Sexual Behavior and Socioecological Factors Influencing Sexual Intercourse Among Adolescents in China: A Cross-Sectional Study.

With the development of economy and the impact of Western culture on Chinese traditional culture, the incidence of sexual intercourse among adolescents keeps increasing year by year. The aim of this study was to investigate the current status of school students' sexual behavior and knowledge, as well as explore the contributing factors from a socioecological perspective. A questionnaire survey was conducted in three secondary schools and three colleges in Shandong Province, China. Data were analyzed using t-test, chi-square test, and binary logistic regression analysis. A total of 1769 (1377/female) students participated in this study. Of these, 162 (9.2%) students had sexual intercourse and 86.24% of sexually active students have engaged in risky sexual behavior. Of 14 predictor variables, binary logistic regression analysis revealed that males, those aged ≥ 18 years old, having discussed sexual issues with parents, lack of school sex education, lower family support, lower resistance to peer influence, and lower social norms cognition were more likely to initiate sexual intercourse. Overall, the incidence of sexual intercourse among students was low, but the incidence of risky sexual behavior was extremely high. Students had poor sexual knowledge and expressed expectation to learn sexual and reproductive health knowledge through channels including school and the Internet, with a comprehensive coverage of knowledge about sexuality. Concerted socioecological forces especially school and family are needed to increase sexual knowledge and prevent risky sexual behaviors among adolescent students.