The road not taken: sexuality education and its associations with sexual knowledge and attitudes among senior high school students in rural areas of Western China

The poor performance and limited availability of sexuality education programs in rural areas of western China increase the danger of younger cohorts being exposed to sexually transmitted diseases (STDs) and engaging in risky sexual behaviors. A traditionally conservative culture, low levels of economic development and the relative lack of faculty resources all contribute to the weakness of sexuality education efforts. This study uses a sample of 164 boys and 195 girls who were senior high school students aged 15–19 in rural western China in 2017. The study aims to explore sexuality education, and sexual and reproductive behaviors, and to identify associations between sexuality education and sexual knowledge and attitudes among adolescents in rural western China. The results reveal a positive association between courses about reproductive health and lectures about STDs, and sexual knowledge; and a positive association between lectures about STDs and sexual attitudes. Our study also found that access to consulting services provided by governmental organization in the field of family planning and reproductive health helped rural adolescents enhance their sexual knowledge. Making such services available appears to offer a feasible method to develop a comprehensive sexuality education system in western China. The study concludes that an improved school-based sexuality education program strictly implemented as a part of the standard school curriculum is an effective way to increase sexual knowledge and promote de-stigmatized sexual attitudes among adolescents in rural western China.