沪浙两地中学生性健康教育需求现况调查

doi:10.11852/zgetbjzz2023-0164

摘要/Abstract

摘要： 目的了解沪浙两地中学生性健康教育需求及影响因素,探讨适宜的教育策略。方法采用自行设计的调查问卷,于2021年10月在上海市和浙江省台州市选取普通初、高中学校各3所,采用分层随机整群抽样方法,抽取初二至高三共2 042名学生开展自填式匿名调查。采用独立样本t检验、χ²检验和Wilcoxon检验进行单因素分析,采用二元Logistic回归进行多因素分析。结果共回收1 733份有效问卷,其中69.4%的学生曾接受过性健康教育,男生接受过性健康教育的比例低于女生(χ² =24.897),台州就读学生接受过性健康教育的比例低于上海就读学生(χ²＝7.949),差异均有统计学意义(P<0.05);51.7%的学生很满意既往接受的教育,女生表示满意的比例低于男生(χ²＝7.910),高中生表示满意的比例低于初中生(χ²＝13.615),差异均有统计学意义(P<0.05);67.8%的学生认为自己容易获取性健康知识,上海就读学生认为容易获取知识的比例高于台州就读学生,差异有统计学意义(Z＝2.700,P=0.007);63.9%的学生希望学习更多性健康知识,台州就读学生希望学习更多知识的比例高于上海就读学生(χ²＝36.044,P<0.001),差异有统计学意义。性心理(52.8%)、性卫生保健(48.1%)和性道德法律(46.7%)是需求程度最高的前三类知识,学校(60.2%)和教师(51.0%)是学生最青睐的性健康教育开展场所和提供者。多因素Logistic回归分析显示,男生(OR = 0.54,95%CI: 0.39~0.75)、台州就读(OR＝0.64,95%CI: 0.46~0.87)、与父母一方关系不和(OR＝0.64,95%CI: 0.45~0.92)、家庭经济低于平均水平(OR＝0.42,95%CI: 0.25~0.69)的学生,既往获取过性健康教育的比例更低(P<0.05);台州就读(OR＝1.64,95%CI: 1.10~2.48)和已有月经/遗精(OR＝2.03,95%CI: 1.24~3.33)的学生对性健康教育的获取意愿更高(P<0.05),而父母关系不和睦(OR＝0.49,95%CI: 0.26~0.96)的学生对性健康教育的获取意愿更低(P<0.05)。结论中学生对性健康教育存在较大需求,该需求与学生的性别、就读地区、月经/遗精状态、家庭关系及经济水平显著相关,应着重发挥学校和教师在中学生性健康促进中的作用。

关键词: 中学生, 性健康教育, 需求, 健康促进

Abstract: Objective To investiagte the demand and influencing factors of sexual health education, and to explore appropriate education strategies among middle school students in Shanghai and Zhejiang. Methods A self-designed questionnaire was used to conduct a self-administered anonymous survey in selected six middle schools of Shanghai and Zhejiang Province, China in October 2021. Totally 2 042 students were cluster-sampled. Univariate analysis was performed using t test, χ² test and Wilcoxon test, and multivariate analysis was performed using Logistic regression analysis. Results Among 1 733 valid subjects, 69.4% had received sexual health education before, and it was significantly lower among boys (χ² =24.897) and students in Taizhou (χ² =7.949) compared with girls and students in Shanghai (P<0.05). More than half (51.7%) were very satisfied with their received education, and it was significantly lower among girls (χ²＝7.910) and senior high school students (χ²＝13.615) compared with boys and junior high school students (P<0.05). Near 67.8% of the students believed that they had easy access to sexual health knowledge, and the proportion was significantly higher among students in Shanghai(Z=2.700,P=0.007).Nearly 63.9% were willing to learn more about sexual health, and Taizhou students had a larger demand than Shanghai students (χ²=36.044, P<0.001). Sexual psychology (52.8%), sexual health care (48.1%) and sexual moral law (46.7%) ranked top 3 in what students wanted. Schools (60.2%) and teachers (51.0%) were the most welcome facility and provider of sexual health, respectively. Multiple Logistic regression analysis showed that students who were boys (OR=0.54, 95%CI: 0.39 - 0.75), studied in Taizhou (OR=0.64, 95%CI: 0.46 - 0.87), had good relationship with only mother/father (OR=0.64, 95%CI: 0.45 - 0.92), and students with below-average household finances (OR=0.42, 95%CI:0.25 - 0.69) were less likely to have received sexual health education before. Demands of sexual health education were statistically higher among those studied in Taizhou (OR=1.64, 95%CI: 1.10 - 2.48) and already had spermatogenesis or menstruation (OR=2.03, 95%CI:1.24 - 3.33), while it was statistically lower among those whose parents were in poor relationship (OR=0.49, 95%CI:0.26 - 0.96). Conclusions There are great demands for sexual health education among middle school students, and it is significantly related to gender, region of schooling, spermatogenesis/menstruation status, family relationships and economic level. The role of schools and teachers should be enhanced to promote their sexual health in China.

