Childhood sexual abuse, risky sexual behaviors and adverse reproductive health outcomes among Chinese college students

Childhood sexual abuse (CSA) is a serious public health problem worldwide. We reported the prevalence of CSA and examined its association with risky sexual behaviors and adverse reproductive health outcomes among college students in China. Participants were 17,966 college students from 130 colleges in Eastern, Central, and Western China, who completed the online questionnaire in January–August 2015. Data were obtained from a cluster-random Internet-based survey. Multivariate logistic regression analyses were employed: risky sexual behaviors and adverse reproductive health outcomes were outcome variables, and various types of CSA were predictor variables, while adjusting for socio-demographic and lifestyle characteristics. The overall prevalence of any type of CSA was 27.5%. Most perpetrators were friends/acquaintances (34.6%) or intimate partners (24.7%) of the victims. Respondents who reported penetrative CSA were strongly associated with regular unprotected sex (odds ratio (OR): 3.0, 95% confidence interval (CI): 2.2–4.0), early sexual debut (OR: 5.5, 95% CI: 3.3–9.1), having genital tract symptoms in the last 12 months (OR: 5.0, 95% CI: 4.1–6.0), unintended pregnancy (OR: 6.2, 95% CI: 4.2–9.0), and induced abortion (OR: 5.5, 95% CI: 3.7–8.2) (for boys, the survey asked about history of unintended pregnancy and induced abortion of their sexual partners). A dose-response relationship was found across non-contact, contact, and penetrative CSA. CSA experience may increase the likelihood of risky sexual behaviors and adverse reproductive health outcomes in victims’ early adulthood.