Risky Sexual Behaviors and Repeat Induced Abortion Among Unmarried Young Women in China: Results from a Large, Nationwide, Population-Based Sample

Background: Young women are disadvantaged with respect to their ability to access contraception, which puts them at especially high risk of repeat induced abortion. This study aims to estimate the prevalence of repeat induced abortion and to identify its association with risky sexual behaviors among unmarried young women in China. Materials and Methods: Data were obtained from the Survey of Youth Access to Reproductive Health in China and collected using probability proportionate to size sampling. Population numbers and prevalence of repeat induced abortion by characteristics were calculated among 11,076 unmarried young women aged 15-24 years. Univariate logistic regression, multivariate logistic regression, and logistic regression with propensity score-based weighting were used to elucidate the associations of each risky sexual behavior with repeat induced abortion among sexually active young women. Results: The prevalence of repeat induced abortion was 0.8% (95% confidence interval [CI]: 0.7-1.0) among unmarried young women (11,076) and it accounted for 21.3% of those who had ever had induced abortion. Among sexually active young women, the prevalence of abortion was 4.40% (95% CI: 3.6-5.4). Condom nonuse during the first sexual experience (odds ratio=2.72, 95% CI: 1.55-4.76), sexual activity with multiple partners (9.71, 5.61-16.81), being forced to have sexual intercourse (4.46, 1.44-13.76), casual sex (5.77, 3.28-10.13), commercial sex (4.51, 2.01-10.12), condom nonuse during the most recent sexual encounter (2.01, 1.31-3.08), and having any of the above behaviors (5.68, 2.26-14.28) were associated with repeat abortion. Conclusions: Risky sexual behaviors were associated with repeat abortion among unmarried young women in China. The findings highlight the need for reproductive health promotion programs for unmarried young women in China and other similar settings.