Migration and unprotected sex in Shanghai, China: correlates of condom use and contraceptive consistency across migrant and nonmigrant youth

Purpose: Despite the exceptionally large population of young migrants in China, as well as increasing rates of HIV and sexually transmitted infections in recent years, condom use and contraceptive consistency among this population remains critically under-studied. This study examines the association between migration and condom use and contraceptive consistency.

Methods: A cross-sectional survey of 959 youth aged 15-24 years was conducted in rural and urban Shanghai. Logistic regression was conducted to examine the association between migration status and condom use and consistent contraceptive use. Analyses are stratified by gender.

Results: Overall, only 32% reported condom use at first sex, and <10% reported consistent contraceptive use. Compared with 63.6% of urban nonmigrants, 83.1% of rural-to-urban migrants reported not using a condom at first sex. Multivariate logistic regression models indicate that patterns of migration and gender clearly impact condom use and contraceptive consistency. After adjusting for background characteristics, rural-to-urban migrant males were significantly less likely to report condom use at first sex and consistent contraceptive use with first partner compared with nonmigrants and urban-to-urban migrants. Females living in rural areas who never migrate, by contrast, are least likely to report condom use and consistent contraceptive use compared with other females.

Conclusion: Because rural men who migrate to urban areas and rural nonmigrant young women are at particular risk, programs should target rural areas for both of these groups that would give support to young men before they leave their hometowns, as well as focusing on females who might not have the opportunity to migrate.