Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
Shopping Cart: ( empty )
You are here: Home > Journals > SH > SH16009
RESEARCH ARTICLE
Contents Vol 13(3)

Boundaries of sexual communication: a mixed-method study exploring Chinese young adults’ engagement with online sexual health information

Jingwen Zhang A D , Chloe Nurik B and John B. Jemmott III A C
+ Author Affiliations
- Author Affiliations

A Annenberg School for Communication, University of Pennsylvania, 3620 Walnut Street, Philadelphia, PA 19104, USA.

B School of Arts & Sciences, College Hall, University of Pennsylvania, Philadelphia, PA 19104, USA.

C Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.

D Corresponding author. Email: jzhang@asc.upenn.edu

Sexual Health 13(3) 281-288 https://doi.org/10.1071/SH16009
Submitted: 18 January 2016  Accepted: 1 March 2016   Published: 21 March 2016

Abstract

Background: Although previous research suggests that a majority of Chinese young adults get sexual health information through the Internet, the details of this process and how it translates into subsequent actions are unknown. This study aims to understand the dynamic nature of Chinese young adults’ engagement with online sexual health information (OSHI) through various communication channels to inform the development of effective sexual health intervention strategies. Methods: A mixed-method approach was used, involving individual semi-structured interviews (n = 30) and cross-sectional online surveys (n = 561) with Chinese young adults aged 18 to 25 years. Qualitative themes and prevalence and predictors of engagement with OSHI were analysed. Results: Three themes emerged from the interviews: (1) problem-based searching; (2) multi-criteria evaluation; and (3) stigma of online sharing and discussion. After engaging with OSHI, 87.3% of the survey participants followed online advice on at least one occasion, and 54.9% discussed this information with others (mostly with partners and friends) offline. Having sexual intercourse in the past 3 months was a consistent predictor of engagement with OSHI (P < 0.05). Contrary to previous findings, participants with higher family income were more likely to engage with OSHI (P < 0.05). Conclusions: Chinese young adults obtain sexual health information from online sources when personal problems arise and then circulate this information offline within their peer networks. Although social media interventions have shown some promise, researchers should first increase risk awareness and be cautious about designing programs that promote online sharing or discussion. Finally, researchers need to make extra effort to target young adults with limited resources.

Additional keywords: Internet, interview, online sharing, online survey, sexual behaviour.


References

[1]  Lieber E, Chin D, Li L, Rotheram-Borus MJ, Detels R, Wu Z, Guan J, National Institute of Mental Health (NIMH) Collaborative HIV Prevention Trial Group Sociocultural contexts and communication about sex in China: informing HIV/STD prevention programs. AIDS Educ Prev 2009; 21 415–29.
| Sociocultural contexts and communication about sex in China: informing HIV/STD prevention programs.Crossref | GoogleScholarGoogle Scholar | 19842826PubMed |

[2]  Parish WL, Luo Y, Stolzenberg R, Laumann EO, Farrer G, Pan S. Sexual practices and sexual satisfaction: a population based study of Chinese urban adults. Arch Sex Behav 2007; 36 5–20.
| Sexual practices and sexual satisfaction: a population based study of Chinese urban adults.Crossref | GoogleScholarGoogle Scholar | 17187219PubMed |

[3]  Hu YK, Zheng XY, Cheng G. [Sexual and reproductive health of Chinese youth is urgently needed to put on the policy agenda]. Guo Ji Sheng Zhi Jian Kang/Ji Hua Sheng Yu Za Zhi 2010; 29 392–6..
| 1:CAS:528:DC%2BC3cXns1Shur0%3D&md5=57b449a629572c331cf291df8ad7004aCAS |

[4]  Guo W, Wu Z, Qiu Y, Chen G, Zheng XY. The timing of sexual debut among Chinese youth. Int Perspect Sex R H 2012; 38 196–204.
| The timing of sexual debut among Chinese youth.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhsFOgtrvN&md5=30ec157ab940a0b96cbcdb2cf38b9503CAS |

[5]  Chen H, Zhang L, Han YL, Lin T, Song XM, Chen G, Zheng X. HIV/AIDS knowledge, contraceptive knowledge, and condom use among unmarried youth in China. AIDS Care 2012; 24 1550–8.
| HIV/AIDS knowledge, contraceptive knowledge, and condom use among unmarried youth in China.Crossref | GoogleScholarGoogle Scholar | 22533677PubMed |

