Sexual coercion and health-risk behaviors among urban Chinese high school students

Unifying Public Health Surveillance: A Scoping Review of Global Use of the Youth Risk Behavior Survey

PURPOSE

The Youth Risk Behavior Survey (YRBS) is a well-established surveillance tool designed to document the health risk behaviors of youth. However, there is limited insight into the use of the survey outside of the United States. The aim of this scoping review was to assess the global presence and utilization of the YRBS.

METHODS

A structured electronic search of all publication years (through February 2020) was conducted to identify articles in PubMed and EBSCOhost. The search identified 128 articles that used the YRBS beyond the United States.

RESULTS

More than one-third of all countries, territories, and dependencies were represented in the articles, with the greatest use among upper-middle and high-income economies and those in the East Asia and Pacific geographic region. Priority health-risk behaviors identified were alcohol and other drug use (51%), tobacco use (48%), and unintentional and intentional injuries (44%). The articles predominantly suggested that the survey data be used to influence programs, policies, and practices (57%).

DISCUSSION

The development and proliferation of surveillance systems has allowed for important contributions to public health. Extensive use of the YRBS is notable; however, greater efforts are needed to support more systematic and collaborative approaches for evaluating youth behaviors around the world.

Cyber Sexual Harassment among Adolescent Girls: A Qualitative Analysis

Background: Research efforts are increasingly recognizing young girls’ experiences of technology facilitated sexual harassment, which includes sexual harassment via electronic technology and social networking sites. The current study aimed to qualitatively describe experiences of cyber sexual harassment (CSH), as well as its effects, among a sample of sexually active adolescent girls. Methods: Qualitative interviews (n = 25) were conducted among a sub-group of adolescent girls at risk for CSH (those who reported experiencing sexual or dating violence) who participated in a larger cross-sectional clinic-based study on sexual health. Participants were asked to describe their experiences or peers’ experiences of CSH. Interviews were transcribed, coded, and a thematic analysis approach was used to analyze qualitative findings. Results: Participants reported experiencing several different types of CSH, including (a) being forced or pressured to send sexual photos, (b) receiving unwanted sexual messages/photos, and (c) having sexual photos posted or shared without the sender’s permission. Findings also highlighted the consequences of experiencing CSH, including social isolation and negative effects on girls’ education. Conclusions: These scenarios of CSH described by participants highlight the multiple ways in which girls experience CSH. Our findings begin to inform the development of quantitative survey measures that reflect these specific types of CSH experiences reported by adolescents. The consistent use of such measures will be critical to establish the prevalence and consequences of CSH in future studies on this topic.

Experience of childhood sexual violence and its associations with depressive symptoms among university students in Guangdong, China

BACKGROUND

Sexual violence, especially childhood sexual violence, is a serious social issue, yet the prevalence of childhood sexual violence among university students is unknown. We aimed to investigate the prevalence of these experiences and assess their associations with depressive symptoms.

METHODS

The study included 29,311 participants, mean (SD) age 20.5 (1.4) years, from a cross-sectional survey of a multi-stage stratified cluster random sample from all universities in Guangdong province of China. Data were obtained through an anonymous electronic questionnaire from December 2 to 15, 2019. Undergraduates' experiences of childhood sexual violence were self-reported. Current depressive symptoms were measured by Center for Epidemiological Studies Depression Scale (CESD-10). Stress measures in recent months were measured by the College Student Stress Scale.

RESULTS

The prevalence of childhood sexual violence experience among university students was 4.8 % (95 % confidence interval (CI) = 4.6 %-5.0 %), 7.3 % (95 % CI = 6.9 %-7.7 %) for female students and 1.8 % (95 % CI = 1.6 %-2.0 %) for male students. Sexual violence in childhood was related to students' current depressive symptoms after adjustment for stress and socio, demographic characteristics (adjusted prevalence ratio (PRa) = 1.36, 95 % CI = 1.30-1.42). Significant differences in the association between childhood sexual violence and depressive symptoms were also found by sex.

CONCLUSIONS

Experiences of childhood sexual violence among university students are not negligible and associated with their current depressive symptoms. The association between childhood sexual violence and depressive symptoms among female and male students is different. Schools, families, and society as a whole should be encouraged to provide education on healthy sexual behavior preventive interventions related to sexual violence for childhood students.