Key words: middle school students, sexual health education, demand, health promotion

中图分类号:

R179

曹莉, 王彦欢, 王莹莹, 赵琦, 徐飚, 付朝伟. 沪浙两地中学生性健康教育需求现况调查[J]. 中国儿童保健杂志, 2023, 31(9): 1038-1044.

CAO Li, WANG Yanhuan, WANG Yingying, ZHAO Qi, XU Biao, FU Chaowei. Investigation on demand for sexual health education among middle school students in Shanghai and Zhejiang[J]. Chinese Journal of Child Health Care, 2023, 31(9): 1038-1044.

参考文献

[1] 赵瑞, 武俊青, 周颖, 等. 上海市中学生性与生殖健康相关知识干预效果评价[J]. 中国公共卫生, 2019, 35(6): 758-761.
Zhao R, Wu JQ, Zhou Y, et al. Intervention effect of health education on sexual and reproductive knowledge among middle school students in Shanghai city[J]. Chin J Public Health, 2019, 35(6): 758-761.(in Chinese)
[2] 徐晓莉, 徐东丽, 温晓飒, 等. 上海闵行区青少年青春期性教育现况及对策[J]. 中国学校卫生, 2019, 40(3): 441-445.
Xu XL, Xu DL, Wen XS, et al. Current situation and countermeasures of adolescent sex education in Minhang district, Shanghai[J]. Chin J Sch Health, 2019, 40(3): 441-445.(in Chinese)
[3] 郭帅军, 余小鸣, 孙玉颖. 中国青少年高危性行为的Meta分析[J]. 中国性科学, 2012, 21(10): 69-71, 79.
Guo SJ, Yu XM, Sun YY. A meta-analysis of high-risk sexual behaviors among adolescents in China's Mainland[J]. Chin J Hum Sex, 2012, 21(10): 69-71, 79.(in Chinese)
[4] Zhang D, Bi Y, Maddock JE, et al. Sexual and reproductive health knowledge among female college students in Wuhan, China[J]. Asia Pac J Public Health, 2010, 22(1): 118-126.
[5] 岳廷棉, 孙健. 上海市长宁区高中生性与生殖健康状况调查[J]. 上海预防医学, 2020, 32(5): 412-416.
Yue YM, Sun J. Sexual and reproductive health of high school students in Changning district, Shanghai[J]. Shanghai J Prev Med, 2020, 32(5): 412-416.(in Chinese)
[6] 武俊青, 李亦然, 李玉艳, 等. 中学开展性与生殖健康教育现状调查及需求分析[J]. 中国性科学, 2019, 28(2): 149-153.
Wu JQ, Li YR, Li YY, et al. Investigation and demand analysis on the present situation of sexual and reproductive health education in middle school[J].Chin J Hum Sex, 2019, 28(2): 149-153.(in Chinese)
[7] 李丹, 邹艳, 顾昉, 等. 浙江省青少年青春早期性与生殖健康教育现况调查[J]. 浙江预防医学, 2016, 28(4): 340-345.
Li D,Zou Y, Gu F, et al. An investigation on the status of education and health service related to sexual and reproductive health among early adolescent students[J]. Zhejiang J Prev Med, 2016, 28(4): 340-345.(in Chinese)
[8] Sheikhansari N, Abraham C, Denford S, et al. A qualitative assessment of the sexual-health education, training and service needs of young adults in Tehran[J]. BMC Public Health, 2021, 21(1): 1386.
[9] 何丽芸, 杜莉, 沈心荷, 等. 上海市青少年性与生殖健康教育及服务需求的定性研究[J]. 中国妇幼健康研究, 2018, 29(11): 1457-1461.
He LY, Du L, Shen XH, et al. Adolescent's demands for sexual and reproductive health education in Shanghai: A qualitative research[J]. Chin J Woman Child Health Res, 2018, 29(11): 1457-1461.(in Chinese)
[10] 方笑爱, 张鼎. 某高校大学生性知识认知调查及健康教育需求分析[J]. 健康研究, 2020, 40(1): 40-43.
Fang XA, Zhang D. A survey on college students' knowledge of sex and needs for health education[J]. Health Res, 2020, 40(1): 40-43.(in Chinese)
[11] 纪娟, 李练兵, 黄娅, 等. 重庆地区3所理工高校学生对性与生殖健康知识需求及教育现状满意度调查[J]. 重庆医学, 2013, 42(36): 4436-4437, 4440.
Ji J, Li LB, Huang Y, et al. A survey on demands of sex and reproductive health education and service from university students in Chongqing[J]. Chongqing Med, 2013, 42(36): 4436-4437, 4440.(in Chinese)