[6]  Zheng X, Chen G, Gao CL. [Preliminary findings of the first National Youth Reproductive Health Survey in China] Ren Kou Yu Fa Zhan 2010; 16 2–15. [In Chinese]

[7]  Sheng L, Cao WK. HIV/AIDS epidemiology and prevention in China. Chin Med J 2008; 121 1230–6.
| 18710645PubMed |

[8]  Dong Z, Xu J, Zhang H, Dou Z, Mi G, Ruan Y, Shen L, Min X, Lan G, Li F, Li T, Ning Z, Wu G, She M, Wu Z, China National HIV Prevention Study Group HIV incidence and risk factors in Chinese young men who have sex with men – A prospective cohort study. PLoS One 2014; 9 e97527
| HIV incidence and risk factors in Chinese young men who have sex with men – A prospective cohort study.Crossref | GoogleScholarGoogle Scholar | 24878586PubMed |

[9]  Wei S, Zhang H, Wang J, Song D, Duan Y, Yu F, She M, Wang M, Zhang H. HIV and syphilis prevalence and associated factors among young men who have sex with men in 4 cities in China. AIDS Behav 2013; 17 1151–8.
| HIV and syphilis prevalence and associated factors among young men who have sex with men in 4 cities in China.Crossref | GoogleScholarGoogle Scholar | 22198314PubMed |

[10]  Wu J, Meng Z, Xu J, Lei Y, Jin L, Zhong P, Han R, Su B. New emerging recombinant HIV-1 strains and close transmission linkage of HIV-1 strains in the Chinese MSM population indicate a new epidemic risk. PLoS One 2013; 8 e54322
| New emerging recombinant HIV-1 strains and close transmission linkage of HIV-1 strains in the Chinese MSM population indicate a new epidemic risk.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXitVymtLc%3D&md5=2eedb38b6a8717c82064b486acf24cd9CAS | 23372706PubMed |

[11]  Zhang J, Jemmott JB. Unintentional exposure to online sexual content and sexual behavior intentions among college students in China. Asia Pac J Public Health 2015; 27 561–71.
| Unintentional exposure to online sexual content and sexual behavior intentions among college students in China.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC28XktlentLw%3D&md5=e6e30b68fab5b65859b7248e6e197a1fCAS | 25527202PubMed |

[12]  Buhi ER, Daley EM, Oberne A, Smith SA, Schneider T, Fuhrmann HJ. Quality and accuracy of sexual health information web sites visited by young people. J Adolesc Health 2010; 47 206–8.
| Quality and accuracy of sexual health information web sites visited by young people.Crossref | GoogleScholarGoogle Scholar | 20638014PubMed |

[13]  Magee JC, Bigelow L, Dehaan S, Mustanski BS. Sexual health information seeking online: a mixed-methods study among lesbian, gay, bisexual, and transgender young people. Health Educ Behav 2012; 39 276–89.
| Sexual health information seeking online: a mixed-methods study among lesbian, gay, bisexual, and transgender young people.Crossref | GoogleScholarGoogle Scholar | 21490310PubMed |

[14]  Barman-Adhikari A, Rice E. Sexual health information seeking online among runaway and homeless youth. J Soc Social Work Res 2011; 2 89–103.
| Sexual health information seeking online among runaway and homeless youth.Crossref | GoogleScholarGoogle Scholar |

[15]  Borzekowski DL, Fobil JN, Asante KO. Online access by adolescents in Accra: Ghanaian teens’ use of the internet for health information. Dev Psychol 2006; 42 450–8.
| Online access by adolescents in Accra: Ghanaian teens’ use of the internet for health information.Crossref | GoogleScholarGoogle Scholar | 16756437PubMed |

[16]  Niederdeppe J, Hornik RC, Kelly BJ, Frosch DL, Romantan A, Stevens R. Exploring the dimensions of cancer-related information seeking and scanning behavior. Health Commun 2007; 22 153–67.
| Exploring the dimensions of cancer-related information seeking and scanning behavior.Crossref | GoogleScholarGoogle Scholar | 17668995PubMed |

[17]  Metzger MJ, Flanagin AJ. Digital media, youth, and credibility. Cambridge: MIT Press; 2008.

