15415名青少年性发育及性与生殖健康相关知识态度行为调查分析

Investigation and analysis of sexual development situation and knowledge,attitude and behavior about sexual and reproductive health of 15415 adolescents in China

目的了解在校青少年性发育及性与生殖健康相关知识态度行为,比较不同性别、不同地区、不同学校青少年间的差异,明确重点人群。方法调查采取多阶段分层整群抽样的方法,于2017年10月在我国11个省份的15个区/县中抽取初中、普通高中和职业高中青少年为研究对象,共15415名。采用自行设计的调查问卷,收集青少年一般情况、性发育和性与生殖健康相关知识的认知和行为。结果女性青少年自我报告月经初潮平均年龄为(12.5±1.1)岁,男性青少年自我报告初次遗精平均年龄(13.2±1.5)岁。青少年对导致怀孕行为、安全有效避孕行为、艾滋病传播途径的知晓率分别为76.6%、13.1%和41.4%。东部地区青少年对上述知识的知晓率均高于中部和西部地区(χ^(2)值分别为44.349、22.285、10.316,P<0.05);女生对导致怀孕行为和艾滋病传播途径的知晓率高于男生(χ^(2)值分别为13.133、30.793,P<0.05),而安全有效避孕方法的知晓率低于男生(χ^(2)=31.206,P<0.05)。青少年对同学有性行为持赞成态度的报告率为4.6%,男生高于女生,职高学生高于普高和初中(χ^(2)值分别为516.297、787.519,P<0.05);对同学看色情影视节目、网页、杂志持赞成态度的达5.8%,男生高于女生,职高高于普高和初中(χ^(2)值分别为495.290、1379.307,P<0.05)。青少年性行为报告率为2.4%,男生高于女生,职高生高于普高中和初中生(χ^(2)值分别为81.824、99.280,P<0.05)。结论青少年性发育有提前趋势,性与生殖健康相关知识的认知行为有待提高,职业中学生是干预的重点人群,妇幼保健机构应进一步加强青少年性与生殖健康服务。

Objective To learn current situation of sexual development and knowledge,attitude and behavior about sexual and reproductive health of adolescents in school,and to compare the differences among adolescents of different genders,regions and schools,and identify key groups of the population.Methods The survey adopted multi-stage stratified cluster sampling method.In October 2017,15415 adolescents from junior middle school,general high school and vocational high school in 15 districts/counties of 11 provinces of China were selected as survey subjects.A self-designed questionnaire was used to collect data including general information,status of sexual development,and knowledge,attitude and behavior about sexual and reproductive health of the school adolescents.Results The average age of self-reported menarche was 12.5±1.1 years old in female adolescents and average age of self-reported the first spermatorrhea was 13.2±1.5 years old in male adolescents.The awareness rates of behaviors leading to pregnancy,safe and effective contraception and routes of human immunodeficiency virus(HIV)transmission or acquired immunodeficiency syndrome(AIDS)were 76.6%,13.1%and 41.4%respectively.And the awareness rates of the students on the three aspects in the eastern regions were higher than those in the western regions and the middle regions of China(χ^(2)=44.349,22.285 and 10.316 respectively,all P<0.05).The awareness rates of the girls on behaviors leading to pregnancy and the route of HIV transmission was higher than those of the boys(χ^(2)=13.133 and 30.793 respectively,both P<0.05),while their awareness rate of safe and effective contraception methods was lower than that of the boys(χ^(2)=31.206,P<0.05).The report rate of teenagers′approval attitude towards schoolmates or classmates′sexual behaviors was 4.6%,of which,the boys′approval rate was higher than the girls′approval rate,and the approval rate of the vocational school students was higher than that of the general high school and junior middle school(χ^(2)=516.297 and 787.519 respectively,both P<0.05).5.8%of the students were in favor of their schoolmates or classmates watching pornographic film and television programs,or reading pornographic websites and magazines,of which,the approval rate in the boys was higher than that in the girls,and the approval rate in the vocational high school students was higher than that in the general high school students and junior middle school students(χ^(2)=495.290 and 1379.307 respectively,both P<0.05).The self-reporting rate of the adolescents having sexual behaviors was 2.4%,of which,the self-reporting rate in the boys was higher than that in the girls,and the self-reporting rate in the vocational high school students were higher than that in the general high school and junior middle school students(χ^(2)=81.824 and 99.280 respectively,both P<0.05).Conclusion The sexual development of the adolescents tends to advance,and their knowledge,attitude and behavior about sexual and reproductive health need to be improved.The adolescents in the vocational middle schools are key population of the intervention.Maternal and child health institutions should strengthen services in adolescents′sexual and reproductive health further.