Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Prevalence of and disparities in HIV-related sexual risk behaviours among Chinese youth in relation to sexual orientation: a cross-sectional study

Chao Guo A , Lei Zhang A , Zhenjie Wang A , Gong Chen A and Xiaoying Zheng A B
+ Author Affiliations
- Author Affiliations

A Institute of Population Research/WHO Collaborating Centre on Reproductive Health and Population Science, Peking University, Haidian District, Beijing 100871, China.

B Corresponding author. Email: xzheng@pku.edu.cn

Sexual Health 13(4) 383-388 https://doi.org/10.1071/SH15190
Submitted: 24 September 2015  Accepted: 8 March 2016   Published: 2 June 2016

Abstract

Background: The aim of this study was to calculate the prevalence rate of HIV-related sexual risk behaviours (HSRB) among Chinese youth and determine whether there was an association between sexual orientation and HSRB. Methods: This study used a nationally representative survey of youth aged 15–24 years in China. Population numbers, prevalence, and proportions were calculated where appropriate. χ2 tests were used to determine the difference within categorical variables. Multivariate logistic regression was used to calculate the adjusted odd ratios (AOR) and 95% confidence interval (CI). Results: The rate of any HSRB among sexually active youth was 79.43%, and the most common HSRB was lack of condom use during the first sexual experience (66.02%). After adjusting for demographic and socioeconomic variables (sex, age, residence, living with parents or not, father’s education and annual family income), non-heterosexual orientation was found to significantly increase the odds of HSRB (AOR = 2.42, 95% CI: 1.16–5.05). Conclusions: Non-heterosexual youth are at a higher risk of partaking in HSRB. The high prevalence of HSRB indicates the insufficiency of sex education for Chinese youth, especially for non-heterosexual youth. Greater efforts should be made to increase reproductive and sexual health services for Chinese youth.

Additional keywords: condom use, non-heterosexual.


References

[1]  United Nations Children’s Fund (UNICEF). Opportunity in crisis: preventing HIV from early adolescence to young adulthood. New York: UNICEF; 2011.

[2]  The Joint United Nations Programme on HIV/AIDS (UNAIDS). World AIDS Day Report 2014: fact sheet. Geneva: UNAIDS; 2014.

[3]  Ministry of Health of the People’s Republic of China. China AIDS response progress report. Beijing: Ministry of Health of the People’s Republic of China; 2012 Available at: http://unaids.org.cn/pics/20120614140133.pdf [verified 22 March 2015].

[4]  Ma Q, Ono-Kihara M, Cong L, Xu G, Zamani S, Ravari SM, et al Sexual behaviour and awareness of Chinese university students in transition with implied risk of sexually transmitted diseases and HIV infection: a cross-sectional study. BMC Public Health 2006; 6 232
Sexual behaviour and awareness of Chinese university students in transition with implied risk of sexually transmitted diseases and HIV infection: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar | 16981985PubMed |

[5]  Goedert JJ. What is safe sex? Suggested standards linked to testing for human immunodeficiency virus. N Engl J Med 1987; 316 1339–42.
What is safe sex? Suggested standards linked to testing for human immunodeficiency virus.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL2s3gtFOktQ%3D%3D&md5=e719c9c51d7c78957d4a4666cb3a98b6CAS | 3472078PubMed |

[6]  McCauley HL, Dick R, Tancredi D, Goldstein S, Blackburn S, Monasterio E, et al Adolescent relationship abuse, sexual assault, and disparities in sexual risk by sexual orientation among female clients of school-based health centres. J Adolesc Health 2014; 54 S5–6.
Adolescent relationship abuse, sexual assault, and disparities in sexual risk by sexual orientation among female clients of school-based health centres.Crossref | GoogleScholarGoogle Scholar |

[7]  Robinson JP, Espelage DL. Peer victimization and sexual risk differences between lesbian, gay, bisexual, transgender, or questioning and nontransgender heterosexual youths in grades 7–12. Am J Public Health 2013; 103 1810–9.
Peer victimization and sexual risk differences between lesbian, gay, bisexual, transgender, or questioning and nontransgender heterosexual youths in grades 7–12.Crossref | GoogleScholarGoogle Scholar | 23947999PubMed |

