重庆市15~24岁未婚青少年性行为现状及其影响因素

Sexual behavior and the influential factors among unmarried adolescents aged 15-24 in Chongqing

目的了解重庆市15~24岁未婚青少年性行为的现状以及相关危险因素,为制定有针对性的干预措施提供依据。方法2020年6-12月,采用随机抽样的方法抽取重庆市8个区县开展调查。校内青少年选择:根据入组区县的情况随机抽取辖区内1所职业高中/中专及1所大专/大学作为调查学校,并随机抽取1个班级入组研究。校外青少年选择:在调查区县中先随机抽样确定社区,通过社区工作人群找到辖区内符合条件的青少年为志愿者,以方便抽样的方法纳入研究对象。采用自行设计的问卷调查青少年的一般情况和性行为情况,分析性行为的相关因素。结果共2627名青少年参与调查,青少年性行为发生率为17.40%(457/2627),在有过性行为的青少年中,高危性行为发生率为60.83%(278/457)。多因素分析结果显示,年龄是性行为的危险因素(OR=2.367,95%CI:1.979~1.831),是高危性行为的保护因素(OR=0.692,95%CI:0.48~0.997);相对于校外青少年,职高/中专生和大专/大学生发生性行为可能性更低(OR=0.593,95%CI:0.416~0.846;OR=0.43,95%CI:0.325~0.567),而大专/大学生发生高危性行为可能性更低(OR=0.547,95%CI:0.322~0.929)。性行为自我效能高是降低性行为及高危性行为的保护因素(OR=1.143,95%CI:1.118~1.168;OR=1.063,95%CI:1.02~1.107)。结论重庆市青少年高危性行为问题严峻,提高性行为和安全套使用自我效能,可能降低高危性行为,有利于促进青少年身心的健康发展。

Objective To understand the current status of sexual behavior and related risk factors among unmarried adolescents aged 15-24 years in Chongqing,and to provide evidences for the development of targeted sexual health interventions.Methods From June to December 2020,8 districts and counties in Chongqing were selected for the survey using a random sampling method.1 occupational high school/junior high school and 1 college/university in the district were randomly selected as the survey schools.In each survey school,one class was randomly selected.Survey communities were determined by randomly selection in the survey districts,and eligible adolescents in the selected communities were recruited through convenience sampling method via community youth volunteers.A self-administered questionnaire was used to investigate the situation of sexual behaviors among adolescents and to analyze the factors related to sexual behavior.Results A total of 2627 adolescents participated in the survey,and the prevalence of having experiences of sexual behavior among the study population was 17.40%(457/2627).Among those who had experiences of sexual behaviors,the prevalence of high-risk sexual behavior was 60.83%(278/457).Multifactorial analysis showed that older age was a risk factor for sexual behavior(OR=2.367,95%CI:1.979-1.831)but a protective factor for high-risk sexual behavior(OR=0.692,95%CI:0.48-0.997).Compared to out-of-school adolescents,occupational/secondary school students and college/university students were less likely to have sexual behavior(OR=0.593,95%CI:0.416-0.846,OR=0.43,95%CI:0.325-0.567).In addition,college/university students were less likely to have high-risk sex(OR=0.547,95%CI:0.322-0.929).People with a high sexual self-efficacy was less likely to have sexual behaviors(OR=1.143,95%CI:1.118-1.168)and high-risk sexual behaviors(OR=1.063,95%CI:1.02-1.107).Conclusions There is a concern of the prevalence of high-risk sexual behaviors among adolescents in Chongqing.To improve the self-efficacy in sexual behavior and condom use may help to reduce high-risk sexual behaviors and to improve the physical and mental health development of adolescents.