[12] 朱丹玲, 马健, 廖慧霞, 等. 深圳市福田区中学生生殖健康知识来源及需求分析[J]. 中国妇幼卫生杂志, 2017, 8(1): 35-38, 42.
Zhu DL, Ma J, Liao HX, et al. Analysis of the demand and source of reproductive health knowledge among junior high school students in Futian district of Shenzhen city[J]. Chin J Women Child Health, 2017, 8(1): 35-38, 42.(in Chinese)
[13] 张春江, 陈如婷, 江剑平. 中学生家长对家庭性教育的态度和行为调查分析[J]. 保健医学研究与实践, 2020, 17(6): 12-17.
Zhang CJ, Chen RT, Jiang JP. A survey and analysis of the attitudes and behaviors toward sex education at home among parents of middle school students[J]. Health Med Res Pract, 2020, 17(6): 12-17.(in Chinese)
[14] 张妍, 韩历丽, 高丽丽, 等. 北京市15～24岁未婚青少年高危性行为调查研究[J]. 实用预防医学, 2020, 27(10): 1189-1192.
Zhang Y, Han LL, Gao LL, et al. High-risk sexual behavior among unmarried adolescents aged 15-24 years in Beijing[J]. Pract Prev Med, 2020, 27(10): 1189-1192.(in Chinese)
[15] 陈黎跃, 刘秀红, 董文斌, 等. 2005-2019年玉溪市10～24岁青少年性传播疾病流行特征与趋势分析[J]. 中国皮肤性病学杂志, 2021, 35(1): 57-65.
Chen LY, Liu XH, Dong WB, et al. Analysis of epidemiological trends and characteristics of sexual transmitted disease among adolescents aged 10 to 24 years in Yuxi prefecture from 2005 to 2019[J]. Chin J Dermatovenereol, 2021, 35(1): 57-65.(in Chinese)
[16] Santelli JS, Grilo SA, Choo TH, et al. Does sex education before college protect students from sexual assault in college?[J]. PLoS One, 2018, 13(11): e0205951.
[17] 李晶, 王燕. 北京市某区高中生性与生殖健康知识、态度与行为调查研究[J]. 中国初级卫生保健, 2014, 28(6): 39-42.
Li J, Wang Y. Research onknowledge, attitude and practice toward sexual and reproductive health for high school students in Beijing[J]. Chinese Primary Health Care, 2014, 28(6): 39-42.(in Chinese)
[18] 曹婷婷, 赵温, 张颖. 北京市海淀区部分中学生性知识、态度及需求途径调查分析[J]. 健康研究, 2021, 41(4): 387-389, 394.
Cao TT, Zhao W, Zhang Y. Investigation and analysis of knowledge, attitude and demand pathways of middle school students in Haidian district, Beijing[J]. Health Res, 2021, 41(4): 387-389, 394.(in Chinese)
[19] Saiz EG, Sarda V, Pletta DR, et al. Family functioning as a protective factor for sexual risk behaviors among gender minority adolescents[J]. Arch Sex Behav, 2021, 50(7): 3023-3033.
[20] Mason-jones AJ, Mathews C, Flisher AJ. Can peer education make a difference? Evaluation of a South African adolescent peer education program to promote sexual and reproductive health[J]. AIDS Behav, 2011, 15(8): 1605-1611.
[21] Nelson KM, Pantalone DW, Carey MP. Sexual health education for adolescent males who are interested in sex with males: An investigation of experiences, preferences, and needs[J]. J Adolesc Health, 2019, 64(1): 36-42.
[22] UNESCO. International technical guidance on sexuality education (Revised)[R/OL]. Paris: UNESCO, 2018. http://unesdoc.unesco.org/images/0018/001832/183281c.pdf.
[23] 曹璠璠. 中国青少年性与生殖健康教育现状及效果的系统评价[J]. 人人健康, 2019(19): 261.
Cao FF. Status and effectiveness of sexual and reproductive health education for adolescents in China: A systematic review[J]. Health for Everyone, 2019(19):261.(in Chinese)
[24] 覃恺洋, 汤永隆, 翁玲玲. 重庆市父母性教育态度对青少年性知识的影响[J]. 中国学校卫生, 2017, 38(4): 512-515.
Qin KY, Tang YL,Weng LL. Possible impacts of sex education attitude of parents on adolescent's sex related knowledge acquisition[J]. Chin J Sch Health, 2017, 38(4): 512-515.(in Chinese)