Abstract
Sexually active young people face an increasing public health burden of unintended pregnancies and sexually transmitted diseases due to improper contraception. However, environmental and social factors related to young people’s contraception remain unclear. To identify the key factors, we applied ensemble machine learning methods to the data of 12,280 heterosexual Chinese college students who reported sexual intercourse experience in the National College Student Survey on Sexual and Reproductive Health in 2020 (NCSS-SRH 2020). In the order of variable importance, convenient access to contraceptives, certain attitudes towards sex, sexual health knowledge level, being an only-child, and purchasing a bachelor’s or master’s degree were positively associated with a high frequency of contraceptive use. In contrast, smoking, free access to contraceptives, a specific attitude towards marriage, and negotiation with a sexual partner were negatively associated with a higher frequency of contraceptive use. Our analysis provides insights into young people’s contraceptive use under a typically conservative culture of sexuality. Compared to previous studies, we thoroughly investigated internal and external factors that might impact young people’s decision on contraception while having sex. Under a conservative culture of sexuality, the effects of the external factors on young people’s contraception may outweigh those of the internal factors.
Highlights
With abortion as the leading cause of death among young girls, unintended pregnancy brings a heavy burden globally [1]
To see how the important factors affected young people’s contraceptive behaviors, we further evaluated their effects under a conservative culture of sexuality
We further found that pursuing a bachelor’s degree was positively associated with frequency of contraceptive use (FCU) among males (OR: 1.51, 95% confidence intervals (95% CIs) 1.25–1.82), and pursuing a master’s degree was positively associated with FCU among females (OR: 1.53, 95% CI 1.15–2.03)
Summary
With abortion as the leading cause of death among young girls (aged 10–24 years), unintended pregnancy brings a heavy burden globally [1]. 38% of an estimated 210 million pregnancies worldwide are unintended, of which 22% result in abortion [2]. Unintended pregnancies posed severe physical and psychological health issues in young girls, causing significant social burdens [3]. Young people face various options of modern contraceptive methods, including condoms, oral contraceptives, injectable contraceptives, emergency contraceptive pills, and intrauterine contraceptive devices (IUD) [5]. Of these methods, using condoms has been regarded as the most convenient and efficient
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