Background The study aimed to discuss the importance of socioeconomic status (SES) and family sexual attitudes and investigate their association with sexual and reproductive health in a large sample of Chinese young adults. Methods We analysed a large sample of 53 508 youth aged 15–24 years from an internet-based survey from November 2019 to February 2020. Multivariable logistic regression analyses were employed to examine the association between SES, family sexual attitudes, and sexual and reproductive health (SRH), stratified by sex and adjusting for potential confounders. Results Individuals with the highest expenditure were more likely to engage in early sexual intercourse (female: OR 4.19, 95% CI 3.00 to 5.87; male: OR 3.82, 95% CI 2.84 to 5.12). For both sexes, the likelihood of young adult sexual risk-taking such as first intercourse without using a condom, acquiring sexually transmitted infections, and pregnancy was lower in those with higher maternal educational attainment, whereas it was higher in those with open family sexual attitudes. Conclusions Lower SES and open family attitudes toward sex had a significant association with a range of adverse young adulthood SRH outcomes. Public health policies should focus on more deprived populations and advocate suitable parental participation to reduce risky sexual behaviours in youth.

This study aimed to reveal sex and urban–rural differences in the association between childhood sexual abuse (CSA) and mental health among Chinese college students. The study used data from the “National College Student Survey on Sexual and Reproductive Health 2019”, a cross-sectional study conducted in all 31 provinces of mainland China. Weighted logistic regression analysis was conducted to determine the association between CSA (noncontact CSA, contact CSA, and penetrative CSA) and mental health (suicide attempts and mental disorders). Among 49,728 students, 39.42% of the male participants and 43.55% of the female participants had ever experienced CSA. According to the OR results of logistic regression analysis, compared to females, males in the contact CSA group (AOR: 3.49, 95% CI: 1.95–6.23) and the penetrative CSA group (AOR: 8.79, 95% CI: 3.15–24.52) had higher odds of suicide attempts. Participants from rural and suburban areas that were categorized in the penetrative CSA group were more likely to report suicide attempts (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban AOR: 4.86, 95% CI: 2.52–9.36) and mental disorders (rural: AOR: 4.01, 95% CI: 1.51–10.62, suburban: AOR: 4.86, 95% CI: 2.52–9.36). In conclusion, the findings revealed a high prevalence of CSA in both sexes and reported that males are more vulnerable to the adverse effects of CSA. In addition, we also found that undergraduates growing up in rural and suburban areas are more vulnerable to the adverse psychological effects of CSA. Policymakers should pay more attention to this vulnerable population and implement effective measures to alleviate mental trauma.

This study aimed to investigate the association between early sexual initiation and suicide attempts (SAs) among Chinese young people. Our analysis included 9131 college students who had sexual experience from a national sample of 31 provincial administrative regions. Self-reported age at first intercourse was categorized as ≤15, 15–18, and ≥18 years, and the experience of SAs was recorded and analyzed. Compared with females whose sexual debut age was ≥18 years, those ≤15 years (defined as early sexual initiation) had higher odds of SAs in both the forced debut group (odds ratio (OR) 17.04, 95% confidence interval (CI) 4.87–59.66) and the voluntary debut group (OR 37.63, 95% CI 14.96–94.66). Early sexual initiators who lived in rural areas were more inclined to have SAs (female: OR 65.76, 95% CI 19.80–218.42; male: OR 15.39, 95% CI 1.64–144.19). Early sexual initiators who never had parent–child communication about sex were more likely to report having SAs (female: OR 37.81, 95% CI 12.28–116.46). Sexual debut during adolescence, particularly early sexual initiation, was a crucial risk factor for SAs among both sexes. Comprehensive sexuality education and smooth parental communication about sex will provide a supportive environment for young people and hence reduce the potential risks of SAs.

Background: This study aimed to evaluate the effects of an internet-based and teacher-facilitated sexuality education package on the sexual knowledge and attitudes of Chinese adolescents. Methods: Six middle schools where no sexuality education had been performed with a total of 501 adolescent students (245 males and 256 females) were included in the trial. In total, 14 classes were randomly assigned to the intervention (internet-based sexuality education package) or the control group (classes were conducted as per normal). Students’ sexual knowledge and attitudes were assessed at the baseline, at the end of the intervention, and 12 months after the intervention. Generalized linear models were employed to assess the effects of the intervention. Results: Positive effects of the intervention were observed on sexual knowledge (β = 4.65, 95% CI: 4.12—5.17) and attitudes (β = 1.25, 95% CI: 1.00—1.50) at the end of the intervention. After 12 months, the effects sustained but the magnitude declined for sexual knowledge (β = 2.39, 95% CI: 1.85—2.93) and attitudes (β = 0.49, 95% CI: 0.23—0.75). There were no significant differences between male and female students. Conclusions: Although further modifications are required, the sexuality education package can increase the accessibility of comprehensive sexuality education to adolescents in rural areas in China.

Sexual assault and harassment (SAH) has become an increasing global concern that disproportionately impacts gender and sexual minority youth, yet research is scarce outside Western nations. In addition, sexual assault and sexual harassment are closely related experiences in both academic inquiries on sexual victimization and public discussion in the global #Metoo movement. Drawing from a large Chinese college student sample (N = 50,818), we investigated the prevalence of SAH victimization during childhood, adolescence, and emerging adulthood, as well as the SAH disparities between sexual minority and heterosexual youth. The population‐weighted prevalence of SAH victimization was estimated to be 20.23% during childhood, 42.87% during adolescence, and 21.87% during emerging adulthood, with more than half of the youth (55.41%) having ever experienced any SAH. Logistic regression results suggested girls and sexual minorities were disproportionally impacted across childhood, adolescence, and emerging adulthood. The discussion is framed in the context of Chinese culture and current Chinese legislation related to SAH.