Can the Internet be used effectively to provide sex education to young people in China?
OBJECTIVE
To assess the feasibility and effectiveness of sex education conducted through the Internet.


METHODS
Two high schools and four colleges of a university in Shanghai were selected as the research sites. Half of these were assigned to the intervention group and the other half to the control group. The interventions consisted of offering sexual and reproductive health knowledge, service information, counseling and discussion to all grade one students in the intervention group. The intervention phase lasted for 10 months and was implemented through a special website, with web pages, online videos, Bulletin Board System (BBS) and expert mailbox. In total, 624 students from the intervention, and 713 from the control schools and colleges participated in the baseline survey, and about 97% of them were followed up in postintervention survey to assess changes that can be attributed to the sex education interventions provided through the Internet.


RESULTS
The median scores of the overall knowledge and of each specific aspect of reproductive health such as reproduction, contraception, condom, sexually transmitted infections (STIs) and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) were significantly higher in the intervention group as compared with those in the control group at postintervention (p < .0001), although no significant differences were found between these two groups in the baseline survey (p > .05). Group by time interaction effects in ordinal logistic regression analysis were found on knowledge score (p < .0001) and in attitude of high school students toward sex-related issues (p < .05), suggesting that interventions increased subjects' knowledge significantly and changed high school students' attitudes to being less liberal toward sex. The intervention also had positive influence on students' attitudes toward providing contraceptive service for unmarried people.


CONCLUSIONS
Providing sex education to students in Shanghai through the Internet was found feasible and effective. The Internet-based sex education program increased students' reproductive health knowledge effectively and changed their attitudes toward sex-related issues in terms of being less liberal toward sex and more favorable to providing services to unmarried young people. The Internet thus offers an important and hitherto untapped potential for providing sex education to students and young people in China.
Lou
Chao-hua
CH
Department of Epidemiology and Social Science on Reproductive Health, Shanghai Institute of Planned Parenthood Research, Shanghai, China. chaohual@sippr.stc.sh.cn
Zhao
Quan
Q
Gao
Er-Sheng
ES
Shah
Iqbal H
IH
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002681:China; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D012574:Schools; D012736:Sex Education / Q000379:methods*; D011795:Surveys and Questionnaires; D014495:Universities