The relationship between sexual behavior and nonsexual risk behaviors among unmarried youth in Three Asian Cities

Xiaowen Tu, Chaohua Lou, Ersheng Gao, Nan Li, Laurie S. Zabin

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Background: Health risk behaviors in adolescents and youth, such as smoking, alcohol, drug use, violence, suicide, and unprotected sexual behavior, are issues of major public health concern. Addressing the relationship between sexual behavior and nonsexual risk behaviors will make a significant contribution to the design of effective intervention programs for this population of adolescents and unmarried youth. Methods: This cross-sectional study was conducted in three Asian cities with a common heritage of Confucian values: Hanoi, Shanghai, and Taipei. Data were collected in 2006 from 17,016 youth aged 1524 years residing in both urban and rural districts of the three settings. The relationships between sexual behavior and seven nonsexual risk behaviors among unmarried adolescents were examined using χ 2 tests, logistic regression models, Cox regression models, and cluster analysis. Results: Sexual behavior was associated with seven nonsexual risk behaviors, especially with smoking, drinking, drug use, and running away from home. In terms of the age at initiation of risk behaviors, smoking and drinking were usually initiated before sexual intercourse. Sexual behavior and nonsexual risk behaviors co-occurred in the high-risk group in all three cities. Youth having the highest risk of sexual behavior were more likely to have the highest risk of nearly all nonsexual risk behaviors, with the exception of fighting in Hanoi and gambling in Shanghai and Taipei. Conclusions: Sexual behavior among unmarried youth is correlated with nonsexual risk behaviors but with different patterns across the three settings. Interventions aimed at reducing unprotected sex generally focus only on the sexual behavior; however, considering the correlations found here between sexual and nonsexual risk behaviors, they should target multiple risk behaviors.

Original languageEnglish (US)
Pages (from-to)S75-S82
JournalJournal of Adolescent Health
Issue number3 SUPPL.
StatePublished - Mar 2012


  • Nonsexual risk behaviors
  • Sexual behavior
  • Unmarried youth

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health


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