A Latent Class Analysis of Sexual Behavior and Associations with Sex Education, Smoking, Drinking, and Pornography Use Among Chinese Youth

The incidence of sexually transmitted diseases has alarmingly increased among Chinese youth in the past decade, and newly diagnosed cases of AIDS have almost doubled between 2010 and 2015. However, little is known about classes of sexual behavior among Chinese youth and associations with their other health behavior or experience of sex education. This study aimed to first identify classes of sexual behavior using latent class analysis and then to examine their associations with sex education, smoking, alcohol drinking, and pornography use. Data were from 13,865 unmarried youth aged 18-24 from the 2009 National Youth Reproductive Health Survey. Six indicators were used: timing of the first sexual intercourse, the number of past-year sexual partners, sex outside of a relationship, incidence of pregnancy, and contraceptive use at the latest and the first sexual intercourse. Four classes were identified: no sex (Class 1, 69%), safer sex (Class 2, 13%), early risk (Class 3, 13%), and multiple risk (Class 4, 5%). Smoking, drinking, and regular pornography use were associated with increased odds of being in the multiple risk class relative to the safer sex class. Sex education, smoking, and pornography use were associated with decreased odds of being in the no sex class relative to the safer sex class. The findings revealed qualitatively different classes of sexual behavior among Chinese youth and important roles of sex education, substance use, and pornography use. Reproductive health service providers can offer individually tailored services to serve youth with different profiles and needs.

Lifetime Prevalence of Sexual Violence and Its Associated Factors among High School Female Students in Jarso District, Oromia Region, Eastern Ethiopia

Background

Sexual violence is a serious public health problem affecting millions of young girls and women across the world. Recently, the issue of sexual violence against schoolgirls has garnered global and national attention with implications for health and education outcomes. Sexual violence is driven by a multitude of risk factors that occur at different levels. Understanding the magnitude, risk factors, and conceptuality of sexual violence is crucial for setting priorities and elimination efforts at different levels. Therefore, the objective of this study was to determine the lifetime prevalence of sexual violence and associated factors among high school female students in Jarso district, Oromia region, eastern Ethiopia.

Methods

A school-based cross-sectional study was conducted in public high schools of Jarso district, eastern Ethiopia, from 1^st March to 5^th April 2019. A multistage sampling technique was used to select 559 eligible study participants. Data were collected by a structured self-administered questionnaire. The outcome measure of interest was lifetime sexual violence. Bivariate and multivariable logistic regression analyses were done. Statistically significant association of variables had been declared based on the adjusted odds ratio (AOR) with its 95% CI and p value < 0.05.

Results

The overall magnitude of sexual violence among female students was 28.6% (95% CI: 25%-32.2%) in the study area. Forty (7.2%) participants have experienced coercive sex against their consent. Participant's level of education ((AOR = 1.5, 95% CI (1.03–2.30)), being unmarried ((AOR = 2.80, 95% CI (1.40–5.81)), consumption of alcohol ((AOR = 3.41, 95% CI (1.11–10.40)), using substances (hashish and/or shisha) ((AOR = 2.6, 95% CI (1.02–6.50)), and ever initiated sexual intercourse ((AOR = 5.9, 95% CI (3.3–10.7)) were positively and statistically associated with sexual violence at p value < 0.05.

Conclusion

The overall magnitude of sexual violence was relatively high (28.6%). Thus, any intervention aimed to address sexual violence should consider the identified associated risk factors in the study area.

Combined Associations of Smoking and Bullying Victimization With Binge Drinking Among Adolescents in Beijing, China

Background: Binge drinking and smoking among adolescents are serious public concerns. However, very few studies have explored the reinforcement of bullying victimization by such behavior. Our study aimed at examining the individual and combined associations of smoking and bullying victimization with binge drinking among adolescents in Beijing, China. Methods: A total of 33,694 students aged 13-17 years old in Beijing, China were anonymously investigated via the cross-sectional Chinese Youth Risk Behavior Surveillance Survey from April to May 2014. A three-stage stratified sampling was used to select participants. Factors such as sociodemographic variables and indicators of smoking, bullying victimization, and binge drinking were analyzed with multiple logistic regressions, and joint and additive interaction effects were tested. Results: Overall, ever-drinking prevalence was 59.1% (boys: 64.4%; girls: 53.7%). Past 30-day binge drinking was 11.5% (boys: 15.6%; girls: 7.4%) and frequent binge drinking was 2.3% (boys: 3.3%; girls: 1.0%). Past 30-day smoking was 10.7% (boys: 16.4%; girls: 5.0%) and past 30-day bullying victimization was 48.7% (boys: 57.3%; girls: 40.1%). The combined effects of smoking and bullying victimization on occasional binge drinking (OR = 6.49, 95% CI = 5.60-7.52) and frequent binge drinking (OR = 10.32, 95% CI = 7.52-14.14) were significant, and the additive interaction effect was significant for current smoking and bullying victimization on frequent binge drinking (OR = 10.22, 95% CI = 9.43-11.07). The additive interaction effect for current smoking and bullying victimization on frequent binge drinking was significant among boys. Conclusion: Bullying victimization reinforced the association of smoking with frequent binge drinking, especially with findings specific to boys. Programs to prevent smoking or bullying or both may reduce binge drinking among adolescents in China.

Factors associated with sexual violence among female administrative staff of Mekelle University, North Ethiopia

Objective

To assess factors associated with sexual violence among female administrative staffs of Mekelle University, North Ethiopia.

