Characteristics and determinants of sexual behavior among adolescents of migrant workers in Shangai (China)

Shangai Xin Hua Hospital affiliated with Shangai Jiaotong University School of Medicine, Shangai, PR China.
BMC Public Health (Impact Factor: 2.26). 07/2009; 9(1):195. DOI: 10.1186/1471-2458-9-195
Source: PubMed


China is facing a critical challenge of rapid and widespread human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) increase. Rural-to-urban migration plays a crucial role in shifting the HIV/sexual transmitted infection (STI) epidemic. The purpose of this study was to assess the prevalence of sexual behaviors and the correlates among the early adolescents of migrant workers in China.
A cross-sectional study was conducted in 10 junior high schools from April to June of 2008. A total of 2821 adolescents aged 14.06 +/- 0.93 years (8.9% of migrant workers vs. 91.1% of general residents) participated in the survey. A self-administrated questionnaire was used to collect information on knowledge, attitude, and behaviors associated with increased risk for HIV/STI.
The percentage of adolescents who ever had sexual intercourse or had sexual intercourse in last three months was 7.2% and 4.3% in adolescents of migrant workers, respectively; in contrast, 4.5% and 1.8% in their peers of general residents, respectively. 47.3% adolescents of migrant workers and 34.3% of those adolescents of general residents reported no condom use in sexual intercourse during last three months. Multivariate logistic regression analyses found that migration was a independent risk factor for sexual intercourse in last three months in our sampled adolescents (odds ratio [OR] = 1.23, 95% confidence interval [CI]: 1.01-1.72). In adolescents of migrant workers, factors such as lower family income (OR: 2.22, CI: 1.09-3.05 for low level; OR:1.25, CI: 1.04-1.59 for medium level), younger age at first sexual intercourse (OR: 1.24, CI: 1.09-1.57), lower knowledge on HIV/AIDS (OR: 0.93, CI: 0.90-0.97), and fewer communication on HIV/AIDS related issues (OR: 0.79, CI: 0.90-0.97) were related to sexual intercourse in last three months.
Based on these results, we advocated that heightened concerns targeting the adolescents of migrant workers be particularly necessary, given their higher level of sexual experience, lower socioeconomic status, restricted reproductive health information, and vulnerability to HIV/STI.

