| [BACKGROUND] The non-consensual sex is experienced by significant percentages of young people in both developed countries and developing countries. These experiences adversely affect physical and mental health. In China, there are more and more cases reported about various kinds of non-consensual sex, including sexual harassment, rape/attempted rape, sex trafficking/forced prostitution in recent years. All of these reports have urged the issue to the priority of the concern to study seriously. However, there are few studies focusing on the non-consensual sex, and all of which are very limited in content and depth. These few studies only attended to sexual coercion or sexual abuse, and can’t include various forms of non-consensual sex, such as harassment through short messages/internet/phone call, exposing body, harassment of body language and instruments, peeping, verbal harassment, bodily harassment, attempted rape, sexual coercion and childhood sexual abuse, etc. And these few studies obtained survey data only simply through asking whether respondents had experienced non-consensual sex or sexual coercion. Meanwhile these studies can’t deeply focus on the consequences and victim’s help-seeking behavior. The issue of non-consensual sexual experiences among young people in China is clearly an important yet under-researched subject. Although there is fairly well-developed literature abroad, but the results differ significantly in different countries. And these study results in different countries can’t be directly compared with each other, since sexual behavior is influenced strongly by sociocultural context.[OBJECTIVES] To study the prevalence of various non-consensual sex and the situation (such as perpetrators, the places, reactions, and help-seeking behaviors, etc) and explore it’s related factors and negative effects using data from non-consensual sex survey conducted among university students and unmarried young women seeking abortion in Shanghai.[METHODS]This is a cross-sectional survey conducted among young people under 24 years old including unmarried young women seeking abortion and third-grade university students in Shanghai. Different sampling procedures were adopted. University students from 4 different types of universities located in Shanghai were selected through multiple-stage sampling and were interviewed through computer-assisted self-interviewing (CASI) techniques in May-July 2009. For unmarried young women seeking abortion,3 hospitals providing routine abortion services were conveniently selected as the research sites and respondents selected through sequential sampling in the family planning clinics were similarly surveyed in October 2009-May 2010. All respondents were anonymously self-interviewed by computer-assisted self-interviewing (CASI) techniques with investigators assisting only in cases like encountering difficulties. Information on respondents’backgrounds, self-evaluating and attitude, health risk behaviors, sexual experiences, situation of various forms of non-consensual sex, victim’s coping styles, help-seeking behaviors and adverse consequences, etc were collected in the survey which took about 20-30 minutes. Data were analyzed with SAS software 9.1 edition and Amos 17.0 edition. Varied statistical methods including ANOVA, chi-square test, logistic regression model, cluster and discriminant analysis, and structural equation model were used in the analysis.[RESULTS]1. General information.893 unmarried young women seeking abortion,430 male and 667 female university students were included in the analysis sample. The average age was about 21.5 years old.2. Prevalence of non-consensual sex. The prevalence of various non-consensual sex was different but very high in general, whether for unmarried young women seeking abortion or for university students, especially for female respondents. For female respondents, the prevalence of ordinary body harassment was highest (57.67%-63.12%), followed by verbal harassment and harassment through short messages (32.92%-38.23%). While males suffered more of harassment through short messages, ordinary body harassment, harassment through Email/BBS messages, and verbal harassment (20.00%-36.51%). It was worth noting that 12.32% of unmarried young women seeking abortion and 27.34% of sexually active female university students had been forced to have sexual intercourse. The main form of sexual coercion females experienced was "someone lured/seduced me using words to have sexual intercourse" (57.27%-65.71%), and 11.43%-13.64% of female victims had been physically forced to have sexual intercourse. Not only are women,5.88% of the sexually active male students also had been forced to have sexual intercourse and the main form was also "luring/seducing using words". Percentages of childhood sexual abuse were relatively high which were respectively 16.69% for unmarried young women seeking abortion,10.23% and 18.14% for male and female university students, and of which "perpetrators exposed their genitals to victims" was the most common abused form (4.19%-12.74%).3. Perpetrators. The perpetrators of different