The socioeconomic and lifestyle determinants of contraceptive use among Chinese college students: a cross-sectional study

Abstract

Background: Chinese youth have become more sexually active over the years, yet their behaviours of contraceptive use are influenced by socioeconomic and lifestyle factors. This study aimed to investigate the socioeconomic and lifestyle determinants of contraceptive use among Chinese college students, and to investigate quantitatively their reasons for choosing different contraceptive methods. Methods: The study used the data from a cross-sectional survey, which was conducted in 2015 among 17,517 students from 130 colleges and professional schools in mainland China. Chi-square tests were performed to test the differences in the awareness and uses of contraceptives between male and female students. Multivariable logistic regression models were used to analyse the associations between socioeconomic and lifestyle factors and contraceptive uses. Results: Condoms (95%), oral contraceptives (91%) and emergency contraceptives (71%) were the most commonly known contraceptive methods among the sample of Chinese youth that were surveyed. Among male participants, high monthly expenditure (OR = 1.37, 95%CI: 1.07-1.75), light alcohol consumption (OR = 1.47, 95%CI: 1.03-2.11), and high sexual knowledge (OR = 1.96, 95%CI: 1.57-2.45) were positively associated with contraceptive uses, while tobacco use (OR = 0.47, 95%CI: 0.23-0.95) showed a negative association with contraceptive uses. Among female students, suburban residency (OR = 1.38, 95%CI: 1.03-1.83), high level of parental education (OR = 1.96, 95%CI: 1.19-3.22), moderate alcohol consumption (OR = 2.66, 95%CI: 1.05-6.77), and high sexual knowledge (OR = 1.50, 95%CI: 1.18-1.91) were positively associated with contraceptive uses, while tobacco use (OR = 0.60, 95%CI: 0.36-0.99) showed a negative association. Conclusions: A series of socioeconomic and lifestyle factors were associated with contraceptive choices among Chinese college students. Targeted sexual education programs are in demand to improve the awareness and the use of contraceptives in this population.

Identify Key Determinants of Contraceptive Use for Sexually Active Young People: A Hybrid Ensemble of Machine Learning Methods

“…The FCU was initially computed as a 5-level ordinal categorical variable (1-Never; 2-Seldom; 3-About half of the time; 4-Usually; 5-Always) in the survey and was re-coded as a composite score ranging from 1 to 3 (1-Level 1: Never & Seldom; 2-Level 2: About half of the time & Usually; 3-Level 3: Always) for a more parsimonious and informative indication in analyses. Referring to previous related studies [3,[12][13][14], we included 25 potential variables (covariates) across eight domains: education-related factors, socio-economics, attitudes towards sexuality, sexual health knowledge, sexual and mental health history, contraceptive accessibility, family-related factors, and lifestyles. The factors associated with FCU were later selected from the variables of these domains.…”

“…The gap between the actual use and awareness of contraceptive methods corresponds to a complex interaction by the factors related to contraceptive behaviors. Previous studies have revealed significant associations between contraceptive use and a number of internal factors like awareness, attitudes, and self-experiences [3,6,7,9,11]. Compared to these internal factors, more and more external (i.e., environmental) factors were also verified as influential on young people's behaviors of sexual health.…”

“…Compared to these internal factors, more and more external (i.e., environmental) factors were also verified as influential on young people's behaviors of sexual health. The socioeconomic status, sex education, family background, and accessibility of contraceptives have been reported to be associated with young people's contraceptive use [3,12]. In addition, mental health history and lifestyles were shown as associated with contraceptive experience of young people [12][13][14].…”

“…In each year, 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]. Regarding the negative impacts, modern contraceptive methods have been proved to be the most effective way for young people to prevent unintended pregnancies and their related complications [4].…”

“…Available evidence shows that sexually active young people usually do not expect pregnancy [6]. They are supposed to have positive attitudes and good awareness towards contraception, but their actual contraceptive use during sexual intercourse is not ideal, especially in developing countries [4,7], where they face tremendous obstacles in obtaining or practicing modern methods of contraception [3,[8][9][10]. The gap between the actual use and awareness of contraceptive methods corresponds to a complex interaction by the factors related to contraceptive behaviors.…”