Perceptions of social norms played an important role in the occurrence of casual sex among Yi minority residents in China: a population-based study

Assessing parental marital quality and divorce related to youth sexual experiences and adverse reproductive health outcomes among 50,000 Chinese college students

BACKGROUND

This study aimed to investigate the associations between parental marital quality, divorce, and sexual and reproductive health outcomes among Chinese young people.

METHODS

The study included 51,124 students from a large-scale cross-sectional study in China from 2019 to 2020. The exposures were parental marital quality and legal marital status reported by students. The dichotomous outcomes included sexual experiences, high-risk sexual behaviors, unintended health outcomes, and sexual abuse. Multivariate logistic regression models adjusting for socio-demographic factors were used to assess the relationship between parental marital quality, divorce, and sexual and reproductive health outcomes, stratified by sex.

RESULTS

A total of 10.72% of the surveyed students' parents had divorced. Participants from divorced family rated perceived parental marital quality less than half of the ratings on a 10-point scale of those from intact family (3.22 vs. 7.44). Parental divorce was associated with a higher likelihood of sexual abuse, high-risk sexual behaviors, and unintended health outcomes. A higher perceived parental marital quality was associated with a lower probability of adverse sexual and reproductive health experiences and outcomes, such as forced penetrative vaginal or anal intercourse (male: OR: 0.73, 95% CI: 0.64-0.83; female: OR:0.71, 95% CI: 0.65-0.77), casual sexual intercourse (male: OR: 0.78, 95% CI: 0.73-0.83; female: OR: 0.77, 95% CI: 0.72-0.83), and sexually transmitted infections (male: OR: 0.79, 95% CI: 0.70-0.89; female: OR: 0.82, 95% CI: 0.73-0.91).

CONCLUSIONS

Parental marital quality and status are associated with poorer sexual and reproductive health outcomes among young adults, suggesting that specific intervention programs should be implemented for children from unharmonious families or divorced families to prevent adverse sexual and reproductive health outcomes.

Multifaceted Determinants of Sexual Intercourse with Non-Regular Female Sex Partners and Female Sex Workers among Male Factory Workers in China-A Cross-Sectional Survey

With a stratified multi-stage sampling approach, 1361 male factory workers in the Longhua district of the Shenzhen Municipality of China were selected to investigate the multifaceted determinants of sexual intercourse with non-regular female sex partners (NRP) and female sex workers (FSW) among them. The results showed that 24.5% and 21.2% of participants had sexual intercourse with NRP and FSW in the past 6 months, respectively. More specifically, at the individual level, perceived higher job stress and maladaptive coping styles were linked with a higher likelihood of having sexual intercourse with NRP and FSW (adjusted odds ratios [AOR] ranged from 1.06 to 1.17). At the interpersonal level, those who had higher exposure to information related to sexual intercourse with NRP or FSW were more likely to have sex with these female sex partners (AOR: 1.08 & 1.11). At the social structural level, perceived social norms supporting multiple sex partnerships were linked with a higher likelihood of having sexual intercourse with NRP and FSW (AOR: 1.10 & 1.11). No interaction effects were found between the variables at different levels. Providing pre-employment training to clarify roles and job duties, introducing adaptive coping strategies, and addressing misconceptions of social norms are useful strategies to reduce sexual intercourse with NRP or FSW.

Associations between impulsive personality traits and HIV-related knowledge, beliefs and behaviours among college students in Chengdu, China: a cross-sectional study

BACKGROUND

Impulsive personality traits (IPTs) are key predictors of individuals' engagement in sexual risk behaviours. This study investigated the associations between IPTs and HIV-related knowledge, beliefs and behaviours among Chinese college students.

METHODS

A sample of 1062 freshmen (first year) and sophomore (second year) students was obtained through stratified random sampling from 11 universities and colleges in Chengdu, China. The sociodemographic information, and HIV-related knowledge, beliefs and behaviours were investigated. A 20-item Short UPPS-P Impulsive Behaviour Scale (S-UPPS-P) was employed to estimate IPTs. Contingency table analyses (χ2) and adjusted logistic regression were used to analyse the association between IPTs and HIV-related knowledge, beliefs and behaviours.

