Gender differences in sexual health knowledge, attitude and behavior among Chinese college students and the influencing factors of sexual behavior
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摘要:
目的 了解我国在校大学生性健康知识、态度、行为现状，为全社会开展性教育提供参考依据，以提高大学生性健康水平。 方法 于2022年8—11月采用方便抽样方法，在全国34个省级行政区的大学中抽取24 816名在校大学生，采用自行设计的问卷开展线上网络调查，利用SPSS 26.0软件进行描述性分析，并采用χ2检验和logistic回归分析模型对在校大学生性健康现状进行分析。 结果 性知识方面，男、女生避孕方法知晓率分别为90.4%、83.5%，差异均有统计学意义(均P<0.05)；性态度方面，“婚前性行为”“开放或同居”“一夜情或约炮”男生接受度分别为42.1%、45.5%、12.2%，女生接受度分别为20.4%、20.0%、2.0%，差异均有统计学意义(均P<0.05)；性行为方面，民族、性取向、性知识知晓情况及是否为独生子女是女生发生性行为的影响因素。与少数民族女生相比，汉族女生发生性行为是其1.817倍(95% CI: 1.513~2.181)；与异性恋女生相比，非异性恋女生发生性行为是其2.163倍(95% CI: 1.749~2.675)；与不知晓避孕方法的女生相比，知晓的女生发生性行为是其19.898倍(95% CI: 12.093~32.738)；与非独生子女的女生相比，是独生子女的女生发生性行为是其2.945倍(95% CI: 2.412~3.595)。 结论 大学生在性健康知识、态度、行为方面存在较多问题，建议高校等教育部门应予以高度重视，充分利用互联网、课堂等平台开展相关的科普教育，加强性健康教育的通识教育。 Abstract:Objective To understand the current situation of sexual knowledge, attitude and behavior of Chinese college students, and provide reference for the whole society to carry out sex education, so as to improve the level of sexual health of college students. Methods From August to November 2022, a convenient sampling method was adopted to select 24 816 college students from universities in 34 provinces, municipalities directly under the Central government and autonomous regions across the country. A self-designed questionnaire was used to carry out online survey, and SPSS 26.0 software was used for descriptive analysis. Chi-square test and logistic regression analysis model were used to analyze the sexual health status of college students. Results In terms of sexual knowledge, the knowledge rate of male and female contraceptive methods was 90.4% and 83.5%, respectively, and the difference was statistically significant (P<0.05). In terms of sexual attitudes, the acceptance rates of "premarital sex", "open or cohabitation" and "one-night stand or hookup" were 42.1%, 45.5% and 12.2% for male students, and 20.4%, 20.0% and 2.0% for female students, respectively, with statistical significance (all P<0.05). In terms of sexual behavior, ethnic group, sexual orientation, sexual knowledge, and whether girls are the only child are the influencing factors of sexual behavior. The sexual activity of Han girls was 1.817 times that of minority girls (95% CI: 1.513-2.181). Non-heterosexual girls were 2.163 times likely to have sex than heterosexual girls (95% CI: 1.749-2.675). Women who knew about contraception were 19.898 times likely to have had sex (95% CI: 12.093-32.738) than those who did not know about contraception. Women who were only children were 2.945 times likely to have sex than women who were not only children (95% CI: 2.412-3.595). Conclusions College students have many problems in sexual knowledge, attitude and behavior, so it is suggested that universities and other education departments should attach great importance to it, make full use of Internet, classroom and other platforms to carry out relevant popular science education, and strengthen the general education of sexual health education. -
表 1 在校大学生不同性别基本情况
Table 1. Basic situation of different genders in college students
特征
Feature男性① Male①
(n=6 220)女性① Female①
(n=18 596)合计① Total①
(n=24 816)特征
Feature男性① Male①
(n=6 220)女性① Female①
(n=18 596)合计① Total①
(n=24 816)年龄组/岁 Age/years 学校性质 Nature of school 15~＜20 2 009(32.3) 6 529(35.1) 8 538(34.4) 公办 Public school 5 969(96.0) 17 998(96.8) 23 967(96.6) 20~＜24 3 805(61.2) 11 337(61.0) 15 142(61.0) 民办 Private school 251(4.0) 598(3.2) 849(3.4) 24~＜35 406(6.5) 730(3.9) 1 136(4.6) 宗教信仰 Religion 学历 Education background 有 Yes 223(3.6) 439(2.4) 662(2.7) 专科 Junior college 1 778(28.6) 8 434(45.4) 10 212(41.1) 无 No 5 997(96.4) 18 157(97.6) 24 154(97.3) 本科 Undergraduate course 3 937(63.3) 9 182(49.4) 13 119(52.9) 独生子女 Only child 硕士及以上 Master degree or above 505(8.1) 980(5.2) 1 485(6.0) 是 Yes 2 313(37.2) 3 848(20.7) 6 161(24.8) 生源地 Origin of student 否 No 3 907(62.8) 14 748(79.3) 18 655(75.2) 城镇 Cities and towns 2 879(46.3) 7 935(42.7) 10 814(43.6) 性取向 Sexual orientation 农村 Village 3 341(53.7) 10 661(57.3) 14 002(56.4) 异性恋 Heterosexual 5 581(89.7) 16 180(87.0) 21 761(87.7) 民族 Nationality 非异性恋 Non-heterosexual 639(10.3) 2 416(13.0) 3 055(12.3) 汉族 Han 4 850(78.0) 13 472(72.4) 18 322(73.8) 少数民族 Ethnic minorities 1 370(22.0) 5 124(27.6) 6 494(26.2) 注：①以人数(占比/%)表示。
Note: ① Number of people(proportion/%).