Results

From the total number of participants, 188 (52.8%) had shift work and 110 (30.9%) of these had day and night shift. About half 180 (50.2%) of the participants face sexual violence similarly, 53 (14.9%) of the victims of violence performed by their boss. In multiple logistic regression analysis young age [AOR: 2.319 (1.059–5.075)], educational status of secondary school or less [AOR: 1.981 (1.126–3.485)], office and students related workplace [AOR: 4.143 (1.975–8.687), 2.887 (1.396–5.973)], having night shift [AOR: 2.131 (1.258–3.611)], having multiple partner (AOR: 8.916 (3.052–26.047)] and knowing other female violated in office [AOR: 3.920 (2.326–6.606)] were the factors associated with sexual violence.

Gender differences in suicidal ideation and health-risk behaviors among high school students in Beijing, China

Background

Suicide is still the leading cause of death in the 15 to 34-year age group, especially for girls aging 15 to 19-year old. In China particularly, the suicide rate of female is 60% higher than male. The gender difference on suicidal ideation and its patterns with academic, family, social and health-risk factors is unknown among adolescents in Beijing, China.

Methods

A total of 33 635 students in grades 7-12 in Beijing participated in the 2014 Chinese Youth Risk Behavior Surveillance. Data were stratified by gender and associations with suicidal ideation were analyzed using χ² test and multivariate regression analyses. The interaction effects on suicidal ideation between gender and the related behaviors were also analyzed.

Results

The prevalence of suicidal ideation was significantly higher for girls (13.3%) than boys (10.7%). The multivariate regression analyses indicated that high academic pressure, running away from home, feeling lonely or sad/hopeless, being bullied, fighting, and binge drinking were significantly associated with suicidal ideation in boys and girls. Factors more strongly associated with suicidal ideation in girls than boys were being in junior vs senior high school (girl vs boys: 1.24 vs NA), high academic pressure (2.42 vs 1.55), ever smoking (1.52 vs NA), binge drinking (1.30 vs 1.17), fighting once (1.63 vs 1.06) and being sad/hopeless (2.39 vs 2.04) and their interaction with gender were all statistically significant (P < 0.05). A lower likelihood of suicidal ideation was found among boys, but not girls, who had PE class two or more days per week.

Conclusions

Girls showed more vulnerability to suicidal ideation than boys particularly among girls in junior school, reporting high academic pressure, smoking, binge drinking and fighting. The combinations of risk factors and differential patterns for boys and girls point to high-risk groups and potential targets for gender-specific suicide prevention.

Prevalence of non-contact and contact childhood sexual abuse: An Internet-based sample of men who have sex with men in China

Background

The prevalence of childhood sexual abuse (CSA) is high among Western men who have sex with men (MSM), and CSA is associated with certain socio-demographic variables and with human immunodeficiency virus (HIV) status. Little is known about CSA among Chinese MSM; therefore, we explored the prevalence and frequency of non-contact (e.g., sexual invitations, exhibitionism) and contact (e.g., intercourse, genital contact) forms of CSA in an Internet-based sample of MSM in China. We also examined the associations between the participants’ socio-demographic characteristics and HIV status, and their histories of CSA.

Methods

We surveyed MSM from 30 Chinese provinces in 2014–2015; 1,030 (mean age = 25.15 years, SD = 6.32) and 1,020 (mean age = 25.05 years, SD = 5.95) respondents were eligible for inclusion in the non-contact and contact CSA groups, respectively.

Results

Prevalence of non-contact and contact CSA was 36.2% and 29.8%, respectively; 20.4% and 15.0% had experienced non-contact and contact CSA ≥ 3 times, respectively. Most respondents were young adults, well educated, single, had never “come out,” and self-identified as gay or bisexual men. Univariate analyses showed that respondents who had experienced contact CSA were more likely to be HIV-positive than those who had never experienced contact CSA. Multivariate analyses showed that non-contact CSA was associated with less education, being in a relationship with a woman or a man, and having “come out.” Contact CSA was associated with less education, higher income, and being in a relationship with a man. Respondents who had experienced non-contact CSA ≥ 3 times were more likely to be less educated, “out,” and to be in a relationship with a woman or a man. Respondents who had experienced contact CSA ≥ 3 times were more likely to be less educated and to be in a relationship with a man.

Conclusions

It is necessary to pay closer attention to CSA among MSM and other sexual minorities in China.

An epidemiological overview of child sexual abuse

Child sexual abuse (CSA) is a universal problem with grave life-long outcomes. The estimates vary widely depending on the country under study, the definitions used, the type of CSA studied, the extent of coverage, and quality of data. This study intended to assess the magnitude and the issues related to CSA. We searched databases such as PubMed, Google scholar, web (newspaper reports), and government websites. The relevant data was extracted from these sources for gathering evidence on CSA and secondary data analysis was done. The prevalence of CSA was found to be high in India as well as throughout the world. CSA is an extensive problem and even the lowest prevalence includes a huge number of victims. It also has various adverse effects on the psychological, physical, behavioral, and interpersonal well-being of the victim. Hence, stringent measures should be taken for the prevention and control of this hidden public health issue.