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Background: Youth with disabilities have the same right to sexual and reproductive health (SRH) as their peers without disabilities. However, their needs and rights are often ignored. Little is known about the knowledge, needs and access barriers related to SRH information among youth with different types of disabilities in China. Methods: A cross-sectional survey was carried out among 473 unmarried youth aged 15–24 with visual, hearing, physical disabilities in both urban and rural areas in China. Results: Out of a maximum possible score of 100, respondent's median score ranged from 30 to 50 for knowledge related to sexual physiology, STIs/HIV/AIDS and contraception. For these three categories of knowledge, respondents with hearing and physical disabilities or from rural areas scored lower than their counterparts with visual disabilities or from urban areas. The multivariate analyses showed that the residential area and education level were strong correlates of knowledge among respondents with visual and hearing disabilities. Other significant correlates were age for respondents with visual impairment and physical impairment, and single child status in the family and father's education level for respondents with hearing impairment. Sources of and barriers and preferences in accessing SRH information differed by type of disabilities, residential areas and gender. In general, school teachers were the primary and most preferred sources of SRH knowledge, followed by the Internet, peers/friends and parents. Unaware of where to get accurate information and feeling embarrassed to seek information were the two most frequently mentioned barriers in accessing SRH information. Conclusion: Respondents had poor knowledge of SRH and limited access to SRH information, especially those from rural areas. Efforts should be made to promote school and family-based sexuality education tailored for youth with different types of disabilities. Plain language summary: Youth with disabilities have the same sexual and reproductive health (SRH) needs as their peers without disabilities and the equal right to attain the highest standard of SRH. However, their SRH needs and rights are often overlooked or neglected. Studies on SRH among unmarried youth with disabilities are very limited in China. This study used data collected from 473 unmarried youths with different types of disabilities from both urban and rural areas in China, to understand their SRH knowledge and its associated factors, as well as barriers and preferences in accessing sexuality-related information. This study demonstrated that unmarried youth with disabilities lacked knowledge of SRH, especially those with hearing or physical disabilities and those from rural areas. In general, residential area and education level were significant correlates of knowledge among respondents. Sources of and barriers and preferences in accessing SRH information varied across types of disabilities, residential areas and gender. In general, school teachers were the primary and most preferred sources of knowledge, followed by the Internet, peers and parents. Unaware of the available sources of accurate information and feeling embarrassed to seek information were the most frequently mentioned barriers in accessing SRH information. The findings of the study highlight the need to reduce the barriers to sexuality education for unmarried youth with different types of disabilities. Efforts should be made to promote school and family-based sexuality education tailored for youth with different types of disabilities and empower them to seek information proactively. [ABSTRACT FROM AUTHOR]

Gender dissatisfaction is often linked to adverse health outcomes and is an under-researched area of adolescent health. The aim of our study was to examine the associations of gender dissatisfaction with adolescent mental distress and sexual victimization. We conducted a cross-sectional study in April 2019 using a computerized self-administered questionnaire to collect data on the gender dissatisfaction, mental distress, and sexual victimization among Chinese adolescents. We used multivariate logistic models to estimate sex-stratified adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the associations of gender dissatisfaction with mental distress and sexual victimization. Our study involved 538 female and 556 male students from grades 7 to 11. Among the female students, gender dissatisfaction was significantly associated with depression (AOR, 2.04, 95%CI, 1.17–3.58), anxiety (AOR, 2.13, 95%CI, 2.00–2.27), suicidal ideation (AOR, 2.36, 95%CI, 2.02–2.76), sexting victimization (AOR, 1.67, 95%CI, 1.11–2.51), and nonphysical sexual harassment (AOR, 1.72, 95%CI, 1.08–2.76). Among the male students, gender dissatisfaction was significantly associated with oral-–genital contact (AOR, 5.86, 95%CI, 2.74–12.54), attempted sexual assault (AOR, 9.63, 95%CI, 6.91–13.42), and completed sexual assault (AOR, 14.71, 95%CI, 1.16–187.33). Our findings suggest gender dissatisfaction is associated with adolescent mental distress and sexual victimization, underscoring the importance of implementing comprehensive sexual education with gender perspectives in China. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the associations between sexual-related knowledge, access to school and family sexuality education, and the experience of sexual intercourse, in order to make recommendations on sexuality education for vocational secondary school students in China. Methods: A cross-sectional study was conducted among 3180 vocational secondary school students in the Shanghai municipality and the Shaanxi province, China. Data were collected through an online, electronic questionnaire, which included socio-demographics, sexual-related knowledge, sources of information, and sexual-related behaviors. Results: The score on sexual-related knowledge among girls (53.8) is higher than that of boys (48.8), and that of participants from Shanghai (55.2) is higher than their counterparts from Shaanxi (47.6). The proportions of girls (70% and 41.7%, respectively) and participants from Shanghai (65% and 35.7%, respectively) who reported acquiring sexual information from their schools/teachers and parents are higher than that of boys (54.3% and 21.0%, respectively) and their counterparts from Shaanxi (59.7% and 27.4%, respectively). About 6% of participants had experienced sexual intercourse and 10% had watched porn actively. Experience of sexual intercourse was associated with higher sexual-related knowledge scores (OR = 1.01, 95% CI: 1.00–1.02) and active porn watching (OR = 2.63, 95% CI: 1.79–3.84) but was not associated with school and family sexuality education. Conclusions: Vocational secondary school students had poor sexual knowledge and inadequate school and family sexuality education. School and family-based comprehensive sexuality education should be promoted among vocational secondary school students. [ABSTRACT FROM AUTHOR]