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表 2 在校大学生不同性别性知识情况
Table 2. Sexual knowledge of different genders in college students
特征 Feature 组别 Grouping 男性① Male ①
(n=6 220)女性① Female ①
(n=18 596)χ2值
valueP值
value避孕方法 Contraceptive methods 知晓 Know 5 623(90.4) 15 533(83.5) 175.124 < 0.001 不知晓 Unknow 597(9.6) 3 063(16.5) 艾滋病知识 AIDS-related knowledge 母婴传播 Mother-to-child transmition 5 270(84.7) 16 018(86.1) 7.600 0.006 血液传播 Blood transmission 5 687(91.4) 17 447(93.8) 42.150 < 0.001 性传播 Sexual transmission 5 109(82.1) 15 784(84.9) 26.296 < 0.001 蚊子叮咬 Mosquito bites 1 795(28.9) 6 289(33.8) 52.219 < 0.001 咳嗽、打喷嚏 Cough and sneeze 742(11.9) 3 124(16.8) 84.055 < 0.001 拥抱、握手 Hug and shake hands 290(4.7) 1 079(5.8) 11.620 0.001 共饮一杯水 Share a glass of water 904(14.5) 3 706(19.9) 89.698 < 0.001 不知道 Unknow 183(2.9) 450(2.4) 5.114 0.024 注：①以人数(占比/%)表示。
Note: ① Number of people(proportion/%).
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表 3 在校大学生不同性别性态度情况
Table 3. Sexual attitudes of different genders in college students
特征 Feature 组别 Grouping 男性① Male ①
(n=6 220)女性① Female ①
(n=18 596)χ2值
valueP值
value婚前性行为 Premarital sex 不能接受 Unacceptable 1 232(19.8) 5 831(31.4) 1 174.700 < 0.001 可以理解，但自己不会 Understand, but won′t do it 2 368(38.1) 8 971(48.2) 可以接受 Acceptable 2 620(42.1) 3 794(20.4) 开房或同居 Open house or live together 不能接受 Unacceptable 1 197(19.2) 6 105(32.8) 1 595.448 < 0.001 可以理解，但自己不会 Understand, but won′t do it 2 191(35.3) 8 774(47.2) 可以接受 Acceptable 2 832(45.5) 3 717(20.0) “一夜情”或“约炮” One night of love or booty call 不能接受 Unacceptable 3 340(53.7) 13 764(74.0) 1 532.812 < 0.001 可以理解，但自己不会 Understand, but won′t do it 2 119(34.1) 4 463(24.0) 可以接受 Acceptable 761(12.2) 369(2.0) 对性行为的看法 Views on sexual behavior 正常 Normal 4 290(69.0) 10 378(55.8) 552.334 < 0.001 感觉羞耻 Feel ashamed 147(2.3) 534(2.9) 可以理解 Comprehensible 1 155(18.6) 3 672(19.7) 不知道 Unknow 212(3.4) 2 323(12.5) 说不清楚 Equivocal 416(6.7) 1 689(9.1) 对自慰行为的看法 Views on masturbation 正常 Normal 3 037(48.8) 6 481(34.9) 1 176.409 < 0.001 感觉羞耻 Feel ashamed 345(5.6) 772(4.2) 可以理解 Comprehensible 1 935(31.1) 4 636(24.9) 不知道 Unknow 355(5.7) 4 488(24.1) 说不清楚 Equivocal 548(8.8) 2 219(11.9) 注：①以人数(占比/%)表示。
Note: ① Number of people(proportion/%).
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表 4 在校大学生不同性别性行为情况
Table 4. Sexual behavior of different genders in college students
特征 Feature 组别 Grouping 男性① Male ①
(n=6 220)女性① Female ①
(n=18 596)χ2值
valueP值
value性行为发生情况 Sexual behavior 发生过 Yes 1 080(17.4) 1 149(6.2) 713.204 < 0.001 没有发生过 No 5 140(82.6) 17 447(93.8) 性行为时是否避孕 Contraceptive status 避孕 Yes 1 009(93.4) 1 100(95.7) 5.829 0.016 不避孕 No 71(6.6) 49(4.3) 注：①以人数(占比/%)表示。
Note: ① Number of people(proportion/%).