[8]  Everett BG, Schnarrs PW, Rosario M, Garofalo R, Mustanski B. Sexual orientation disparities in sexually transmitted infection risk behaviours and risk determinants among sexually active adolescent males: results from a school-based sample. Am J Public Health 2014; 104 1107–12.
Sexual orientation disparities in sexually transmitted infection risk behaviours and risk determinants among sexually active adolescent males: results from a school-based sample.Crossref | GoogleScholarGoogle Scholar | 24825214PubMed |

[9]  Saewyc E, Skay C, Richens K, Reis E, Poon C, Murphy A. Sexual orientation, sexual abuse, and HIV-risk behaviours among adolescents in the Pacific Northwest. Am J Public Health 2006; 96 1104–10.
Sexual orientation, sexual abuse, and HIV-risk behaviours among adolescents in the Pacific Northwest.Crossref | GoogleScholarGoogle Scholar | 16670224PubMed |

[10]  van Griensven F, Kilmarx P, Jeeyapant S, Manopaiboon C, Korattana S, Jenkins R, et al The prevalence of bisexual and homosexual orientation and related health risks among adolescents in northern Thailand. Arch Sex Behav 2004; 33 137–47.
The prevalence of bisexual and homosexual orientation and related health risks among adolescents in northern Thailand.Crossref | GoogleScholarGoogle Scholar | 15146146PubMed |

[11]  Patel SA, Bangorn S, Aramrattana A, Limaye R, Celentano DD, Lee J, et al Elevated alcohol and sexual risk behaviours among young Thai lesbian/bisexual women. Drug Alcohol Depend 2013; 127 53–8.
Elevated alcohol and sexual risk behaviours among young Thai lesbian/bisexual women.Crossref | GoogleScholarGoogle Scholar | 22770462PubMed |

[12]  Blake SM, Ledsky R, Lehman T, Goodenow C, Sawyer R, Hack T. Preventing sexual risk behaviours among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools. Am J Public Health 2001; 91 940–6.
Preventing sexual risk behaviours among gay, lesbian, and bisexual adolescents: the benefits of gay-sensitive HIV instruction in schools.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzhvVyqsw%3D%3D&md5=1bbd1cf620c425dfb534011a7aeec279CAS | 11392938PubMed |

[13]  Yu FZ, Yang GG, Yu X. Review on homosexuality research in China. Med Infant 2005; 12 1758–61. [in Chinese]

[14]  Yu X, Guo S, Sun Y. Sexual behaviours and associated risks in Chinese young people: a meta-analysis. Sex Health 2013; 10 424–43.
Sexual behaviours and associated risks in Chinese young people: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 23962473PubMed |

[15]  Song D, Zhang H, Wang J, Han D, Dai L, Liu Q, et al Sexual risk behaviours and their correlates among gay and non-gay identified men who have sex with men and women in Chengdu and Guangzhou, China. Int J STD AIDS 2013; 24 780–90.
Sexual risk behaviours and their correlates among gay and non-gay identified men who have sex with men and women in Chengdu and Guangzhou, China.Crossref | GoogleScholarGoogle Scholar | 23970588PubMed |

[16]  Wong FY, Huang ZJ, He N, Smith BD, Ding Y, Fu C, et al HIV risks among gay- and non-gay-identified migrant money boys in Shanghai, China. AIDS Care 2008; 20 170–80.
HIV risks among gay- and non-gay-identified migrant money boys in Shanghai, China.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c7jtlSruw%3D%3D&md5=72e5cc7e090a6ea50503c944a624b838CAS | 18293125PubMed |

[17]  Zheng XY, Chen G, Han YL, Chen H, Lin T, Qiu Y. Survey of youth access to reproductive health in China. Population and Development 2010; 16 2–16. [in Chinese]

[18]  Hindin MJ, Fatusi AO. Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions. Int Perspect Sex Reprod Health 2009; 35 58–62.
Adolescent sexual and reproductive health in developing countries: an overview of trends and interventions.Crossref | GoogleScholarGoogle Scholar | 19620089PubMed |

[19]  Guttmacher Institute. American teens’ sexual and reproductive health. New York: Guttmacher Institute; 2014. Available at: http://www.guttmacher.org/pubs/FB-ATSRH.pdf [verified 25 March 2015].

