Navigating sexual norms abroad
Cultural values, sex education, and risk among international students in China
DOI:
https://doi.org/10.32674/x9ssv541Keywords:
Traditional values, Sex education, Sexual behavior, Sexual risk, Sexual assault, International students, China, Structural equation modelingAbstract
International students often navigate unfamiliar sexual norms and limited access to context-specific sex education while studying abroad. This study examines how traditional sexual values and inadequate sex education shape sexual behaviors and vulnerability to sexual victimization among international students in China. Using a mixed-methods design, data from 482 students and 20 interviews were analyzed. Findings reveal a paradox: traditional values were linked to lower sexual activity but also reduced awareness of safe sex practices. Inadequate sex education was associated with greater sexual risk behaviors. Both factors increased vulnerability to sexual victimization, with sexual behavior mediating these relationships. The findings underscore the need for culturally responsive sex education, consent awareness, and targeted support services for international students.
References
Burton, O., Rawstorne, P., Watchirs-Smith, L., Nathan, S., & Carter, A. (2021). Teaching sexual consent to young people in education settings: a narrative systematic review. Sex Education, 23(1), 18–34. https://doi.org/10.1080/14681811.2021.2018676
Claxton, S. E., DeLuca, H. K., & Van Dulmen, M. H. M. (2015). The Association between alcohol use and engagement in casual sexual Relationships and Experiences: A Meta-Analytic Review of Non-Experimental Studies. Archives of Sexual Behavior, 44(4), 837–856. https://doi.org/10.1007/s10508-014-0392-1
Coker, A. L., Fisher, B. S., Bush, H. M., Swan, S. C., Williams, C. M., Clear, E. R., & DeGue, S. (2014). Evaluation of the Green Dot Bystander Intervention to reduce interpersonal violence among college students across three campuses. Violence Against Women, 21(12), 1507–1527. https://doi.org/10.1177/1077801214545284
Costello, A., Maunsell, C., Cullen, C., & Bourke, A. (2022). A Systematic review of the provision of sexuality education to student teachers in initial teacher education. Frontiers in Education, 7. https://doi.org/10.3389/feduc.2022.787966
Dey, S. (2024). Asian International students’ barriers to reporting sexual harassment incidents. Journal of International Students, 14(4), 902–918. https://doi.org/10.32674/jis.v14i4.6711
Dijkstra, T. K., & Henseler, J. (2015). Consistent partial least squares path modeling1. MIS Quarterly, 39(2), 297–316. https://doi.org/10.25300/misq/2015/39.2.02
Duval, A., Lanning, B. A., & Patterson, M. S. (2018). A Systematic Review of Dating violence risk factors among Undergraduate college students. Trauma Violence & Abuse, 21(3), 567–585. https://doi.org/10.1177/1524838018782207
Ellin, M. R. B., Hazariah, A. H. S. B., Arifin, S. R. M., Hasan, H. B., Othman, S. B., & Zain, N. M. B. (2024). Examining Asian Parents’ Perspectives and Challenges in Sexual and Reproductive Health Education with Implications for Public Health: A Systematic Review. Indian Journal of Public Health, 68(3), 407–417. https://doi.org/10.4103/ijph.ijph_1281_23
Evans, W. D., Ulasevich, A., Hatheway, M., & Deperthes, B. (2020). Systematic Review of Peer-Reviewed Literature on Global Condom Promotion Programs. International Journal of Environmental Research and Public Health, 17(7), 2262. https://doi.org/10.3390/ijerph17072262
Fethi, I., Daigneault, I., Bergeron, M., Hébert, M., & Lavoie, F. (2022). Campus sexual violence. Journal of International Students, 13(1). https://doi.org/10.32674/jis.v13i1.3685
Forbes-Mewett, H. (2020). Vulnerability and resilience in a mobile world. Journal of International Students, 10(3), ix–xi. https://doi.org/10.32674/jis.v10i3.2002