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表 5 在校大学生不同性别性行为情况
Table 5. Sexual behavior of different genders in college students
特征 Feature 人数
Number of people有① Yes① 无① No① χ2值
valueP值
value特征 Feature 人数
Number of people有① Yes① 无① No① χ2值
valueP值
value生源地 Origin of student 11.316 < 0.001 性取向 Sexual orientation 0.787 0.375 城镇 Cities and towns 2 879 550(19.1) 2 329(80.9) 异性恋 Heterosexual 5 581 961(17.2) 4 620(82.8) 农村 Village 3 341 530(15.9) 2 811(84.1) 非异性恋 Non-heterosexual 639 119(18.6) 520(81.4) 民族 Nationality 0.514 0.473 性知识 Sexual knowledge 92.553 < 0.001 汉族 Han 4 850 851(17.5) 3 999(82.5) 知晓 Know 5 623 1 061(18.9) 4 562(81.1) 少数民族 Ethnic minorities 1 370 229(16.7) 1 141(83.3) 不知晓 Unknow 597 19(3.2) 578(96.8) 学校性质 Nature of school 0.849 0.357 独生子女 Only child 14.715 < 0.001 公办 Public school 5 969 1 031(17.3) 4 938(82.7) 是 Yes 2 313 457(19.8) 1 856(80.2) 民办 Private school 251 49(19.5) 202(80.5) 否 No 3 907 623(15.9) 3 284(84.1) 宗教信仰 Religion 9.679 0.002 有 Yes 223 56(13.3) 167(86.7) 无 No 5 997 1 024(17.1) 4 973(82.9) 注：①以人数(占比/%)表示。
Note: ① Number of people(proportion/%).
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表 6 影响女生性行为的单因素分析
Table 6. Single factor analysis of influencing female sexual behavior
特征 Feature 人数
Number of people有① Yes① 无① No① χ2值
valueP值
value特征 Feature 人数
Number of people有① Yes① 无① No① χ2值
valueP值
value生源地 Origin of student 54.658 < 0.001 性取向 Sexual orientation 5.86 0.015 城镇 Cities and towns 7 935 607(7.6) 7 328(92.4) 异性恋 Heterosexual 16 180 973(6.0) 15 207(94.0) 农村 Village 10 661 542(5.1) 10 119(94.9) 非异性恋 Non-heterosexual 2 416 176(7.3) 2 240(92.7) 民族 Nationality 40.712 < 0.001 性知识 Sexual knowledge 200.06 < 0.001 汉族 Han 13 472 926(6.9) 12 546(93.1) 知晓 Know 15 533 1 132(7.3) 14 401(92.7) 少数民族 Ethnic minorities 5 124 223(4.4) 4 901(95.6) 不知晓 Unknow 3 063 17(0.6) 3 046(99.4) 学校性质 Nature of school 0.029 0.865 独生子女 Only child 120.891 < 0.001 公办 Public school 17 998 1 111(6.2) 16 887(93.8) 是 Yes 3 848 384(10.0) 3 464(90.0) 民办 Private school 598 38(6.4) 560(93.6) 否 No 14 748 765(5.2) 13 983(94.8) 宗教信仰 Religion 0.957 0.328 有 Yes 439 32(7.3) 407(92.7) 无 No 18 157 1 117(6.2) 17 040(93.8) 注：①以人数(占比/%)表示。
Note: ① Number of people(proportion/%).
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表 7 影响女生性行为的多因素logistic回归分析模型
Table 7. Multivariate logistic regression analysis model of female sexual behavior
特征 Feature β值
valuesx Wald χ2值
valueOR值 value
(95% CI)P值
value生源地(以农村为参照)Origin of student(Take the village as a reference) 城镇 Cities and towns 0.058 0.090 0.441 0.944(0.792~1.126) 0.521 民族(以少数民族为参照)Nationality(Take the Ethnic minorities as a reference) 汉族 Han 0.597 0.093 40.861 1.817(1.513~2.181) < 0.001 性取向(以异性恋为参照)Sexual orientation(Take the Heterosexual as a reference) 非异性恋 Non-heterosexual 0.771 0.108 50.631 2.163(1.749~2.675) < 0.001 性知识(以不知晓为参照)Sexual knowledge(Take the unknown as a reference) 知晓 Know 2.991 0.254 138.565 19.8 98(12.093~32.738) < 0.001 独生子女(以否为参照)Only child(Take no as a reference) 是 Yes 1.080 0.282 539.991 2.945(2.412~3.595) < 0.001
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