Migration and Unprotected Sex in Shanghai, China: Correlates of Condom Use and Contraceptive Consistency Across Migrant and Nonmigrant Youth

doi:10.1016/j.jadohealth.2011.12.007

Journal of Adolescent Health

Volume 50, Issue 3, Supplement, March 2012, Pages S68-S74

https://doi.org/10.1016/j.jadohealth.2011.12.007 Get rights and content

Abstract

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.

Section snippets

Subjects and procedure

The analysis is based on the Three-City Asian Adolescent and Youth Survey conducted in 2006. The data were collected from 17,016 young people aged 15–24 years in urban and rural districts of Taiwan, Shanghai, and Hanoi. The overall goal of the study was to investigate the impact of family, peers, community, and exposure to media and modernization on adolescent sexual and reproductive health issues. The household sampling process for Shanghai was based on a three-stage method, and participants

Descriptive results

The percentage of unprotected sex was high across all groups; only 32% of the total sample indicated using a condom during their first sexual experience. Rural-to-urban migrants disproportionately reported the highest prevalence of unprotected sex with first partner. Among rural-to-urban migrants, 83.1% had unprotected sex compared with 71.2% of rural nonmigrants, 63.6% of urban nonmigrants, and 64.3% of urban-to-urban migrants (p = .031).

Only 22% of the sample reported consistent contraceptive

Discussion

Despite China's exceptionally large migrant population and increasing STI trends, to the best of our knowledge, this is the first study that has evaluated condom use among 15–24-year-olds by migration status. These findings suggest that rural-to-urban migrants, in particular, are at a greater disadvantage compared with other groups. They are most likely to be in the lowest wealth group, have less education, more likely to live alone or in work dormitories, and migrate for employment

Acknowledgments

The authors would like to thank Laurie Schwab Zabin—Principal Investigator of this study—David Bishai, and Mark Emerson for their assistance with data collection and editing.

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Original articleMigration and Unprotected Sex in Shanghai, China: Correlates of Condom Use and Contraceptive Consistency Across Migrant and Nonmigrant Youth

Abstract

Purpose

Methods

Results

Conclusion

Section snippets

Subjects and procedure

Descriptive results

Discussion

Acknowledgments

2002 HIV/AIDS epidemic and prevention efforts in China [news release]

Characteristics and determinants of sexual behavior among adolescents of migrant workers in Shangai (China)

BMC Public Health

Gender, migration and HIV in rural KwaZulu-Natal, South Africa

PLoS One

Migration and gender in China's HIV/AIDS epidemic in gender policy and HIV in China

Internal migration and health in China

Lancet

HIV/AIDS in China: 1990–2001

AIDS Behav

Risk of HIV/AIDS in China: Subpopulations of special importance

Sex Transm Infect

Epidemiology of HIV in China

BMJ

China's floating population and the potential for HIV transmission: A social-behavioural perspective

AIDS Care

Rural-urban migration and gender division of labor in transitional China

Int J Urban Reg Res

China's floating population: Definitions, data and recent findings

Urban Stud

Preventing HIV/AIDS in young people: A systematic review of the evidence from developing countries

HIV incidence and sexually transmitted disease prevalence associated with condom use: A population study in Rakai Uganda

AIDS

High prevalence of syphilis and other sexually transmitted diseases among sex workers in China: Potential for fast spread of HIV

AIDS

Effectiveness of condoms in preventing HIV transmission

Soc Sci Med

HIV knowledge and risk behaviour of female sex workers in Yunnan Province, China: Potential as bridging groups to the general population

AIDS Care

HIV-related risk behaviors and history of sexually transmitted diseases among male migrants who patronize commercial sex in China

Sex Transm Dis

A qualitative study on commercial sex behaviors among male clients in Sichuan Province, China

AIDS Care

Original article
Migration and Unprotected Sex in Shanghai, China: Correlates of Condom Use and Contraceptive Consistency Across Migrant and Nonmigrant Youth