Patterns and correlates of Chinese adolescents' sexual knowledge and attitudes: A cross-sectional study of high school students

Background. Facing an increasing risk of early sex, adolescents face tremendous difficulties in making informed decisions regarding their emerging sexuality. At a moment in which China is entering a HIV/AIDS era, the understanding of high school students' sexual knowledge and attitudes has strategic importance in developing effective interventions to achieve optimal sexual and reproductive health among adolescents and young adults.;Data and methods. This study is a secondary analysis of the data from baseline survey of Impact Evaluation of China Youth Reproductive Health Project. The 3494 samples represent students in three types of high school in China: urban normal high schools, vocational schools, and rural normal high schools. Patterns of sexual knowledge and sexual attitudes among high school students are described. Simple and multiple linear regressions are used to identify individual and contextual correlates of sexual knowledge and sexual attitudes among male and female high school students.;Results. The overall sexual knowledge among high school students is low, especially regarding those sensitive aspects of sexuality development. Despite their relatively higher risk of early sexual involvements and early sex, vocational school students' sexual knowledge is lower than that of normal high schools students. Students' sexual attitudes depend on the sensitivity of the subject. While students accept sexual dreams and sexual fantasy as normal, they still have reservations toward masturbation and early sexual involvements. Many students perceive early love among students as private and show considerable permissiveness toward such behaviors. Among the significant correlates of sexual knowledge and sexual attitudes, students' individual characteristics including their pubertal and sexual development and communications on sexual matters among peer groups have the strongest influences. On the other hand, the impacts of family and students' past school sexuality education are quite limited for both male and female students. The fact that correlates of students' sexual knowledge and sexual attitudes have similar structures suggests both of them are determined by the same mechanism, and this finding has profound policy and programmatic implications.