Associated Factors of Sexual Initiation among Male Vocational High School Students in Zhejiang Province, China: A Cross-sectional Study


Cite item

Full Text

Abstract

Aims:This study aims to investigate the factors associated with sexual initiation among male vocational high school students (MVHSS) in Zhejiang Province, and provide a scientific basis for preventing unsafe sexual behavior and sexual health issues among adolescents.

Background:The prevalence of sexual behavior among young students has risen significantly in recent years. Contracting HIV poses a serious physical and psychological burden on young individuals and their families. Thus, it is imperative to promptly and effectively address the spread of HIV among young people.

Objective:The objectives of this study are to investigate the demographic characteristics of male vocational high school students (MVHSS) who have engaged in sexual activity and to identify associated factors, such as sexual attitudes and lifestyle, that may influence sexual initiation among this population, and to offer recommendations for interventions and policy development aimed at promoting healthy sexual behaviors among MVHSS.

Methods:A survey was conducted among vocational high school students in grades one and two in Zhejiang Province. Variables that were statistically significantly associated with sexual initiation in bivariate analyses were included in a multivariate logistic regression model, which adopted a backward elimination procedure with a p-value > 0.10 as the exclusion criterion. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to describe the relationship between dependent and outcome variables.

Results:Of the 1032 male participants, 17.4% had initiated sexual behavior. The multivariate analysis results indicated thatThose who were frequent smokers (adjusted OR[AOR] =4.89, 95% CI: 2.36–10.13), those who reported having been in love (AOR=2.86, 95% CI: 1.84–4.44), those currently in love (AOR=4.47, 95% CI: 2.68–7.45), those willing to have sex with a high school student (AOR =2.63, 95% CI: 3.31–6.50), those willing to pay for sex (AOR =1.90, 95% CI: 1.10–3.27), and those who had received sex education and STDs/AIDS prevention education in school (AOR =2.21, 95% CI: 1.53–3.18) were more likely to initiate sexual behavior.

Conclusion:Sexual attitudes among MVHSS are liberal, and the prevalence of sexual initiation is high. Interventions targeted at improving sexual safety education, reducing the rate of early initiation of sexual behavior, and promoting condom use among students must be implemented to reduce the risk of HIV infections and STDs among sexually active MVHSS.

About the authors

Xiang Zhao

Department of Health Education Institute, Zhejiang Provincial Center for Disease Control and Prevention

Email: info@benthamscience.net

Zhongrong Yang

AIDS and TB Control and Prevention, Huzhou Center for Disease Control and Prevention

Email: info@benthamscience.net

Hui Wang

Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention

Email: info@benthamscience.net

Yu Huang

Department of Health Education Institute, Zhejiang Provincial Center for Disease Control and Prevention

