Background: Gender equality in sex education is important to protect adolescents from unexpected pregnancies and sexually transmitted infections. The aim of this study was to examine gender differences in sex-related education, knowledge, and attitudes, and to identify factors that may contribute to these gender differences. Methods:A cross-sectional survey was distributed to 191 adolescents from four high schools in Fuzhou, China. Multivariable regression analyses were used to determine the associations between individual factors and their knowledge, attitudes.Results: Over 80% the responding adolescents lacked knowledge about contraception, and half of them cannot recognize all the AIDS transmitted routes. Boys got a lower level sex-related knowledge score than girls. However, parents were more likely to answer girls’ questions about sex than boys (p<0.001), and sex education courses were delivered later to boys (p=0.003). Gender difference of knowledge score was not identified in the multivariable linear regression model, while education from parents/school and sex education need score were found to be positive factors. In the multivariable logistic regression models, parents’ positive responses to adolescents’ questions and need score were associated with respondents’ attitudes with adolescence.Conclusions: Our findings indicated that Chinese high school students had a low level sex-related knowledge and education needs. Several individual factors may explain gender differences in adolescents’ sexual knowledge and attitudes. Designation of targeted sex education programs should consider these individual factors in the future.
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