Peer, Parental, and Educational Influences on Sexual and Reproductive Health Literacy Among Young Adults

Abstract

Background: Sexual and reproductive health literacy (SRHL) is a public health challenge for young adults, who are vulnerable to issues such as unintended pregnancy and STIs. This study aimed to assess SRHL and its predictors. Methods: A cross-sectional study was conducted at a university in Guangzhou, China. The study employed a two-stage cluster sampling design. In Stage 1, five faculties were randomly selected from twenty using simple random sampling. In Stage 2, within each selected faculty, classes were selected using probability-proportional-to-size (PPS) sampling. A Totally of 557 participants aged 18 – 24 years who were currently in a romantic relationship were enrolled from five faculties. SRHL was measured using the 12-item Sexual and Reproductive Health Literacy questionnaire (SRHL-12Q). Data were analyzed using Pearson correlation and linear regression analysis. Results: Among 557 participants in relationships (mean age 20.52 ± 1.38 years; 50.3% male), most reported poor levels of peer influence (47.6%), parental communication (49.4%), and SRH education (45.1%). Regarding SRHL, 35.0% had low, 43.4% moderate, and 21.5% high literacy. Multiple linear regression (adjusted R² = 0.601) identified peer influence (β = 0.329, p < 0.001) and SRH education and services (β = 0.454, p < 0.001) as significant predictors of SRHL. Parental communication was not a significant predictor (β = 0.051, p = 0.281). Conclusion: One-third of university students in relationships demonstrated inadequate SRHL, highlighting an urgent public health concern. Peer-led SRH education and enhanced university-based SRH services are recommended as evidence-based intervention targets. Parent–child communication regarding SRH should be initiated earlier, prior to the transition to young adulthood, as it was not a significant predictor in this university-age sample.