| BackgroundStatus of premarital sexual intercourse, unintended pregnancy, abortion and associated factors among Chinese college students remain to be seen.Objectives1.To ascertain the current status of premarital sex, unintended pregnancy, bortion and contraceptive practice among college students in China, and to provide evidence for aimed contraceptive service and education in college/university.2. To explore the demand of sexual education and contraception service among college student in China, and to provide some important information for education administrators and policy makers in establishing policies for contraceptive education and services.3. To evaluate the factors associated with premarital sex among unmarried students and with unintended pregnancy among students who active in premarital sex, and to provide theoretical bases for further contraceptive education and services.4. To evaluate the intervention effect on contraceptive knowledge, attitude, practice among college/university students, and to provide some background information for further contraceptive education in college/university.Methods1. The self-completed questionnaire was was employed, which was designed after a thorough review of similarly published reports, and was developed by the pilot tests on a group of 800 undergraduates. Through multistage, stratified, probability cluster sampling, the cross-sectional descriptive study was conducted in 80000 students from 49 colleges/universities in 7 cities of China for their contraceptive knowledge, attitude, practice and requirement.2. Factors associated with a history of premarital sex and a history of pregnancy were entered in univariate analyses. Those factors significant in the univariate analyses (p<0.01) were then entered in a multivariate logistic regression model that was analyzed using forward stepwise logistic regression model, with p value<0.01 as the criterion for including a variable in the model.3. Based on the teaching materials Reproductive Health and Birth Control, contraceptive lectures were conducted in college students from Wuhan and Chongqing, and contraceptive services were provided for them through the website, too. Questionnaire survy was conducted anonymously in college students before intervention and half a year after intervention, to explore the change of contraceptive knowledge, attitude and practice.Results1.Of the 79 773 voluntary participants,93.1%(74 258) responded validly and completely. The major cognitions of contraception listed in the questionaire were low, and female's cognitions were more superior to male's, medical students' was superior to non-medical students'(both.<0.01). Premarital sex and unmarried cohabitation were accepted by more than 70% of college students, and the rate of acceptance among male and non-medical students was higher than that among female and medical students, respectively(P<0.01).87.2% students of them thought learning more contraceptive knowledge was necessary.14.4% of responders acknowledged a history of premarital sexual intercourse(standardized prevalence rate of premarital sexual intercourse was 15.4%), and the rate was higher among male and non-medical students than that among female and medical students, respectively.28.7% of college/university students active in premarital sex always used contraception in sexual intercourse.25.2% of college/university students active in premarital sexual intercourse had a history of pregnancy, and the incidence of unintended pregnancy among male students was higher than that among female students (P<0.01), but the difference was not seen between medical students and non-medical students (P>0.01).2. To the 74258 investigated students, the most popular channels of sexual knowledge were from magazines and books (70.1%), internet(54.6%),and peers and classmates (41.6%). The best way of obtaining sexual knowlege was considered by them as from magazines and books (69.2%), courses or lectures (61.4%), and internet (48.5%). 57.3% of students active in sexual intercourse get contraception from supermarkets and drugstore, only 5.9% of them was from hospital in campus. To students active in premarital sex, the ideal way to get contraceptives/condoms was from supermarkets (51.7%) and hospital in campus (18.3%),respectively. More than 80% of students were unsatisfied with the contraceptive education and services provided by school. 