RESULTS

The S-UPPS-P scale measure of IPTs yielded scores among college students ranging from 26 to 70. Students with a greater level of IPTs were more likely to have a high level of HIV stigma (aOR=1.46, 95% CI: 1.13-1.89), and a low level of HIV knowledge (aOR=1.41, 95% CI: 1.11-1.80) and HIV prevention beliefs (aOR=1.40, 95% CI: 1.09-1.80). All variables of HIV-related behaviours were not significantly associated with IPTs (all P>0.05).

CONCLUSIONS

Future campus health education should provide HIV education without neglect of early identification of students' IPTs.

Health-Related Quality of Life of HIV-Positive and HIV-Negative Pregnant Women in an Impoverished Area: Cross-sectional Study

Background

Liangshan prefecture of Sichuan province was an impoverished mountainous area in China, where the annual number of HIV-positive pregnant women accounted for approximately 10% of China’s total population in the decades before 2020. In general, pregnant women living here are likely to be physically and mentally different from those in other places.

Objective

This study aims to explore the health-related quality of life (HRQoL) of pregnant women living with HIV in an impoverished area.

Methods

From December 2018 to January 2019, HIV-positive and HIV-negative parturients within 18 months after delivery were recruited in Liangshan Prefecture, Sichuan Province. Questionnaires were designed to collect their demographic data, while the EuroQol 5-Dimension, 3-Level questionnaire was used to measure their HRQoL when they were in the second trimester from 4 to 6 months of pregnancy, and their quantitative health scores were converted to corresponding healthy utility values by using the Chinese Utility Value Integral System (time trade-off coefficient).

Results

A total of 250 pregnant women (133 HIV-positive and 117 HIV-negative) were enrolled in the study. Among them, 55 (41.35%) and 75 (64.10%) of HIV-positive and HIV-negative pregnant women self-reported full health (healthy state 11111), respectively. The median health utility value of the 250 pregnant women was 0.961 (IQR –0.046 to 0.961), and those of the HIV-positive and HIV-negative pregnant women were 0.875 (0.424-0.961) and 0.961 (IQR –0.046 to 0.961), respectively. We observed a significant difference only in the dimension of anxiety or depression between the two groups (P=.002) and no significant difference in the distribution of health utility indices between the two groups in terms of maternal age, education level, occupation, annual household income, prenatal care visits, family size, and medical insurance category. Multivariate ordinal logistic regression analysis showed that age (odds ratio [OR] 0.62, P<.05) and prenatal care visit (OR 0.29, P<.01) were independent risk factors for health status.

Conclusions

Most pregnant women self-reported satisfactory HRQoL in this impoverished mountainous area. HIV-negative pregnant women had an edge over HIV-positive pregnant women, and there were significant differences in anxiety or depression dimensions between the two groups.

Sexual Victimization in Adulthood and Associated Factors Among Men and Women: Cross-Sectional Evidence from Mainland China

Limited empirical research addresses sexual victimization and related factors among the general adult population in China. To address this gap, we explored the association between sexual victimization in adulthood and associated factors (unwanted sexual experiences [USE] before age 18, binge drinking prior to sex, hooking up, violent pornography use, awareness and perceived behavioral control of consent, and sexual refusal assertiveness) among a convenience Chinese sample. A cross-sectional study was performed in September 2020 among 898 screened men and women from 29 provinces in mainland China. Overall, 52.5% of men and 57.9% of women experienced sexual victimization at least once in adulthood. Men and women differed in the severity of sexual victimization in adulthood, with the mean severity scores of women being significantly higher than those of men. Hierarchical ordinal logistic regression revealed that, after considering control variables, correlates of severity of sexual victimization in adulthood included gender (OR 3.17, 95% CI 2.30-4.40), severity of USE before age 18 (OR 2.28, 95% CI 1.92-2.73), binge drinking prior to sex (OR 2.52, 95% CI 1.83-3.49), hook-up history (OR 2.24, 95% CI 1.49-3.39), violent pornography use (OR 1.07, 95% CI 1.04-1.09), lack of perceived behavioral control of communicating consent (OR 1.04, 95% CI 1.01-1.07), and sexual refusal assertiveness (OR 0.92, 95% CI 0.89-0.95). These findings indicate that early adverse sexual experiences, potential risky sexual behaviors, violent pornography use, and beliefs about consent and refusal may play an important role in predicting sexual victimization among Chinese adults.