Email: info@benthamscience.net

Weiyong Chen

Department of HIV/STD Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention

Author for correspondence.
Email: info@benthamscience.net

References

  1. Djiadeu P, Begum H, Archibald C, et al. Risk of transmission of HIV to infants during breast/chest feeding when mothers/birthing parents living with HIV are on antiretroviral therapy: a protocol for a rapid review. BMJ Open 2024; 14(5): e084436. doi: 10.1136/bmjopen-2024-084436 PMID: 38719325
  2. Zegeye B, Anyiam FE, Ahinkorah BO, et al. Women's decision-making capacity and its association with comprehensive knowledge of HIV/AIDS in 23 sub-Saharan African countries. Arch Publ Heal 2022; 80(1): 111.
  3. Ma R, Zhang Q, Zhao C, et al. The consensus guideline of perioperative antiviral therapy for AIDS patients in China based on clinical practice. Front Med (Lausanne) 2023; 10: 1267236. doi: 10.3389/fmed.2023.1267236 PMID: 38126075
  4. Berhe H, Godana W, Boti Sidamo N, et al. Perceived Social Support and Associated Factors Among Adults Living with HIV/AIDS Attending ART Clinic at Public Hospitals in Gamo Zone, Southern Ethiopia 2021. HIV AIDS (Auckl) 2022; 14: 103-17. doi: 10.2147/HIV.S351324 PMID: 35341218
  5. Armoon B, Fleury MJ, Higgs P, et al. Prevalence, socio-demographics and service use determinants associated with disclosure of HIV/AIDS status to infected children: a systematic review and meta-analysis by 1985-2021. Arch Publ Heal 2022; 80(1): 154.
  6. Huang J, Wu H, Lin S, et al. Spatial−temporal analysis of HIV/AIDS and syphilis in mainland China from 2007 to 2017. J Med Virol 2022; 94(7): 3328-37. doi: 10.1002/jmv.27725 PMID: 35297065
  7. Chen W, Yang J, Jiang J, et al. A spatial analysis of the epidemiology of HIV-infected students in Zhejiang province, China. BMC Infect Dis 2021; 21(1): 430. doi: 10.1186/s12879-021-06033-7 PMID: 33962557
  8. Liang E, Nkwonta CA, Goldsamt LA, Navarra AMD. A qualitative assessment of retention in HIV care among adolescents and young adults (AYA) living with HIV in New York City. AIDS Care 2024; 1-10. doi: 10.1080/09540121.2024.2373402 PMID: 38976575
  9. Benoni R, Cavallin F, Casigliani V, et al. Assessing the resilience of HIV healthcare services provided to adolescents and young adults after the COVID-19 pandemic in the city of Beira (Mozambique): an interrupted time series analysis. AIDS Res Ther 2024; 21(1): 29. doi: 10.1186/s12981-024-00621-8 PMID: 38724976
  10. Mthiyane N, Shahmanesh M, Copas A, et al. Uptake of multi-level HIV interventions and HIV-related behaviours among young people in rural South Africa. PLOS Global Public Health 2024; 4(5): e0003258. doi: 10.1371/journal.pgph.0003258 PMID: 38820546
  11. Shahmanesh M, Chimbindi N, Busang J, et al. Effectiveness of integrating HIV prevention within sexual reproductive health services with or without peer support among adolescents and young adults in rural KwaZulu-Natal, South Africa (Isisekelo Sempilo): 2 × 2 factorial, open-label, randomised controlled trial. Lancet HIV 2024; 11(7): e449-60. doi: 10.1016/S2352-3018(24)00119-X PMID: 38925731
  12. Yang Z, Chen W, Chen W, et al. Factors associated with voluntary HIV counseling and testing among young students engaging in casual sexual activity: a cross-sectional study from Eastern China. BMC Public Health 2024; 24(1): 1109. doi: 10.1186/s12889-024-18562-2 PMID: 38649927
  13. Kugler KC, Vasilenko SA, Butera NM, Coffman DL. Long-term consequences of early sexual initiation on young adult health: A causal inference approach. J Early Adolesc 2017; 37(5): 662-76. doi: 10.1177/0272431615620666 PMID: 28529400
  14. Olum R, Geng EH, Kitutu FE, Musoke PM. Feasibility, acceptability and preliminary effect of a community-led HIV self-testing model among adolescent girls and young women in Rural Northern Uganda: a quasi-experimental study protocol. Implement Sci Commun 2024; 5(1): 56. doi: 10.1186/s43058-024-00596-7 PMID: 38773505
  15. van Wyk B, Roomaney RA. Patterns and predictors of HIV comorbidity among adolescents and young adults in south africa. Int J Environ Res Public Health 2024; 21(4): 457. doi: 10.3390/ijerph21040457 PMID: 38673368
  16. Abiodun O, Sodeinde K, Jagun O, et al. Influence of perception of family support and functioning on adolescent high-risk sexual behavior. Am J Trop Med Hyg 2020; 104(3): 1153-63. doi: 10.4269/ajtmh.20-0732 PMID: 33289467
  17. Yang T, Qing L, Wang Y, et al. Influence of HIV/AIDS knowledge on HIV testing behavior among young students (14-27 years) with a history of sexual activity: chain mediation analysis of social discrimination, self-efficacy, and sexual behavior characteristics. AIDS Care 2024; 36(4): 561-8. doi: 10.1080/09540121.2023.2280460 PMID: 38088933
