Abstract

BackgroundLittle is known about sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong. It is of public health importance to investigate this topic to inform sex education, policymaking, and prevention and intervention programs.MethodsBased on the Youth Sexuality Survey conducted by Hong Kong Family Planning Association (FPAHK) in 2011, this study explored the characteristics of sexual knowledge, attitudes, and high-risk sexual behaviors among 1,126 unmarried youth aged 18 to 27 years. Multiple logistic regressions were performed to examine factors associated with unmarried youth’s premarital sex, casual relationships, multiple sex partners, and premarital pregnancy.ResultsUnmarried youth in Hong Kong had adequate sex knowledge, but contraceptive knowledge was deficient. The majority of unmarried youth (63.8%) held liberal attitudes toward premarital sex and about half held liberal attitudes toward any form of sexual activity and premarital pregnancy. Around 60% held conservative attitudes toward causal sex relationships and multiple sex partners. Males tended to hold more liberal attitudes toward high-risk sex behaviors than female youth. Approximately 41.5% of unmarried youth reported having engaged in premarital sex, whereas less than 10% engaged in high-risk sexual behaviors. Males also reported higher amounts of premarital sex, casual sex relationships, and multiple sex partners. Females reported higher levels of sexual coercion. Logistic regressions indicated that being older, coming from a divorced family, out of school status and liberal attitudes toward risky sex behavior were more likely to engage in premarital sex or high-risk sex behaviors, and being female, being better educated and being immigrants were less likely to engage in premarital sex. However, being immigrants was more likely to engage in casual relationship and to have multiple partners.ConclusionsPremarital sex is becoming more prevalent among unmarried youth in Hong Kong, and a small proportion of young adults are engaging in high-risk sexual behaviors. Sex education and HIV prevention programs should equip them with adequate knowledge on contraception and condom use. Intervention programs can start with their attitudes toward sex.

Highlights

  • Little is known about sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong

  • Immigrants were nearly 40% less likely to engage in premarital sex than local youth (OR = 0.60, 95% confidence level interval (CI) = 0.41 - 0.90)

  • Young adults with higher education levels were nearly 50% less likely to engage in premarital sex than those with junior high or lower education levels (OR = 0.43, 95% CI = 0.29 – 0.62 [for senior high education]; odds ratio (OR) = 0.50, 95% CI = 0.33 – 0.75 [for college or higher education] )

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Summary

Introduction

Little is known about sex knowledge, attitudes, and high-risk sexual behaviors among unmarried youth in Hong Kong. It is of public health importance to investigate this topic to inform sex education, policymaking, and prevention and intervention programs. Among researchers and prevention and intervention programs, young people have always been considered most vulnerable to HIV infections. Over 60% of all HIV infections in China occur within young people between 15 and 29 years old [9]. It is of great public health importance to investigate sex knowledge, attitudes, and behaviors among unmarried youth. Doing so provides evidence for effective delivery of youth health services and guides public health policymaking

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