Needs and Preferences Regarding Sex Education Among Chinese College Students: A Preliminary Study

International Family Planning Perspectives, Sep 2004 by Li, Ying, Cottrell, Randall R, Wagner, Donald I, Ban, Maosheng

CONTEXT: College students are more likely than other student populations to be sexually active. To improve sex education in China among this group, educators must know college students'needs and their preferences for receiving information on sexuality.

METHODS: In 2002, students at a large Chinese university completed surveys about their history of school-based sex education and their other sources of information on sexuality. The survey also explored students'preferences for topics to be included in a college-level sex education course, comfort level with receiving information on these topics and views of effective teaching strategies.

RESULTS: Before college, 47% of respondents had received no school-based education on sexual behavior; however, all respondents had taken a class covering reproduction, typically beginning in middle school (78%). Reading material, radio, classroom lecture and parents were more popular sources of information among females than among males; friends, the Internet and personal sexual experience were more frequent sources for males than for females. Higher proportions of males than females favored including sex therapy and masturbation in a hypothetical course. In addition, males felt more comfortable than females discussing 7 1 of 20 subjects; the two genders indicated similar levels of comfort in talking about the other topics. Males and females differed on how best to convey information on sexuality, with females generally favoring private methods, such as reading.

CONCLUSIONS: More comprehensive school-based sex education is needed for Chinese youth. When developing and implementing such programs, health educators should consider differences between males'and females'preferred ways for receiving information on sexuality.

In ternational Family Planning Perspectives, 2004,30(3): 128-133

Sex education in China dates back many centuries. In fact, the oldest existing books on sexuality were published in China, in around 200 B.c.1 Some books explicitly described human sexual response and sexual techniques, some provided information on how to prevent sexual dysfunction and others offered information on how to adjust one's level of sexual activity to maintain longevity.2 Gradually, however, sexual attitudes began to change in the 12th century during the Song Dynasty.3 The government began to closely control people's sexual lives and to restrict sexual expression; eventually, sexual conservatism became so pervasive that any communication about sexuality was considered taboo.4

This very conservative attitude toward sexuality began to change after the 1949 founding of the People's Republic of China. In the 1950s, the government began to recognize the importance of sex education, and it published several books on sexuality targeted at the general public.5

Societal change, however, came slowly. Attitudes in the adult population remained conservative,6 but views and behaviors among youth began changing rapidly. After the government adopted the Reform and Open Policy of 1978, Western values and beliefs about sexuality flooded into China. With changes in social ideology and in the traditional extended family structure, reduced social control and an information boom, youth became increasingly interested in sexual expression and many became involved in high-risk sexual behaviors.7

In the late 1970s, in response to concerns related to the country's large population and high birthrate, the government established its one-child policy, under which married couples typically were limited to a single child.*8 Because the policy implicitly required couples to use effective birth control methods, it provided further rationale for supporting comprehensive sex education. Three additional factors supported implementing sex education for Chinese youth: a lack of knowledge about sexuality among youth;9 a documented desire of youth to receive sex education;10 and concern that youth were receiving mixed messages about sex, some of which might encourage risky sexual behavior and sex crimes.11

Responding to a perceived need, in 1988, the Ministry of Education and the State Family Planning Commission required that sex education be incorporated in middle school curricula nationwide. In 1993, the Ministry of Education issued Guideline to Health Education for University Students, which included adolescent sex education as an essential component. In 2002, the government officially declared its commitment to sex education by integrating the requirement to provide sex education to middle school students with the Population and Family Planning Law of the People's Republic of China.

As a result of the national policy requiring adolescent sex education, most young people entering college in China today have already received some school-based sex education. Most, however, view that education as too conservative and as inadequate to meet their needs.12 Chinese college students-including the 5%13 to 20%,14 or more,15 who are sexually experienced-need more and better instruction to help them make informed and responsible decisions. This may be especially important today, given their increased interest in sex and involvement in high-risk sexual behaviors during recent years.16 Thus, a discrepancy exists between the need lor quality information on sexuality and the information provided in sex education courses.17