  18. Weyandt L, DuPaul GJ, Shepard E, et al. Longitudinal examination of sexual risk behavior in college students with and without attention-deficit/hyperactivity disorder. Arch Sex Behav 2023; 52(8): 3505-19. doi: 10.1007/s10508-023-02660-0 PMID: 37548880
  19. Choruma DJ, Choruma SD, Pasirayi RM. Catch them young: Knowledge and awareness levels of HIV and AIDS transmission among high school students in Harare, Zimbabwe. Afr J AIDS Res 2021; 20(3): 224-31. doi: 10.2989/16085906.2021.1979060 PMID: 34635019
  20. Clayton HB, Kilmer G, DeGue S, et al. Dating violence, sexual violence, and bullying victimization among high school students —youth risk behavior survey, united states, 2021. MMWR Suppl 2023; 72(1): 66-74. doi: 10.15585/mmwr.su7201a8 PMID: 37104527
  21. Szucs LE, Pampati S, Li J, et al. Role of the COVID-19 pandemic on sexual behaviors and receipt of sexual and reproductive health services among U.S. high school students — youth risk behavior survey, united states, 2019–2021. MMWR Suppl 2023; 72(1): 55-65. doi: 10.15585/mmwr.su7201a7 PMID: 37104536
  22. Li S, Huang H, Xu G, Cai Y, Shi R, Shen X. HIV/AIDS-related knowledge, sources and perceived need among senior high school students: a cross-sectional study in China. Int J STD AIDS 2009; 20(8): 561-5. doi: 10.1258/ijsa.2008.008433 PMID: 19625589
  23. Li X, Zhang L, Mao R, Zhao Q, Stanton B. Effect of social cognitive theory-based HIV education prevention program among high school students in Nanjing, China. Health Educ Res 2011; 26(3): 419-31. doi: 10.1093/her/cyr001 PMID: 21330355
  24. Ye XX, Huang H, Li SH, et al. HIV/AIDS education effects on behaviour among senior high school students in a medium-sized city in China. Int J STD AIDS 2009; 20(8): 549-52. doi: 10.1258/ijsa.2008.008471 PMID: 19625586
  25. Yang Z, Chen W, Jin M, Chen W, Chen L, Zhou X. Analysis of factors influencing casual sexual behavior among male college students in Zhejiang Province, China. PLoS One 2021; 16(5): e0250703. doi: 10.1371/journal.pone.0250703 PMID: 33939731
  26. Yeo JH, Park H, Kim EY. Predictors of the timing of sexual intercourse initiation among adolescents in south korea. J Community Health 2019; 44(3): 580-6. doi: 10.1007/s10900-018-00605-6 PMID: 30604219
  27. Yang Z, Ma Q, Chen W, et al. Analysis of multiple sexual partners among 2665 male college students who have sexual behaviour in zhejiang province, china. BioMed Res Int 2022; 2022: 1-8. doi: 10.1155/2022/8006537 PMID: 36033568
  28. Kassahun EA, Gelagay AA, Muche AA, Dessie AA, Kassie BA. Factors associated with early sexual initiation among preparatory and high school youths in Woldia town, northeast Ethiopia: a cross-sectional study. BMC Public Health 2019; 19(1): 378. doi: 10.1186/s12889-019-6682-8 PMID: 30947690
  29. Lammers C, Ireland M, Resnick M, Blum R. Influences on adolescents' decision to postpone onset of sexual intercourse: a survival analysis of virginity among youths aged 13 to 18 years. J Adol Heal 2000; 26(1): 42-8.
  30. Yang Y, Jiang J. Influence of family structure on adolescent deviant behavior and depression: the mediation roles of parental monitoring and school connectedness. Public Health 2023; 217: 1-6. doi: 10.1016/j.puhe.2023.01.013 PMID: 36812808
  31. Sieverding JA, Adler N, Witt S, Ellen J. The influence of parental monitoring on adolescent sexual initiation. Arch Pediatr Adolesc Med 2005; 159(8): 724-9. doi: 10.1001/archpedi.159.8.724 PMID: 16061779
  32. Burke L, Nic Gabhainn S, Kelly C. Socio-Demographic, Health and Lifestyle Factors Influencing Age of Sexual Initiation among Adolescents. Int J Environ Res Public Health 2018; 15(9): 1851. doi: 10.3390/ijerph15091851 PMID: 30150572
  33. Ma Q, Ono-Kihara M, Cong L, et al. Early initiation of sexual activity: a risk factor for sexually transmitted diseases, HIV infection, and unwanted pregnancy among university students in China. BMC Public Health 2009; 9(1): 111. doi: 10.1186/1471-2458-9-111 PMID: 19383171
  34. Rudatsikira E, Muula AS, Siziya S. Variables associated with physical fighting among US high-school students. Clin Pract Epidemiol Ment Health 2008; 4(1): 16. doi: 10.1186/1745-0179-4-16 PMID: 18510746
  35. Costa MIF, Rodrigues RR, Teixeira RM, Paula PHA, Luna IT, Pinheiro PNC. Adolescents in situations of poverty: resilience and vulnerabilities to sexually transmitted infections. Rev Bras Enferm 2020; 73 (Suppl. 4): e20190242. doi: 10.1590/0034-7167-2019-0242 PMID: 32965409
  36. Santelli JS, Lowry R, Brener ND, Robin L. The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among US adolescents. Am J Public Health 2000; 90(10): 1582-8. doi: 10.2105/AJPH.90.10.1582 PMID: 11029992

Supplementary files

Supplementary Files
Action
1. JATS XML

Copyright (c) 2024 Bentham Science Publishers