title: Media's contribution to sexual knowledge, attitudes, and behaviors for adolescents and young adults in three Asian cities.
abstract: OBJECTIVE
  Evidence in western countries indicates that the media have associations with adolescents' and young people's sexual behavior that may be as important as family, school, and peers. In this new study of Asian adolescents and young adults in the three cities of Hanoi, Shanghai, and Taipei, the associations between exposure to sexual content in the media and adolescents' and young adults' sex-related knowledge, attitudes, and behaviors are explored in societies with traditional Confucian culture, but at different stages in the process of modernization.
  
  
  METHODS
  The data are from a questionnaire-based cross-sectional study conducted from 2006 to 2007, where a sample of 17,016 adolescents and young adults aged 15-24 years from Shanghai, Hanoi, and Taipei completed face-to-face interviews coupled with computer-assisted self-interviews for sensitive questions. For the objectives of this article, analysis was restricted to the 16,554 unmarried respondents. Exposure to sexual content in the mass media (including the Internet and traditional media), pornographic videos, and a preference for western/Asian movies/videos were the main media influence measures. Sex-related knowledge, premarital sexual permissiveness (PSP), and sex-related behaviors were the main outcome measures. The impact of each of four contexts including family, peer, school, and media on sex-related knowledge, attitudes, and behaviors were assessed using multiple linear regression stratified by gender and city, controlling for age, urban/rural residence, education, and economic status. The change in adjusted R(2) from the multiple linear regression analysis was adopted to indicate the contribution of family, peer, school, and media variables to respondents' sex-related knowledge, attitudes, and behaviors.
  
  
  RESULTS
  The contextual factors, including family, peer, school, and media, explained 30%-50% of the variance in sex-related knowledge, 8%-22% of the variance in PSP, and 32%-41% of the variance in sex-related behaviors. Media variables explained 13%-24% of the variance in sexual knowledge, 3%-13% in PSP, and 3%-13% in sex-related behaviors, which was comparable with that of family, peer, and school variables. These associations differed by city and gender.
  
  
  CONCLUSIONS
  Access to and use of mass media and the messages they present are influential factors on sex-related knowledge, attitudes, and behaviors of unmarried Asian adolescents and young adults, and should be considered in future research and intervention programs attempting to improve reproductive health outcomes.
authors.affiliation: Department of Epidemiology and Social Science, Shanghai Institute of Planned Parenthood Research, Shanghai, PR China. chaohual@yahoo.com
authors.forename: Chaohua
authors.initials: C
authors.lastname: Lou
authors.forename: Yan
authors.initials: Y
authors.lastname: Cheng
authors.forename: Ersheng
authors.initials: E
authors.lastname: Gao
authors.forename: Xiayun
authors.initials: X
authors.lastname: Zuo
authors.forename: Mark R
authors.initials: MR
authors.lastname: Emerson
authors.forename: Laurie S
authors.initials: LS
authors.lastname: Zabin
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D002681:China; D002947:Cities; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008402:Mass Media; D012725:Sexual Behavior; D013624:Taiwan; D014744:Vietnam; D055815:Young Adult