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Open Access Highly Accessed Research article

Sexual attitudes, pattern of communication, and sexual behavior among unmarried out-of-school youth in China

Bo Wang1*, Xiaoming Li2, Bonita Stanton2, Vafa Kamali1, Sylvie Naar-King2, Iqbal Shah3 and Ronald Thomas2

Author Affiliations

1 Department of Community Health Sciences, the University of Southern Mississippi, Hattiesburg, MS, USA

2 The Carman and Ann Adams Department of Pediatrics Prevention Research Center, Wayne State University, Detroit, MI, USA

3 Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland

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BMC Public Health 2007, 7:189  doi:10.1186/1471-2458-7-189

Published: 31 July 2007



In recent years, more adolescents are engaging in premarital sex in China. However, only a limited number of studies have explored out-of-school youth's sexual attitudes and behaviors, critical for prevention intervention development.


Using data from the baseline survey of a comprehensive sex education program that was conducted in a suburb of Shanghai in 2000–2002, this study describes sexual attitudes, patterns of communication on sexual matters, and premarital sexual behavior among 1,304 out-of-school youth. Multivariate logistic regression analysis was conducted to examine the factors associated with youth's premarital sexual intercourse.


The majority (60%) of out-of-school youth held favorable attitudes towards premarital sex. Males were more likely to have favorable attitudes compared with females. Male youth generally did not communicate with either parent about sex, while one-third of female youth talked to their mothers about sexual matters. Both males and females chose their friends as the person with whom they were most likely to talk about sexual matters. About 18% of the youth reported having engaged in sexual intercourse. One-fifth of sexually active youth had always used a contraceptive method, and one-quarter had been pregnant (or had impregnated a partner). There were no gender differences in rate of premarital sex or frequency of contraceptive use. Multivariate analysis revealed that age, education, family structure, parent's discipline, attitudes towards premarital sex, pattern of communication and dating were significantly associated with youth premarital sex.


A substantial proportion of out-of-school youth engage in risky sexual behaviors. Prevention programs that empower communication and sexual negotiation skills, and promote condom use should be implemented for this vulnerable group.