[18]  Pascoe CJ. Resource and risk: youth sexuality and new media use. Sex Res Soc Policy 2011; 8 5–17.
| Resource and risk: youth sexuality and new media use.Crossref | GoogleScholarGoogle Scholar |

[19]  Moldovan-Johnson M, Tan AS, Hornik RC. Navigating the cancer information environment: the reciprocal relationship between patient-clinician information engagement and information seeking from nonmedical sources. Health Commun 2014; 29 974–83.
| Navigating the cancer information environment: the reciprocal relationship between patient-clinician information engagement and information seeking from nonmedical sources.Crossref | GoogleScholarGoogle Scholar | 24359259PubMed |

[20]  Ybarra M, Suman M. Reasons, assessments and actions taken: sex and age differences in uses of Internet health information. Health Educ Res 2008; 23 512–21.
| Reasons, assessments and actions taken: sex and age differences in uses of Internet health information.Crossref | GoogleScholarGoogle Scholar | 16880222PubMed |

[21]  Shang H, Xu J, Han X, Spero Li J, Arledge KC, Zhang L. HIV prevention: bring safe sex to China. Nature 2012; 485 576–7.
| HIV prevention: bring safe sex to China.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XnvVyntLc%3D&md5=9f0130d621f0188490a7c644c591ffa6CAS | 22660303PubMed |

[22]  Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005; 15 1277–88.
| Three approaches to qualitative content analysis.Crossref | GoogleScholarGoogle Scholar | 16204405PubMed |

[23]  Wen Juan Xing online survey. Available online at: http://www.sojump.com/.Chinese [verified 10 November 2013].

[24]  Hong Y, Li X, Mao R, Stanton B. Internet use among Chinese college students: implications for sex education and HIV prevention. Cyberpsychol Behav 2007; 10 161–9.
| Internet use among Chinese college students: implications for sex education and HIV prevention.Crossref | GoogleScholarGoogle Scholar | 17474831PubMed |

[25]  Farrer J. Opening up: youth sex culture and market reform in Shanghai. Chicago: University of Chicago Press; 2002.

[26]  Jones RH. Mediated action and sexual risk: searching for “culture” in discourses of homosexuality and AIDS prevention in China. Cult Health Sex 1999; 1 161–80.
| Mediated action and sexual risk: searching for “culture” in discourses of homosexuality and AIDS prevention in China.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38ros1ahtA%3D%3D&md5=7bebbb9c947817c987ff0c589b970d81CAS | 12295453PubMed |

[27]  Byron P, Albury K, Evers C. “It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information. Reprod Health Matters 2013; 21 35–44.
| “It would be weird to have that on Facebook”: young people’s use of social media and the risk of sharing sexual health information.Crossref | GoogleScholarGoogle Scholar | 23684185PubMed |

[28]  Evers CW, Albury K, Byron P, Crawford K. Young people, social media, social network sites and sexual health communication in Australia: “This is funny, you should watch it” Int J Commun 2013; 7 263–80.

[29]  Lenhart A, Purcell K, Smith A, Zickuhr K. Social media and mobile Internet use among teens and young adults. Washington DC: Pew Research Center; 2010.

[30]  Dobransky K, Hargittai E. Inquiring minds acquiring wellness: uses of online and offline sources for health information. Health Commun 2012; 27 331–43.
| Inquiring minds acquiring wellness: uses of online and offline sources for health information.Crossref | GoogleScholarGoogle Scholar | 21932982PubMed |

[31]  Grana RA, Ling PM. “Smoking Revolution”: a content analysis of electronic cigarette retail websites. Am J Prev Med 2014; 46 395–403.
| “Smoking Revolution”: a content analysis of electronic cigarette retail websites.Crossref | GoogleScholarGoogle Scholar | 24650842PubMed |

[32]  Sorenson SB, Shi R, Zhang J, Xue J. Self-presentation on the Web: agencies serving abused and assaulted women. Am J Public Health 2014; 104 702–7.
| Self-presentation on the Web: agencies serving abused and assaulted women.Crossref | GoogleScholarGoogle Scholar | 24524489PubMed |

[33]  Allison S, Bauermeister JA, Bull S, Lightfoot M, Mustanski B, Shegog R, Levine D. The intersection of youth, technology, and new media with sexual health: moving the research agenda forward. J Adolesc Health 2012; 51 207–12.
| The intersection of youth, technology, and new media with sexual health: moving the research agenda forward.Crossref | GoogleScholarGoogle Scholar | 22921129PubMed |

[34]  Lou C-h, Zhao Q, Gao E-S, Shah IH. Can the Internet be used effectively to provide sex education to young people in China? J Adolesc Health 2006; 39 720–8.
| Can the Internet be used effectively to provide sex education to young people in China?Crossref | GoogleScholarGoogle Scholar | 17046509PubMed |