Fornell, C., & Larcker, D. F. (1981). Evaluating Structural Equation Models with Unobservable Variables and Measurement Error. Journal of Marketing Research, 18(1), 39–50. https://doi.org/10.1177/002224378101800104
Gan, Y., Liu, C., Deng, J., & Zhang, J. (2024). Typological classification of attitudes toward premarital sexual behavior among Chinese undergraduates. BMC Public Health, 24(1), 2651. https://doi.org/10.1186/s12889-024-20172-x
Goldfarb, E. S., & Lieberman, L. D. (2020). Three Decades of Research: The case for Comprehensive Sex Education. Journal of Adolescent Health, 68(1), 13–27. https://doi.org/10.1016/j.jadohealth.2020.07.036
Guzzo, K. B., & Hayford, S. R. (2017). Adolescent reproductive and contraceptive knowledge and attitudes and adult contraceptive behavior. Maternal and Child Health Journal, 22(1), 32–40. https://doi.org/10.1007/s10995-017-2351-7
Haberland, N., & Rogow, D. (2014). Sexuality Education: Emerging Trends in Evidence and practice. Journal of Adolescent Health, 56(1), S15–S21. https://doi.org/10.1016/j.jadohealth.2014.08.013
Henseler, J., Ringle, C. M., & Sarstedt, M. (2014). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115–135. https://doi.org/10.1007/s11747-014-0403-8
Hu, A., Wu, X., Chen, T., & Li, D. (2023). Family Socioeconomic Status and Chinese College Students’ Premarital Sexual Attitudes and Behavior. Population Research and Policy Review, 42(3). https://doi.org/10.1007/s11113-023-09775-1
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling a Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118
Jin, J., & Han, Y. (2025). Understanding cultural perceptions of sexuality in China and their influence on human papillomavirus vaccine hesitancy. Frontiers in Public Health, 12, 1462722. https://doi.org/10.3389/fpubh.2024.1462722
Kettrey, H. H., Thompson, M. P., Marx, R. A., & Davis, A. J. (2023). Effects of Campus Sexual Assault Prevention Programs on Attitudes and Behaviors among American College Students: A Systematic Review and Meta-Analysis. Journal of Adolescent Health, 72(6), 831–844. https://doi.org/10.1016/j.jadohealth.2023.02.022
Kim, E. J., Park, B., Kim, S. K., Park, M. J., Lee, J. Y., Jo, A. R., Kim, M. J., & Shin, H. N. (2023). A Meta-Analysis of the Effects of Comprehensive Sexuality education programs on children and Adolescents. Healthcare, 11(18), 2511. https://doi.org/10.3390/healthcare11182511
Klein, L. B., & Martin, S. L. (2019). Sexual harassment of college and university students: A Systematic review. Trauma Violence & Abuse, 22(4), 777–792. https://doi.org/10.1177/1524838019881731
Kwame, A., Li, H., Petrucka, P., & Maina, G. (2023). Sexual and reproductive health experiences of international students studying in universities of Western countries. Journal of International Students, 14(3). https://doi.org/10.32674/jis.v14i3.6011
Lai, J., Park, E., Amabile, C. J., Boyce, S. C., Fielding-Miller, R., Swendeman, D., Oaks, L., Marvel, D., Majnoonian, A., Silverman, J., & Wagman, J. (2024). “They don’t see us”: Asian students’ perceptions of sexual violence and sexual harassment on three California Public University campuses. Journal of Interpersonal Violence, 39(15–16), 3619–3650. https://doi.org/10.1177/08862605241235912
Li, C., Cheng, Z., Wu, T., Liang, X., Gaoshan, J., Li, L., Hong, P., & Tang, K. (2017). The relationships of school-based sexuality education, sexual knowledge and sexual behaviors—a study of 18,000 Chinese college students. Reproductive Health, 14(1), 103. https://doi.org/10.1186/s12978-017-0368-4
Lim, M. S. Y., Hocking, J. S., Sanci, L., & Temple-Smith, M. (2022). A systematic review of international students’ sexual health knowledge, behaviors, and attitudes. Sexual Health, 19(1), 1–16. https://doi.org/10.1071/sh21073
Lin, L., & Wang, Q. (2022). Adolescents’ filial piety attitudes in relation to their perceived parenting styles: an Urban–Rural Comparative longitudinal study in China. Frontiers in Psychology, 12, 750751. https://doi.org/10.3389/fpsyg.2021.750751
