Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 22, 2020
Date Accepted: Dec 12, 2020
An interactive Web-based Sexual Health Literacy Programme for Safe Sex Practice in Female Chinese University Students: A Multicentre, Randomised Controlled Trial
ABSTRACT
Background:
Sexual health is a major concern among young adults worldwide, which helps prevent sexually transmitted infectious. To foster individual sexual health, the sexual health literacy should be enhanced. Seldom previous evidence designed to incorporate gender-power dynamics, such as sexual coercion, although the prevalence of sexual coercion stays high in China.
Objective:
We aimed to describe the development and systematic evaluation of a sexual health literacy intervention called “Smart Girlfriend” in female Chinese University Students.
Methods:
A multicentre randomised controlled trial was conducted with 781 female university students at five universities with dormitories in Hong Kong. Inclusion criteria were used to select unmarried female university Chinese students who were ≥18 years old and had not received any sexual health intervention in the past 12 months. The primary outcome was self-reported consistency of condom use with every partner in 3-month assessments at 3-month and 6-month follow-up, analysed using zero/one inflated beta (ZOIB) regression. Knowledge, attitudes, norms, and self-efficacy of condom use were appraised by the 25-item Multidimensional Condom Attitudes Scale (MCAS) as the secondary outcome. Intention to treat was applied in analyses.
Results:
Of 1503 individuals screened, 781 (52%) were randomised into two groups. Retention rates at 3-month and 6-month follow-up were 92% and 91%, respectively. Most participants were born locally (72%), and 18% self-reported a sexual minority orientation. ZOIB results regarding consistency of condom use were not significant (Model 1: OR: 2·25, 95% CrI: [0·84, 6·36]; Model 2: OR: 8·03, 95% CrI: [0·22, 330·31]; Model 3: OR: 1·21, 95% CrI [0·78, 1·86]). Consistency in the intervention group was 5% higher (95% CI: [−1·90, 11·63]) compared with the control group at 3-month follow-up, and 1% higher (95% CI: [−5·81, 8·02]) at 6-month follow-up. MCAS scores at 3-month follow-up (intervention: 122·51 ± 15·97 vs control: 119·86 ± 15·85, p < 0·05) were significantly higher in the intervention group.
Conclusions:
An interactive computer-based sexual health literacy programme did not significantly increase consistency of condom use compared with one page of condom use information, but temporarily improved knowledge, attitudes, norms, and self-efficacy regarding condom use. Clinical Trial: This trial was registered with ClinicalTrials.gov, NCT03695679.
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