90.1% of college/university students wished college/university to strengthen the education of contraception,39.5% of students wished college/university to setup curriculum of contraception.3.In the multivariate logistic regression analysis, minority [odds ratio (OR),1.58; 95% confidence interval (CI),1.42-1.75], higher education background (OR,3.11; 95% CI,2.67-3.61), art discipline(OR,2.50; 95% CI,2.38-2.75), having a steady lover (OR,3.76; 95% CI,3.50-4.03), higher disposable income per month (OR,1.44; 95% CI,1.33-1.57), approving the virginity is unimportant(OR,1.36; 95% CI, 1.28-1.44), approving of sexual liberation (OR,1.29; 95% CI,1.21-1.37), regular sexual impulse (OR,1.85; 95% CI,1.74-1.97), regular sexual masturbation (OR,1.49; 95% CI,1.39-1.61) were the risk factors of premarital sexual intercourse for male students; minority (OR,1.30; 95% CI,1.14-1.47), higher education background (OR 3.10; 95% CI,2.55-3.76), art discipline (OR,2.97; 95% CI, 2.66-3.76), having a steady lover (OR,4.65; 95% CI,4.22-5.13), higher disposable income per month (OR,1.37; 95% CI,1.23-1.52), no approving of virginity (OR, 1.45; 95% CI,1.34-1.56), approving of sexual liberation (OR,1.32; 95% CI, 1.23-1.43),approving of sexual masturbation is normal (OR,1.61; 95% CI, 1.47-1.76), regular sexual impulse (OR,2.10; 95% CI,1.87-2.34), regular sexual masturbation (OR,2.23; 95% CI,2.06-2.41) were the risk factors of premarital sexual intercourse for female students.Having no steady lover [odds ratio (OR),1.250,95% confidence interval (CI), 1.099-1.420], higher disposable income per month (OR,1.181,95% CI,1.060-1.317), younger age at first sexual intercourse (OR,1.941,95% CI,1.622-2.322), unawareness of the course of conception (OR,1.712; 95% CI,1.548-1.890), unawareness of emergency contraception(OR,1.802; 95% CI,1.379-2.353), unawareness of abortion endangering women's future pregnancy(OR,1.330; 95% CI, 1.182-1.499), unawareness of abortion endangering women's physical and mental health (OR,1.629; 95% CI,1.414-1.876), approving of sexual liberation(OR,1.429; 95% CI,1.292-1.577), unawareness of premarital pregnancy endangering the parties' reputation (OR,1.229; 95% CI,1.093-1.382), lack of condom use in first sex (OR, 1.354; 95% CI,1.231-1.489), none of contracetive education provided by college(OR, 1.508; 95% CI,1.343-1.695), none of contracetive services provided by college(OR, 1.878; 95% CI,1.622-2.174) were the risk factors of unintended pregnancy for male graduates'partners or female students who active in premarital sex.4. Compared with before intervention, the cognition regarding ovulation period and emergency contraception were improved after intervention(P<0.01). The proportion of "most concerned about contraceptive effectiveness in using contraception" was increased, but the proportions of "opposes the sexual liberation" and "against unmarried cohabitation" were declined, the prevalence rate of sexual intercourse among male students was increased after intervention(P<0.01). The proportions of "always use contraception" and "use condoms in sexual intercourse" were increased, and incidence of unintended pregnancy was declined after intervention (all P<0.01).Conclusions 1. College/university students have an open attitude towards sex, a compared low prevalence rate of premarital sexual intercourse, and a high incidence of unintended pregnancy among students active in premarital sexual intercourse. But the cognition of contraception among them are poor.2. The contraceptive services and education provided by college/university are lagging behind students' requirement. Students wish college/university strengthen the contraceptive education and service.3. The prevalence rate of premarital sexual intercourse among college students is increased with longer period between their initiation of sexual activity and marriage. Unawareness of safe sex and open attitude towards sex increases the incidence of unintended pregnancy.4. Lectures of contraception increase the cognition and ability of safe sex, decrease the incidence of unintended pregancy among students active in premarital sex modestly, but enhance the open attitude towards sex, increase the prevalence rate of premarital sex.Suggestions1. Contraceptive education and services should be carried out as soon as possible in college/university.2. Contraceptive teaching content should be integrated and improved. Contraceptive methods should be emphasized just like sexual abstinence.3. Contraceptive education should be setup in middle school.
|
PDF Full Text Request