Liu, Y., Lu, L., Wang, Y. Y., Wilkinson, M. R., Ren, Y., Wang, C., Zhang, F., Gao, J., & Liu, S. (2020). Effects of health education on HIV/AIDS related knowledge among first year university students in China. African Health Sciences, 20(4), 1582–1590. https://doi.org/10.4314/ahs.v20i4.10
Lyu, J., Shen, X., & Hesketh, T. (2020). Sexual Knowledge, Attitudes and Behaviors among Undergraduate Students in China—Implications for Sex Education. International Journal of Environmental Research and Public Health, 17(18), 6716. https://doi.org/10.3390/ijerph17186716
Lyu, Z., & Chai, X. (2024). Media Influence on Intergenerational Attitudes toward Non-Conventional Sexual Behaviors in Contemporary China: Evidence from Chinese General Social Survey. International Journal of Sexual Health, 36(1), 77–99. https://doi.org/10.1080/19317611.2024.2304117
Mahmood, R., Ahmed, W., Mahmood, S., Suleman, R. M. F., Shabbir, M., & Wang, F. Y. (2026). From challenges to coping strategies. Journal of International Students, 16(3), 35–62. https://doi.org/10.32674/rcg6jt52
Mainwaring, C., Gabbert, F., & Scott, A. J. (2022). A Systematic review exploring variables related to bystander intervention in sexual violence contexts. Trauma Violence & Abuse, 24(3), 1727–1742. https://doi.org/10.1177/15248380221079660
Martin, P., Cousin, L., Gottot, S., Bourmaud, A., De La Rochebrochard, E., & Alberti, C. (2020). Participatory Interventions for Sexual Health Promotion for Adolescents and Young Adults on the internet: Systematic review. Journal of Medical internet Research, 22(7), e15378. https://doi.org/10.2196/15378
Mbengo, F., Adama, E., Towell-Barnard, A., Bhana, A., & Zgambo, M. (2022). Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: a systematic review. BMC Infectious Diseases, 22(1), 679. https://doi.org/10.1186/s12879-022-07649-z
Mujal, G. N., Taylor, M. E., Fry, J. L., Gochez-Kerr, T. H., & Weaver, N. L. (2019). A Systematic Review of Bystander Interventions for the Prevention of Sexual Violence. Trauma Violence & Abuse, 22(2), 381–396. https://doi.org/10.1177/1524838019849587
Mundie, A., Lazarou, M., Mullens, A. B., Gu, Z., & Dean, J. A. (2021). Sexual and reproductive health knowledge, attitudes and behaviors of Chinese international students studying abroad (in Australia, the UK and the US): a scoping review. Sexual Health, 18(4), 294–302. https://doi.org/10.1071/sh21044
Peng, Y., & Zheng, Y. (2024). Relation between attitudes toward pornography consumption, peer sexual behaviors and attitudes toward premarital sex among the college students in Guangdong province, China. Humanities and Social Sciences Communications, 11(1). https://doi.org/10.1057/s41599-024-03431-5
Podsakoff, P. M., MacKenzie, S. B., Lee, J., & Podsakoff, N. P. (2003). Common method biases in behavioral research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879–903. https://doi.org/10.1037/0021-9010.88.5.879
Qadeer, T., Javed, M. K., Manzoor, A., Wu, M., & Zaman, S. I. (2021). The experience of International Students and Institutional Recommendations: A comparison between the students from the developing and developed regions. Frontiers in Psychology, 12, 667230. https://doi.org/10.3389/fpsyg.2021.667230
Qing, L., Wang, Y., Yang, T., Chen, X., Zhang, M., Bu, Q., Tan, B., & Deng, D. (2022). Study on HIV/AIDS knowledge, sexual attitudes, sexual behaviors, and preventive services among young students in Chongqing, China. Frontiers in Public Health, 10, 982727. https://doi.org/10.3389/fpubh.2022.982727
Sani, A. S., Abraham, C., Denford, S., & Ball, S. (2016). School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis. BMC Public Health, 16(1), 1069. https://doi.org/10.1186/s12889-016-3715-4
Shibuya, F., Estrada, C. A., Sari, D. P., Takeuchi, R., Sasaki, H., Warnaini, C., Kawamitsu, S., Kadriyan, H., & Kobayashi, J. (2023). Teachers’ conflicts in implementing comprehensive sexuality education: a qualitative systematic review and meta-synthesis. Tropical Medicine and Health, 51(1), 18. https://doi.org/10.1186/s41182-023-00508-w
