Boundaries of sexual communication: a mixed-method study exploring Chinese young adults' engagement with online sexual health information.

Abstract

Although previous research suggests that a majority of Chinese young adults get sexual health information through the Internet, the details of this process and how it translates into subsequent actions are unknown. This study aims to understand the dynamic nature of Chinese young adults' engagement with online sexual health information (OSHI) through various communication channels to inform the development of effective sexual health intervention strategies. A mixed-method approach was used, involving individual semi-structured interviews (n=30) and cross-sectional online surveys (n=561) with Chinese young adults aged 18 to 25 years. Qualitative themes and prevalence and predictors of engagement with OSHI were analysed. Three themes emerged from the interviews: (1) problem-based searching; (2) multi-criteria evaluation; and (3) stigma of online sharing and discussion. After engaging with OSHI, 87.3% of the survey participants followed online advice on at least one occasion, and 54.9% discussed this information with others (mostly with partners and friends) offline. Having sexual intercourse in the past 3 months was a consistent predictor of engagement with OSHI (P<0.05). Contrary to previous findings, participants with higher family income were more likely to engage with OSHI (P<0.05). Chinese young adults obtain sexual health information from online sources when personal problems arise and then circulate this information offline within their peer networks. Although social media interventions have shown some promise, researchers should first increase risk awareness and be cautious about designing programs that promote online sharing or discussion. Finally, researchers need to make extra effort to target young adults with limited resources.