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Sexual and reproductive health and attitudes towards sex of young adults in China
  1. Siyu Zou1,2,
  2. Wenzhen Cao1,3,
  3. Yawen Jia2,
  4. Zhicheng Wang1,
  5. Xinran Qi4,
  6. Jiashu Shen2,
  7. Kun Tang1
  1. 1Vanke School of Public Health, Tsinghua University, Beijing, China
  2. 2School of Public Health, Peking University Health Science Centre, Beijing, China
  3. 3Department of Information Management, Peking University, Beijing, China
  4. 4School of Nursing, Capital Medical University, Beijing, China
  1. Correspondence to Professor Kun Tang, Vanke School of Public Health, Tsinghua University, Beijing 100191, China; tangk{at}


Background The study aimed to discuss the importance of socioeconomic status (SES) and family sexual attitudes and investigate their association with sexual and reproductive health in a large sample of Chinese young adults.

Methods We analysed a large sample of 53 508 youth aged 15–24 years from an internet-based survey from November 2019 to February 2020. Multivariable logistic regression analyses were employed to examine the association between SES, family sexual attitudes, and sexual and reproductive health (SRH), stratified by sex and adjusting for potential confounders.

Results Individuals with the highest expenditure were more likely to engage in early sexual intercourse (female: OR 4.19, 95% CI 3.00 to 5.87; male: OR 3.82, 95% CI 2.84 to 5.12). For both sexes, the likelihood of young adult sexual risk-taking such as first intercourse without using a condom, acquiring sexually transmitted infections, and pregnancy was lower in those with higher maternal educational attainment, whereas it was higher in those with open family sexual attitudes.

Conclusions Lower SES and open family attitudes toward sex had a significant association with a range of adverse young adulthood SRH outcomes. Public health policies should focus on more deprived populations and advocate suitable parental participation to reduce risky sexual behaviours in youth.

  • reproductive health
  • sexual behavior
  • health education

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  • Contributors SZ conceived the study. SZ did the main literature and data analysis. SZ and WC wrote the first draft. WC designed the survey, undertook data collection and cleaning. All the authors (SZ, WC, YJ, ZW, XQ, JS and KT) contributed to the interpretation of the data. SZ, WC, ZW, XQ and KT edited the manuscript. All authors read and approved the final manuscript.

  • Funding 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 and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the Institution Review Board of Tsinghua University (#20190083).

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

  • Data availability statement The data that support the findings of this study are available on reasonable request from the corresponding author (KT). The data are not publicly available due to research ethics board restrictions.

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