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Self-identified sexual orientations and high-risk sexual behaviours among Chinese youth
  1. Yuning Liu1,2,
  2. Minhui Yang2,
  3. Chunshan Zhao3,
  4. Shihui Tan4,
  5. Kun Tang2
  1. 1 Global Health and Population, Harvard T.H Chan School of Public Health, Boston, MA, USA
  2. 2 Research Center for Public Health, Tsinghua Univeristy, Beijing, China
  3. 3 Department of Global Health, Peking University School of Public Health, Beijing, China
  4. 4 School of Basic Medical Scieinces, Peking University, Beijing, China
  1. Correspondence to Professor Kun Tang, Beijing, China; tangk{at}


Purpose High-risk sexual behaviour is a factor affecting the health of sexual minority students, yet few related studies have been completed among Chinese students. This article explores the distribution of sexual minority groups and its association with high-risk sexual behaviours and symptoms of sexually transmitted infections(STIs) among Chinese college students.

Methods An internet-based questionnaire was applied, and a sample of 17 966 surveys from 130 Chinese colleges was collected. Based on their self-reports, participants were classified into the following groups: homosexual male or female, heterosexual, bisexual, and sexual orientation unknown. High-risk sexual behaviours were defined as having sexual intercourse before the age of 18 years, having one's sexual debut with a non-regular partner, having had more than four sexual partners before investigation, and having mostly had sexual intercourse without using condoms. Logistic regression models were constructed to analyse the associations.

Results The proportions of the homosexual males and females, and the bisexual groups were 1.62%, 0.88% and 5.07%, respectively. Homosexual males were more likely to have their sexual debut with a non-regular partner (OR 4.79, 95% CI 3.38 to 6.78), having more than four sexual partners (OR 5.81, 95% CI 4.06 to 8.32), having their sexual debut before the age of 18 years (OR 1.92, 95% CI 1.34 to 2.76), and not using condoms for most episodes of sexual intercourse (OR 1.47, 95% CI 1.00 to 2.17). Similar associations also existed among homosexual females. A positive association between sexual orientation and having symptoms of STIs (OR 1.49, 95% CI 1.02 to 2.18) was found among homosexual males.

Conclusions Sexual minority groups among Chinese college students had a greater risk of engaging in high-risk sexual behaviours and having STI symptoms. Future studies and interventions should focus on this population.

  • sexual minority groups
  • high-risk sexual behaviours
  • sexual transmitted infections
  • college students

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  • YL and MY are joint first authors.

  • Contributorship statement YL, CZ and KT initiated this research during a discussion. They further proposed the specific research question and designed an analysis road map. YL and MY conducted relevant literature reviews to identify the knowledge gap. Based on the review results, YL, MY and KT finalised the analysis framework. CZ, YL and ST conducted the data analysis. YL, MY and ST wrote the article under the instruction of KT.

  • Funding statement The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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