Attitudes toward Same-Sex Attraction and Behavior among Chinese University Students: Tendencies, Correlates, and Gender Differences

Secondary School Students' Views on Sexuality and Sexual Health Education

Objective

This study examined the views of secondary school students on sexuality and sexual health education in Hong Kong, China.

Methods

A total of 818 secondary school students (mean age = 15.3 years, SD = 1.6) participated in this study by completing a questionnaire consisted of items on sociodemographic characteristics, sexual attitudes, and other measuring scales.

Results

Students were slightly permissive in sexual attitudes and supported sexual health education. However, students who were male, highly liberal in sexual attitudes, and low in religiosity and spirituality were less supportive.

Conclusions

Educators may need to address these deterring factors of sexual health education before teaching specific sexual health topics.

Media Influence on Intergenerational Attitudes toward Non-Conventional Sexual Behaviors in Contemporary China: Evidence from Chinese General Social Survey

Objective

Within the context of rapid sociocultural transformation in Chinese society over recent decades, exploring intergenerational disparities in attitudes toward non-conventional sexual behaviors holds sociological significance. Employing a methodology akin to cultivation analysis, this study focuses on the potential influence of television and the internet in narrowing or widening attitudinal disparities between distinct age groups. This is achieved by comparing heavy users of these media to individuals with light media consumption.

Materials and Methods

In the present study, we utilized the 2017 wave of the Chinese General Social Survey, a dataset that is representative of the national demographic of China. Our objective was to explore the potential influence of both traditional media (TV) and new media (the internet) consumption on the attitudes of Chinese adults toward three forms of non-conventional sexual behavior, namely premarital, extramarital, and same-sex behaviors.

Results

Firstly, compared to television, the internet is more likely to contribute to the liberalization of sexual attitudes, though this influence is age sensitive. Secondly, regarding the attitudes toward premarital sex and same sex behaviors, television tends to sustain or create consensus across different generations, whereas the internet tends to widen attitudinal gaps. Lastly, probably due to the moralized nature of extramarital sex in the Chinese context, both television and the internet maintain or produce the conservative consensus, though heavy television viewing could widen the attitudinal gap between young people and the other two age groups.

Discussion and Conclusion

Our study reveals that for premarital sex and same-sex behaviors, heavy television viewing tends to foster or sustain intergenerational consensus, while frequent internet usage tends to augment intergenerational divergence or erode intergenerational agreements. However, the media's impact on intergenerational differences in attitudes toward extramarital sex exhibits distinctive features, likely stemming from the deeply moralized nature of extramarital affairs within Chinese society. To conclude, by conducting a comparative examination of various media landscapes, our research offers a mediated perspective that aids in comprehending the disparities in attitudes toward sexual behaviors across different generations in contemporary China.

The Effect of Perceived Social Support on the Mental Health of Homosexuals: The Mediating Role of Self-Efficacy

OBJECTIVE

The purpose of this study was to investigate the mental health of homosexual adults in China and to explore the effects of perceived social support and self-efficacy on mental health.

METHODS

Two hundred and nine homosexuals were recruited to participate in the online survey. The Perceived Social Support Scale, General Self-efficacy Scale, Self-rating Anxiety Scale and Self-rating Depression Scale were completed through a questionnaire website. Correlation analysis and mediation analysis were used to investigate the relationship between perceived social support, self-efficacy and mental health of homosexuals.

RESULTS

Description analysis showed the following: (1) In this study, 53.9% of the participants had depression symptoms and 46.7% had anxiety problems; (2) perceived social support, self-efficacy, anxiety and depression were significantly related to each other. The mediation effect analysis found that self-efficacy mediates between perceived social support and depression but does not mediate between perceived social support and anxiety.

CONCLUSIONS

The results demonstrated that in the context of Chinese collectivist culture, homosexuals have certain mental health problems, and their perceived social support and self-efficacy are critical protective factors for mental health. Our findings highlight the need to further strengthen social support and self-efficacy in mental health services for Chinese homosexuals.

Bridge of Rainbow: Association Between Internet-Based Social Media Use and Homosexuality Inclusion in China

By using the nationally representative dataset of China Labor-force Dynamics Survey, this paper explored the relationship between internet-based social media use and Chinese people's homosexuality inclusion. Addressing endogeneity by using an instrumental variable approach, the results of instrumental variable-ordered probit model indicated that individuals' internet-based social media use had a positive and significant association with their homosexuality inclusion. Furthermore, the heterogeneity analysis revealed that the heterogeneous effects of internet-based social media use on homosexuality inclusion caused by income, gender, and region. The homosexuality inclusion of respondents with higher income, respondents of female gender, and respondents located in eastern region of China was found to be more evidently associated with internet-based social media use. The functional mechanism analysis suggested that the number of respondents' LGBT friends mediated the overall relationship between internet-based social media use and homosexuality inclusion. The robustness check showed that the results were robust cross different models. The findings in this paper provide new evidence that the effect of information technology development on individual perception and behavior in Chinese context.

