青少年的性与生殖健康知识及格率仅为 53.28 %。青少年的性观念和性行为开放，仅有 25.98 %（352/1 355）的青少年认为婚前不应该有性行为，8.98 %（52/579）的未成年组学生、10.85 %（83/765）的高中生及 26.61 %（157/590）的大学生有过性经历；过去 1 年内，高中生发生酒后性行为和“约炮”行为的比例均显著高于大学生（ χ 2 = 7.888 4、10.382 7，均 P < 0.05）；男性有性行为、看色情作品经历的比例均显著高于女性（ χ 2 = 34.529 2、237.760，均 P < 0.001）。在校期间没有学习过关于艾滋病、孕产与性传播疾病和生理健康知识的青少年分别占 36.16 %（490/1 355）、70.26 %（952/1 355）、39.78 %（539/1 355）。 结论 青少年性与生殖健康知识的了解水平整体偏低，性观念与性行为开放，性行为趋向低龄化，男性性风险高于女性，学校应加强性与生殖健康教育力度和卫生服务可得性，促进青少年健康发展。