Background: This cross-sectional study aimed to identify adverse childhood experience (ACE) subtypes using variable- and person-centered approaches and examine the possible sex-differentiated associations with violence involvement as victim, perpetrator, and victim-perpetrator.Methods: Adolescents aged 10-14 years in three junior high schools in Shanghai, China, were selected using a cluster sampling method in November and December 2017. Participants were surveyed anonymously using a computer-assisted self-interview approach via tablets. Thirteen items modified from the CDC-Kaiser ACE study were used to measure the ACEs. Results show subtypes as neglect, abuse, and household dysfunction by developing cumulative index score from the variable perspective and subgroups identified through the latent class analysis (LCA) from the person perspective. Logistic regression analyses were used to test the association between each ACE subtype and violence victimization and perpetration after adjusting for some demographic characteristics.Results: A total of 1,700 participants were included in the final analysis. Approximately 1,322 (77.76 %) participants reported experiencing at least one ACE. The prevalence of neglect, abuse, and household dysfunction was 64.12 % (n = 1090), 61.29 % (n = 1042), and 18.24 % (n = 310), respectively. Three classes were identified through the LCA: low exposure to all ACEs (n = 854, 50.23 %), high exposure to emotional and physical abuse and neglect (n = 715, 42.06 %), and high exposure to all ACEs (n = 131,7.71 %). After controlling the covariates, experiencing abuse, neglect, and household dysfunction was significantly related to violence victimization (adjusted odds ratio [aOR] = 3.19, 3.29, 2.37, P < 0.001) and victim-perpetrator (aOR = 3.48, 4.41, 5.16, P < 0.001). Adolescent violence perpetration was only found to be associated with being neglected (aOR = 2.37, P = 0.003) and suffering household dysfunction (aOR = 3.25, P < 0.001). LCA revealed the cumulative effects of ACEs on adolescent violence victimization and perpetration. Sex-stratified analysis indicate that girls were more vulnerable to the negative effects of ACEs, with a higher risk of perpetration among girls exposed to distinctive subtypes or multiple ACEs.Conclusions: ACEs were ubiquitous and significantly associated with an elevated risk of violence victimization and perpetration during early adolescence. Future research should examine whether these associations persist over time and the intermediating mechanism from the perspectives of individual neurodevelopment, cognition and resilience ability, and social support. [ABSTRACT FROM AUTHOR]

Adolescent alcohol use was a major social and public health concern given its negative impacts. Previous studies indicated gender role attitudes (GRA) were associated with alcohol use; however, few studies focused on early adolescents (10 to 14 years) and similar researches were not found in China. Objective: This study sought to explore the association between GRA and alcohol use among early adolescents. Methods: A cross-sectional study was conducted among students in grades six to eight across three public secondary schools in Shanghai, China. Data were collected by Computer-Assisted Self-Interview (CASI) questionnaire on mobile tablets. Alcohol use was measured by self-report, and six items with 5-point Likert-type options assessed the attitude toward traditional gender roles. The logistic regression model was adopted to examine the associations between GAR and alcohol use. Results: Totally 1,631 adolescents aged 10 to 14 years with 50.33% of boys included in this study. The mean score of GRA in drinkers was significantly higher than nondrinkers among boys (3.03 vs. 2.78, p < 0.001) but not girls (2.15 vs. 2.18, p = 0.499). After controlling the covariates of age, depression, peers' substance use, social cohesion, etc., we found that more traditional GRA was associated with a higher risk of alcohol use among boys (OR = 1.39, 95%CI: 1.11–1.75), whereas the association was not significant among girls (OR = 0.96, 95%CI: 0.74–1.24). Conclusions: Traditional GRA may increase the risk of alcohol use among early adolescent boys, suggesting that altering traditional GRA among this population group may help to prevent alcohol use. [ABSTRACT FROM AUTHOR]