Impact of Community-based Sex Education and Reproductive Health Service Intervention on Unmarried Youths' Reproductive Health Knowledge and Attitudes Towards Sex-Related Issues

Purpose To examine the effectiveness of a community-based sex education and reproductive service program on unmarried youths' reproductive knowledge and attitudes towards sex-related issues. Methods Two towns in a district of Shanghai were selected as the research sites, one as the intervention site and the other as the control. The intervention lasted 20 months and comprised by three main areas of activities, i. e. , building awareness, offering counseling and services for 15 - 24 aged unmarried young people. In order to test the feasibility and effectiveness of the intervention, base-line survey conducted in both sites prior to the implementation of the intervention, and similar survey conducted in both sites after the intervention been initiated. Totally,1220 unmarried young people from the intervention site,and 1 007 from the control site were interviewed,and about 92% of them were re-interviewed at follow-up. Results The average reproductive knowledge score (the higher the score, the more the knowledge) no significant difference between the intervention and control groups at baseline,but higher in the intervention group than that in the control group at post-intervention(72. 2 ± 10. 2 vs 43. 6 ± 16. 9). For most of the questions on reproduction, contraception and STDs/AIDS in the questionnaire, the correct answer rates in the intervention groups were significantly higher than those in the control group. The intervetion also positive influence on unmarried youths' attitudes towards sex-related issues. There were more subjects in the intervention group who expressed less favorable attitude to premarital sex than that in the control group, i.e. ,less subjects in the intervetion group thought young people could have premarital sex even it based on love or they were willing to do so, while there were more subjects in the intervention group who thought the premarital sex understandable than that in the control group. Besides, there were higher proportions of subjects who thought premarital sex had negative impact on male/female youth, premarital pregnancy was not good and induced abortion does harm to women's health and influences women's fertility in the intervention group than those in the control group. Moreover,subjects' perceptions on safe sex and self-protection from sex risk behavior in the intervetion group were improved. Multi-variable analysis indicated that after the factors that might potentially affect the reproductive knowledge were adjusted, the intervention still the most important influencing factor of the knowledge. Conclusions Sex education and reproductive service in community could increase the reproductive knowledge, and change the sex-related attitudes of adolescents and unmarried young people and made young people hold more positive and rational attitudes towards sex-related issues.