Adolescent Preferences for Sexual Education Expressed By Hong Kong Teens

Background/Purpose: As the rates of sexually transmitted diseases are increasing disproportionally among adolescents and young adults in Hong Kong, sex education has become a topic of interest. China recently passed legislation to mandate age-appropriate sexual education for school-aged children, effective June 2021. However, due to longstanding cultural mores and norms, sex education has a taboo status and is often left to the parents. Prior research hypothesized that there may be discrepancies between where adolescents receive sex education, who provides the education, and teens’ preferred source of knowledge. This study explored adolescent preferences regarding how sex education is provided, so that appropriate, engaging programs can be developed for adolescents.

Methods: Cross-sectional data from a survey of Chinese students from 17 consented secondary schools in Hong Kong were analyzed. Participants were younger than 18 years, in Form 4 and Form 5 (n = 4,869). Evaluated primary outcomes were the discrepancy scores of (1) who teenagers believe should provide sex education vs. preferred sex education source and (2) where teenagers received their sex education vs. their preferred sources. These variables were evaluated as a whole and compared by gender. Categories were created sex education sources, including family, school, printed media, electronic media, and peers. Demographics were also collected.

Results: The bivariate statistics indicated significant gender differences on both question sets. Children believe family (t_(df=4868) = 27.648, p < .001) then school (t_(df=4868) = -12.150, p < .001) should be responsible for providing sexual education. Compared to females, males preferred electronic media (t_(df=4860) = 6.89, p < .001) and peers (t_(df=4858) = 8.77, p < .001) as sources, and received more sex education through these channels. Females preferred to get their information from printed media (t_(df=4865) = 7.32, p < .001) and school resources (t_(df=4711) = -8.80, p < .001). The linear regression indicated gender differences in predicting discrepancy scores based on where the adolescents prefer to source their sex education (F = 71.368, p < .001). Parental education levels did not impact the discrepancy between responsibility and source of sexual education .

Conclusions/Implications: This study exposed large differences between sex education mores and behavior of teenagers. Before developing comprehensive grade-by-grade sexual education programs in Hong Kong, educators should work with adolescents to hear about their source preferences: peer support, online sexual education, and age-appropriate education in schools. Given the large disparity between the role adolescents believe family should play in sexual education and sex education provided by family members, future research should evaluate which specific areas of family engagement would best engage adolescents in the sex education process. Future curricula can be designed with these preferences in mind. Finally, given the rise of STDs among youth, public health initiatives, including sex-appropriate education in schools, must consider the gendered preferences of the adolescents. Engaging youth in sex education planning according to their preferences can increase the participation and fulfill UNESCO’s goals in providing sexual education to world youth to increase their knowledge about sexual development and behaviors, enrich emotional content, and endorse risk reduction.