non-consensual sex were mainly strangers, classmates/friends/internet friends/colleagues, and lovers/boyfriends (girlfriends). Male victims had been perpetrated mainly by classmates/friends/internet friends/colleagues (50.00%-86.05%), while females had been harassed (verbal or bodily) mainly by strangers (42.32%-78.62%) and been forced to have sexual intercourse mainly by lovers/boyfriends (49.09%-62.86%). Most female respondents had experienced forced sexual fondling, attempted forced sex and forced sexual intercourse from males (79.39%-98.15%), while males mostly from same gender (50%-57.58%).4. Victims’ coping and help-seeking behaviors. Respondents had coped with different forms of non-consensual sex through different ways. When faced with verbal harassment, ordinary body harassment and forced sexual fondling, females tended to cope actively (42.76%-59.63%) or to leave (32.29%-56.29%), while males tended to respond passively (63.64%-76.74%). When faced with the same form of non-consensual sex from different perpetrators, respondents also responded differently. Females were more likely to leave to avoid verbal harassment, ordinary body harassment and forced sexual fondling from strangers (43.24%-67.07%), and tended to cope actively with these non-consensual sex from classmates/friends/internet friends/colleagues (57.45%-76.32%). After experiencing verbal harassment, ordinary body harassment, forced sexual fondling and sexual coercion, more than half of unmarried young women seeking abortion (57.09%-61.13%),37.50%-46.51% of male university students and 42.86%-66.30% of females had talked to others for help. And the most people victims talked were classmates/friends/internet friends/colleagues, followed by lovers/boyfriends (girlfriends) and family members/relatives. In addition, compared with male victims, female university students tended to talked to their family members/relatives.5. Adverse consequences. The most adverse consequence victims reported were "emotion became worse" (8.55%-41.82%), and furthermore female victims also reported more "had barriers to get along with the opposite sex" (7.36%-22.86%). Further analysis on the severity of consequences showed that, the more serious female victims suffered, the higher the proportion of adverse effects (increased from 27.75% to 82.73%), and the higher the proportion of more serious adverse effects (increased from 11.45% to 47.27%). Relatively, for male victims the proportion of adverse effects was lower (11.11%-25%) and less serious.6. Factors associated with non-consensual sex. Logistic regression results showed that respondents with more health risk behaviors would be likely to experience various non-consensual sex (OR:ranged from 1.17 to 1.58), and furthermore those unmarried young women seeking abortion having been sexually abused in childhood and having multiple sexual partners were more likely to be forced to have sexual intercourse after 15 years old (OR:2.42 and 3.88).7. Clustering of non-consensual sex. Based on the cluster analysis, unmarried young women seeking abortion and female university students all clustered into 3 clusters according to the non-consensual sex. Most respondents were less prone to non-consensual sex (from 69.54% to 88.01%) and only a very small number of respondents tended to suffer each form of non-consensual sex (2.55%-4.70%). And further analysis on the related factors of different clusters showed that respondents with more health risk behaviors were more likely to be subjected to non-consensual sex (OR:1.41 and 1.69).8. Structural equation model about factors related with forced sexual intercourse. Unmarried young women seeking abortion and female university students having been sexually abused in childhood (the total effects were 0.309 and 0.048 respectively) and with more health risk behaviors (the total effects were 0.162 and 0.106 respectively) tended to be forced to have sexual intercourse after 15 years old. And for unmarried young women seeking abortion childhood sexual abuse were mainly directly affecting the forced sexual intercourse (0.256), while for female university students it mainly had indirect (0.045) effect and the effect was minor.[CONCLUSION]1. The non-consensual sex was experienced by significant percentages of unmarried young women seeking abortion and university students. These experiences adversely affect physical and mental health.2. According to cluster analysis, most young people were less prone to non-consensual sex and only a very small number of young people were more likely to be subjected to various non-consensual sex.3. Young people with more health risk behaviors would be likely to experience various non-consensual sex.4. Female young people having been sexually abused in childhood and with more health risk behaviors tended to be forced to have sexual intercourse. And for unmarried young women seeking abortion, childhood sexual abuse were mainly directly affecting the forced sexual intercourse, while for female university students it mainly had indirect effect and the effect was minor. |
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