[20]  Bogaert AF, Liu J. Physical size and sexual orientation: analysis of the Chinese health and family life survey. Arch Sex Behav 2013; 42 1555–9.
Physical size and sexual orientation: analysis of the Chinese health and family life survey.Crossref | GoogleScholarGoogle Scholar | 23588616PubMed |

[21]  Li X, Zhang L, Stanton B, Fang X, Xiong Q, Lin D. HIV/AIDS-related sexual risk behaviours among rural residents in China: Potential role of rural-to-urban migration. AIDS Educ Prev 2007; 19 396–407.
HIV/AIDS-related sexual risk behaviours among rural residents in China: Potential role of rural-to-urban migration.Crossref | GoogleScholarGoogle Scholar | 17967110PubMed |

[22]  Wang K, Wu J, Zhao H, Li Y, Zhao R, Zhou Y, et al Unmarried male migrants and sexual risk behaviour: a cross-sectional study in Shanghai, China. BMC Public Health 2013; 13 1152
Unmarried male migrants and sexual risk behaviour: a cross-sectional study in Shanghai, China.Crossref | GoogleScholarGoogle Scholar | 24321180PubMed |

[23]  Tang J, Gao X, Yu Y, Ahmed N, Zhu H, Wang J, et al Sexual knowledge, attitudes and behaviours among unmarried migrant female workers in China: a comparative analysis. BMC Public Health 2011; 11 917
Sexual knowledge, attitudes and behaviours among unmarried migrant female workers in China: a comparative analysis.Crossref | GoogleScholarGoogle Scholar | 22151661PubMed |

[24]  Trieu SL, Bratton S, Hopp Marshak H. Sexual and reproductive health behaviours of California community college students. J Am Coll Health 2011; 59 744–50.
Sexual and reproductive health behaviours of California community college students.Crossref | GoogleScholarGoogle Scholar | 21950256PubMed |

[25]  Makenzius M, Gådin KG, Tydén T, Romild U, Larsson M. Male students’ behaviour, knowledge, attitudes, and needs in sexual and reproductive health matters. Eur J Contracept Reprod Health Care 2009; 14 268–76.
Male students’ behaviour, knowledge, attitudes, and needs in sexual and reproductive health matters.Crossref | GoogleScholarGoogle Scholar | 19526422PubMed |

[26]  Wellings K, Collumbien M, Slaymaker E, Singh S, Hodges Z, Patel D, et al Sexual behaviour in context: a global perspective. Lancet 2006; 368 1706–28.
Sexual behaviour in context: a global perspective.Crossref | GoogleScholarGoogle Scholar | 17098090PubMed |

[27]  Zhao S, Gao E, Zabin LS. Unmet needs for reproductive health knowledge among unmarried migrant youth. J Reprod Contracept 2008; 19 227–38.
Unmet needs for reproductive health knowledge among unmarried migrant youth.Crossref | GoogleScholarGoogle Scholar |

[28]  Cui N, Tian A, Li M, Shah IH. Parental support for sexual and reproductive health information and services for unmarried youth in Chengdu, China. Southeast Asian J Trop Med Public Health 2012; 43 997–1008.
| 23077824PubMed |

[29]  Chen H, Zhang L, Han Y, Lin T, Song X, Chen G, et al HIV/AIDS knowledge, contraceptive knowledge, and condom use among unmarried youth in China. AIDS Care 2012; 24 1550–8.
HIV/AIDS knowledge, contraceptive knowledge, and condom use among unmarried youth in China.Crossref | GoogleScholarGoogle Scholar | 22533677PubMed |

[30]  Sina News. CPPCC member: the AIDS infection among students is increasing, sex education should be added into the teaching programs. 2015. Available at: http://top.sina.cn/edu/2015-03-08/tnews-ianfzhnh3702810.d.html?vt=4 [verified 27 March 2015].

[31]  Yang Q. Analysis of homosexuality reported by domestic media. Journalism Lover 2012; 2 54–5. [in Chinese]