Study On Sexual Health Situation And Intervention Effectiveness Of Left-behind Adolescents In Western Rural Area

Objective To analyze the current status of sexual health of left-behindAdolescents of migrant workers in western rural area. To evaluateeffectiveness of a sexual health intervention for rural left-behindMiddle-school students in west China, and explore a effective interventionmodel. Method A questionnaire was designed according to literaturereference. Eight middle schools were multi-stage randomly sampled inrural area of Chongqing, and two classes of each grade were randomlychosen. Total2311adolescents were questionnaire-surveyed by sexualhealth knowledge. The questionnaire was checked by reliability andvalidity. The intervention program conducted in Sichuan was based onsurvey-intervention-survey model. Data were selected from baseline surveyand after-intervention survey on the sexual health KAP of Middle-schoolstudents aged12–15years from3representative schools in rural area. Theintervention was given into3groups: peer-led education group as group A,traditional education as group B, group C as control group. ResultAccording to2089shares of effective pre-survey data,985(accounting for47.2%) left-behind adolescents of migrant workers had lower reproductivehealth knowledge rate than normal group（χ2=8.470, P=0.04）;In junior school students group, male students had lower sexual health knowledgerate than female students, χ2=6.825,P=0.011）;In high school studentsgroup, male students had lower reproductive health knowledge rate thanfemale students (χ2=6.5455, P=0.011）; Logistic regression analysisrevealed: mal（eOR=1.390，95%CI：1.220～1.526），low grade（OR=0.531，95%CI：0.287～0.874），divorce or remarriag（eOR=0.668，95%CI：0.494～0.873），school sexual education insufficiency（OR=0.693，95%CI：0.439～0.937）were the risk factors for sexual knowledge of Left-behind students.By the comparison of baseline survey and after-intervention survey, totalknowledge rate of peer-led education group went up from29.4%to25.3%and average score was raised from6.77±3.14to8.61±2.88(P=0.001); rateof traditional group went up from31.0to57.5%and average score waspromoted from6.89±2.91to7.41±3.11(P=0.024). After-intervention surveyscore of peer-led group(8.61±2.88) was higher than that(7.40±3.11) oftraditional group(t=3.84, P=0.000), difference of the mean value was1.19(95%CI0.58～1.81). Positive rate of sexual health related attitude andbehavior was enhanced(P<0.05), and rate of peer-led group was promotedmore(P<0.05). Conclusions The present level of sexual health knowledgeof western rural adolescents is poor, and the level of left-behind adolescentsis lower than that of normal adolescents. The female group has higherknowledge rate than male group, and there is a gender-based difference insexual health knowledge. The sexual intervention for rural left-behind adolescents in west China has significant effectiveness, and peer-lededucation mode is more effective for sexual health education among ruralleft-behind adolescents. The long-term effectiveness needs further study.