Assessing Parental Marital Quality and Divorce Related to Youth Sexual and Reproductive Health among 50,000 Chinese College Students

Background: This study aimed to investigate the associations between parental marital quality, divorce and sexual and reproductive health outcomes among Chinese young people. Methods: The study included 51,124 students from a large-scale cross-sectional study in China from 2019 to 2020. The exposure is parental marital quality and marital status reported by students. The outcomes are dichotomous variables, including sexual experiences, high-risk sexual behaviors, unintended health outcomes and sexual abuse. Multivariate logistic regression was used to assess the relationship between parental marital quality, divorce and sexual and reproductive health outcomes, stratified by sex and adjusted by socio-demographic covariates. Results: : The prevalence of students' parents who had been divorced was 10.72%, and the divorced family group rated perceived parental marital quality less than half of the ratings of the intact family group. Results showed that parental divorce was associated with a higher likelihood of sexual abuse, high-risk sexual behaviours, and unintended health outcomes. A higher perceived parental marital quality was associated with a lower probability of poorer sexual and reproductive health outcomes, such as forced penetrative vaginal or anal intercourse (male: OR: 0.73, 95%CI: 0.64-0.83; female: OR:0.71, 95%CI: 0.65-0.77), casual sexual intercourse (male: OR: 0.78, 95%CI: 0.73-0.83; female: OR: 0.77, 95%CI: 0.72-0.83), and sexually transmitted infections (male: OR: 0.79, 95%CI: 0.70-0.89; female: OR: 0.82, 95%CI: 0.73-0.91). Conclusions: : Parental marital quality and status are associated with poorer sexual and reproductive health outcomes among young people, suggesting that specific intervention programmes should be implemented for those children from unharmonious families or divorced families to prevent adverse sexual and reproductive health outcomes.