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    • "OPEN ACCESS 2211 lescents between the ages of 15 and 24 years old. Studies have indicated that migrant adolescents are more likely to participate in premarital sex, unprotected sex and early engagement in sexual behavior [5] [10] [11]. They are also less likely to use condoms when compared with nonmigrants [12]. "
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    ABSTRACT: Internal migration in China has introduced cri-tical challenges to the education and health of migrant adolescents. The aim of this study was to explore the differences in sexual knowledge and attitudes among migrate and local adoles-cents. Survey research with a total of 616 ado-lescents in grades equivalent to US 10 th and 11 th grades including 113 migrants completed a self-administered questionnaire. Misconceptions of adolescent physical development, sexual activ-ity, marriage, birth control, sexually transmitted diseases and the probability of pregnancy were found in most of the migrant adolescents. Sig-nificantly lower attitudinal scores were found for the sub-scales of clarity of personal sexual val-ues, understanding of emotional needs, social behavior, sexual responses; attitudes towards gender role, birth control, premarital intercourse, use of force in sexual activity, the importance of family and satisfaction with social relationship in migrant adolescents. Migrant adolescents have a low level of knowledge of sexual activi-ties. The content of education programs should include engagement in sexual behavior to equip adolescents with unbiased and factual knowl-edge. The adolescents have a high demand for family support. School based sex education programs should involve the participation of par-ents to address these issues.
    Full-text · Article · Dec 2013 · Health
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    • "Studies from other countries have shown that the sexual attitudes of young, mobile people become increasingly open and that they are particularly likely to indulge in HIV/AIDS-related sexual risk behavior [14-17]. Similar studies of migrant workers in China have indicated that premarital and extramarital sex appear to have become more accepted among young people [18,19]. Hesketh [20] proposed that traditional attitudes to sexual relationships place migrant workers at low risk for engaging in casual sex. "
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    ABSTRACT: In China, there is increasing concern because of the rapid increase in HIV infection recorded over recent years. Migrant workers are recognized as one of the groups most affected. In this study, HIV/AIDS-related knowledge, attitudes, and behavior among unmarried migrant workers in Shanghai are investigated, with the aim of providing critical information for policy makers and sex educators to reinforce sexual health services and sex health education targeting the behavior and sexual health of unmarried male migrants. A cross-sectional survey was conducted among unmarried male migrant workers in Shanghai, China' largest city and housing the most migrants. A self-administered, anonymous questionnaire was used to collect information on knowledge, attitudes, and behavior associated with increased risk of HIV/AIDS. A total of 2254 subjects were questioned, with a response rate of 91.3%. Among those interviewed, 63.5% reported sexual activities. Misconceptions regarding HIV transmission, poor perception of HIV infection, and low use of condoms were not uncommon. Among those who had sexual intercourse, 73.7% had not used condoms in their last sexual intercourse, and 28.6% reported having engaged in sexual risk behavior (defined as having at least one non-regular partner). Multivariate logistic regression analyses identified several indicators of sexual risk behavior, including younger age at first sexual intercourse (OR: 0.67, 95% CI: 0.31-0.91 for older age at first sexual intercourse), more cities of migration (OR: 2.91, 95% CI: 2.17-3.81 for high level; OR:1.15, 95% CI: 1.06-1.29 for medium level), poor perception of acquiring HIV/AIDS (OR:1.52, 95% CI: 1.33-1.96 for unlikely; OR: 2.38, 95% CI: 1.61-3.70 for impossible), frequent exposure to pornography (OR: 0.33, 95% CI: 0.11-0.43 for never; OR:0.69, 95% CI: 0.60-1.81 for less frequently), not knowing someone who had or had died of HIV/AIDS and related diseases (OR: 2.13, 95% CI: 1.70-2.53 for no), and having peers who engaged in sex with a non-regular sex partner (OR: 4.40, 95% CI: 3.37-5.56 for yes). Today, it is necessary to reinforce sex health education among unmarried migrants and sexual health services should target vulnerable migrant young people.
    Full-text · Article · Dec 2013 · BMC Public Health
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    • "The AHRBQ was derived from our previously established instrument “The Adolescents' Reproductive Health Questionnaire (ARBQ)”. The ARBQ was used to collect information on adolescents' knowledge, attitude, and behaviors concerning HIV/STI, which has been described previously [21]. Based on the 10 items regarding HIV/STI related behaviors in ARBQ, the AHRBQ was developed by adding 9 items according to an updated literature review, qualitative interview in pilot study, and reliability assessment. "
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    ABSTRACT: Background Given the higher prevalence of risky sexual behaviors and substance use, adolescents and youths are at risk for HIV. Despite its importance, however, to the best of our knowledge, there are only a few researches on risky behaviors in Chinese adolescents/youths. The present study aimed to describe the prevalence of sexual and substance use behaviors among a Chinese sample of senior high school students. And more specifically, the associations of socio-demographic factors and substance use with risky sexual behaviors were examined in the sample. Methods A cross-sectional study was conducted in 10 senior high schools. A total of 2668 senior high school students aged 15.17 to 23.42 years participated in the survey. A self-administrated questionnaire was used to collect information on sexual and substance use behaviors. Results The percentages of students who ever had sexual intercourse in lifetime or during last three months were 7.0% and 5.1%, respectively. Among the participants with sexual intercourse during last three months, 42.1% ever had unprotected sexual intercourse and 49.4% had intercourse with two or more partners. Multivariate logistic regression analyses showed that cigarette smoke and illicit drug use were related to unprotected sexual intercourse (defined as “sexual intercourse without condom use”) and younger age of first sexual intercourse was related to multiple-partner sexual intercourse. Conclusions HIV/sexual transmitted infection (STI) health education and prevention are necessary among the Chinese adolescents, particularly among those adolescents with experience of sexual intercourse and/or substance use, which has a long-term beneficial to the control of HIV/STI in China.
    Full-text · Article · Apr 2013 · BMC Public Health
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