Sex differences in the association of childhood sexual abuse severity with premarital sex among Chinese college students in Luzhou, China.

PURPOSE: The adverse health consequences of premarital sex and childhood sexual abuse (CSA) are both global public health problems. Based on a random sample of college students from a Chinese city, this study investigated the relationship between CSA severity and premarital sex among students, focusing on sex differences. METHODS: A total of 2722 college students from 4 schools in Luzhou were recruited by multistage random sampling. Self-administered questionnaires were used to measure CSA experiences and premarital sex. Binary logistic regression analyses were conducted to analyse the relationship between CSA and premarital sex. RESULTS: The prevalence of CSA was 9.39%, and that of mild, moderate and severe CSA was 4.04%, 2.90% and 2.46%, respectively. The premarital sex reporting rate was 22.42%. After adjusting for confounding variables, CSA was positively associated with premarital sex. Notably, a cumulative effect of CSA on premarital sex was observed among students. Further stratification analyses showed that males who experienced CSA had a higher premarital sex rate than females, and this sex difference was also observed among students with different CSA severities. CONCLUSION: CSA and its severity were associated with premarital sex among college students. Furthermore, this association was stronger for males than females. Therefore, it is important to emphasize CSA prevention, especially for boys. These findings can promote understanding of the effects of CSA on premarital sex, and CSA prevention and intervention strategies should consider CSA severity and sex differences.

Relationship between childhood sexual abuse and attitudes toward premarital sexual permissiveness among middle school students in Luzhou, China.

BACKGROUND: In recent years, the number of adolescents engaging in premarital sex has increased, and an increasing number of childhood sexual abuse (CSA) cases have been reported in China. Many studies have indicated that CSA has a well-established association with risky sexual activities. However, only a limited number of studies have explored possible reasons for this association among middle school students, a population that may engage in premarital sex, which is critical for the development of interventions to prevent risky sexual behavior. Based on random samples of middle school students from a Chinese city, this article investigated the relationship between CSA and students' premarital sexual permissiveness (PSP). METHODS: In a cross-sectional study conducted between 2016 and 2017 in Luzhou, China, 2292 middle school and high school students aged 12-18 years were recruited by multistage random sampling. All students were administered anonymous questionnaires. Multiple linear regression and binary logistic regression analyses were conducted to analyze the relationship between CSA and PSP. RESULTS: The prevalence of CSA was 15.4% (354/2292; 95% CI: 14-16.9%). A higher percentage of male respondents (18.2%) than female respondents (12.9%) had experienced CSA. A positive association between CSA and PSP was found among students. Respondents who had suffered CSA exhibited greater PSP, and this relationship was observed in the male sample, female sample and the total student sample in Luzhou (ß = - 3.76, P < 0.05; ß = - 2.79, P < 0.05; and ß = - 2.84, P < 0.05, respectively). Respondents who had suffered CSA were also more likely to express a double standard about premarital sex (odds ratio [OR] =1.41, P < 0.05), especially among male students (odds ratio [OR] =1.63, P < 0.05). CONCLUSIONS: Sex differences in CSA and the relationship between CSA and PSP were significant among this large sample of middle school students in Luzhou (China). The findings suggest that experiencing CSA may be closely related to youth attitudes toward premarital sex, especially among males. Therefore, it is important to emphasize the prevention of CSA and provide adolescent reproductive health programs to reduce the impact of CSA on sexual cognition and attitude, prevent premarital sex and promote positive attitudes toward sexual equality for middle school students.