Steele, B., Martin, M., Sciarra, A., Melendez-Torres, G. J., Esposti, M. D., & Humphreys, D. K. (2023). The Prevalence of Sexual Assault among Higher education students: A Systematic Review with Meta-Analyses. Trauma Violence & Abuse, 25(3), 1885–1898. https://doi.org/10.1177/15248380231196119
Tarzia, L., Henderson-Brooks, K., Baloch, S., & Hegarty, K. (2023). Women Higher Education Students’ Experiences of Sexual Violence: A scoping review and thematic synthesis of qualitative studies. Trauma Violence & Abuse, 25(1), 704–720. https://doi.org/10.1177/15248380231162976
Tsang, E. Y. (2025). From mentor to monster: symbolic power and silence about sexual harassment in China’s ivory tower. Higher Education. https://doi.org/10.1007/s10734-025-01555-4
Vasandani, M., Khan, S., Chandgothia, A., & Davey, A. K. (2026). Understanding the strengths, challenges, and opportunities within the international student life cycle. Journal of International Students, 16(6), 37–58. https://doi.org/10.32674/g9fbsx65
Wang, N. (2016). Parent-Adolescent communication about sexuality in Chinese families. Journal of Family Communication, 16(3), 229–246. https://doi.org/10.1080/15267431.2016.1170685
Wang, X., Lu, L., Wang, X., Qu, M., Yuan, L., Gao, Y., & Pan, B. (2021). Relationships between Cross-Cultural Adaptation, Perceived stress and Psychological Health among international undergraduate students from a medical university during the COVID-19 pandemic: a Moderated Mediation model. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.783210
Widman, L., Choukas-Bradley, S., Noar, S. M., Nesi, J., & Garrett, K. (2015). Parent-Adolescent sexual communication and adolescent safer sex behavior. JAMA Pediatrics, 170(1), 52. https://doi.org/10.1001/jamapediatrics.2015.2731
Wieberneit, M., Thal, S., Clare, J., Notebaert, L., & Tubex, H. (2024). Silenced Survivors: A systematic review of the barriers to reporting, investigating, prosecuting, and sentencing of adult female rape and sexual assault. Trauma Violence & Abuse, 25(5), 3742–3757. https://doi.org/10.1177/15248380241261404
Wong, J. S., Bouchard, J., & Lee, C. (2021). The Effectiveness of College Dating Violence Prevention Programs: A Meta-Analysis. Trauma Violence & Abuse, 24(2), 684–701. https://doi.org/10.1177/15248380211036058
Wood, L., Hoefer, S., Kammer-Kerwick, M., Parra-Cardona, J. R., & Busch-Armendariz, N. (2018). Sexual harassment at Institutions of Higher education: Prevalence, risk, and extent. Journal of Interpersonal Violence, 36(9–10), 4520–4544. https://doi.org/10.1177/0886260518791228
Yu, J., & Xie, Y. (2015). Cohabitation in China: trends and determinants. Population and Development Review, 41(4), 607–628. https://doi.org/10.1111/j.1728-4457.2015.00087.x
Zhang, L., Yu, H., Luo, H., Rong, W., Meng, X., Du, X., & Tan, X. (2022). HIV/AIDS-Related Knowledge and Attitudes among Chinese college students and Associated Factors: a Cross-Sectional study. Frontiers in Public Health, 9, 804626. https://doi.org/10.3389/fpubh.2021.804626
Zhang, W., & Yuan, Y. (2023). Knowledge, attitudes, and practices of parents toward sexuality education for primary school children in China. Frontiers in Psychology, 14, 1096516. https://doi.org/10.3389/fpsyg.2023.1096516
Zhou, Q., Wu, W., Yi, M., Shen, Y., Goldsamt, L., Alkhatib, A., Jiang, W., & Li, X. (2022). HIV knowledge, sexual practices, condom use and its associated factors among international students in one province of China: a cross-sectional study. BMJ Open, 12(8), e058108. https://doi.org/10.1136/bmjopen-2021-058108
Zhou, Y., Cheng, F., & Xu, J. (2024). Religion, Geography, and risky sexual Behaviors among international immigrants living in China: Cross-Sectional study. JMIR Public Health and Surveillance, 10, e44616. https://doi.org/10.2196/44616
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