Comprehensive Sexuality Education Improves Primary Students' Explicit and Implicit Attitudes Toward Homosexuality

Comprehensive sexuality education (CSE) is a curriculum-based process that is inclusive to gender and sexual orientation. We used the attitude toward homosexuality scale and the single category implicit association test (SC-IAT) to measure differences between explicit and implicit attitudes toward homosexuality between migrant children with 6 years CSE learning experience (experimental group, N = 70) and those without (control group, N = 80). We found that the experimental group had more positive explicit and implicit attitudes toward homosexuality than the control group. In conclusion, CSE is a useful process for improving the explicit and implicit attitudes of migrant children toward homosexuality.

Uptake and willingness to use PrEP among Chinese gay, bisexual and other men who have sex with men with experience of sexualized drug use in the past year

Background

Sexualized drug use (SDU) refers to use of any psychoactive substance before/during sexual intercourse. Chemsex is a subset of SDU, which is defined as the use of some specific psychoactive substances (methamphetamine, mephedrone, γ-hydroxybutyrate, ketamine and cocaine) before/during sexual intercourse. SDU and chemsex are prevalent among gay, bisexual and other men who have sex with men (GBMSM). This study investigated uptake and willingness to use pre-exposure prophylaxis (PrEP) among a sample of GBMSM in Hong Kong with experience of SDU in the past year.

Methods

A total of 600 GBMSM were recruited by convenient sampling through outreaching in gay venues, online recruitment and peer referral. Participants completed a cross-sectional anonymous telephone interview. This study was based on a subsample of 580 GBMSM self-reported as HIV negative/unknown sero-status.

Results

Of the participants, 82 (14.1%) and 37 (6.4%) had experience of SDU and chemsex in the past year. The prevalence of PrEP uptake was 4.0% among all participants and 14.6% among those with experience of SDU in the past year. Among GBMSM with experience of SDU in the past year who were not on PrEP (n = 70), 67.1% were willing to use daily oral PrEP in the next 6 months. Multivariate logistic regression models showed that positive attitudes toward PrEP (AOR: 2.37, 95%CI: 1.47, 3.82), perceived support from significant others to use PrEP (AOR: 9.67, 95%CI: 2.95, 31.71), and perceived behavioral control of using PrEP (AOR: 19.68, 95%CI: 5.44, 71.26) were significantly associated with higher willingness to use PrEP.

Conclusion

GBMSM with experience of recent SDU are potentially good candidates of PrEP implementation. This group of GBMSM reported high prevalence of uptake and willingness to use PrEP. Perceptions related to PrEP based on the Theory of Planned Behavior were significantly associated with willingness to use PrEP.

Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study

OBJECTIVES

Suicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents.

DESIGN

Cross-sectional survey.

SETTING

A total of 506 high schools in 7 provinces of China.

PARTICIPANTS

A total of 150 822 students in grades 7-12 who completed the questionnaires (response rate of 95.9%) were included.

MAIN OUTCOME MEASURES

Suicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status.

RESULTS

Of the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06).

CONCLUSIONS

Our study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.

Mental Health Status and Associated Contributing Factors among Gay Men in China

Chinese gay men are preferentially vulnerable to mental health problems because of deep-rooted, traditional social influence that overemphasizes heterosexual marriage, fertility, and filial piety. A cross-sectional survey was conducted from November to December 2017 using the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the status of, and factors associated with the mental health of Chinese gay men. Unadjusted associations between demographic factors and the total score of SCL-90-R were examined using t/F tests or person correlation analysis. The main factors that were most predictive of the aggregate score of SCL-90-R were identified by multiple linear regressions. A total of 367 gay men participated in this survey with an average score of SCL-90-R of 180.78 ± 79.58. The scores of seven dimensions (OCS, INTS, DEPR, ANX, HOS, PHOA, PARI) for Chinese gay men were found to be significantly higher than the national norm (all p < 0.001). Age (B = -1.088, SE = 0.478, p = 0.023), educational level (B = -14.053, SE = 5.270, p = 0.008), and degree of coming out publicly (B = -23.750, SE = 4.690, p < 0.001) were protective factors for participants' mental health status. A gay man who is the only child in his family was more likely to obtain a higher total score of SCL-90-R in China (B = 59.321, SE = 7.798, p < 0.001). Our study reveals the worrying mental health status of Chinese gay men. Shifts in familial, governmental, and societal normas are suggested to improve the current social acceptance towards sexual minority men, as well as to reduce detrimental health effects.