Background: The earlier and unprotected sexual behaviour of young Chinese, and the consequences of these actions, have become a health concern, posing a challenge to traditional Chinese concepts. The aim of the present study was to investigate changes in sexual behaviour and associated risks among adolescents and young people in mainland China over the past three decades.
Methods: A meta-analysis was undertaken to comprehensively review the sexual behaviour of Chinese young people (aged from 10 to 24 years) over the past 30 years. Relevant data published from 1979 to 2009 in the Chinese literature database were identified and retrieved. Analysis was performed based on set criteria.
Results: Seventy-five studies were identified that were published after 1990. Overall, the estimated prevalence of sexual intercourse among young people was 12.6%, with an average age at sexual debut of 19.4 years. The rate of condom use at sexual debut was 37.2%; 53.6% of young people reported not using a condom during the most recent act of sexual intercourse. The rates of unintentional pregnancy and abortion among the sexually active were 15.1% and 10.8%, respectively. Reviewing the data according to decades revealed that the number of young people engaging in sexual intercourse decreased from 14.3% in 1990-1999 to 11.8% in 2000-2009. However, these rates are higher than the prevalence of sexual activity reported before 1990, which, according to sporadic studies, did not exceeded 1%.
Conclusions: There have been increases in sexual activity and high-risk sexual behaviour in Chinese young people in the decades since the adoption of the open door policy in China, particularly since the mid-1990s. High-risk sexual behaviours have contributed to certain adverse consequences in adolescents and young people, such as unwanted pregnancy and sexually transmissible infection. Thus, efficacious intervention strategies need to be developed and implemented.