Prevalence of and factors associated with unintended pregnancies among sexually active undergraduates in mainland China.

In this study, we aimed to determine the prevalence and factors associated with UIP among sexually active undergraduates in mainland China. Between September 8, 2019 and January 17, 2020, a total of 48,660 participants were recruited from the Chinese mainland to complete the self-administered, structured, online questionnaire. This analysis was restricted to 6347 sexually experienced, never-married 15­26 year old undergraduates. Based on a social-ecological theoretical framework, we ran separate multivariate Logistic regression models for men and women to identify sociodemographic, familial and individual variables associated with UIP. Our findings indicate that the overall prevalence of UIP was 17.7%. More specifically, 19.5% of male college students reported they had unintentionally gotten a partner pregnant, while 14.9% of female college students became unintentionally pregnant. Students who experienced UIP were more likely to belong to the older age group, live with only one parent or live without parents at home, report that their family members approve of premarital sex, initiate sexual activity younger than 14 years old and have casual sex partners. Furthermore, females with multiple partners and males who came from low-income households, experienced sexual abuse, perceived difficulties in acquiring condoms and did not know how to use condoms correctly were also at higher risk of having an unintended pregnancy. In order to prevent UIP, a comprehensive intervention measure should be taken to target older students and those engaging in risky sexual behaviors, work with young male students to improve condom use skills, improve the availability of free condoms, optimize the involvement of parents and other family members in their children's sex education.