Sexual Behaviour and Social Connectedness among Asian Secondary School Students in New Zealand

Abstract

Introduction: Although adolescents’ sexual and reproductive health is an important factor influencing their wellbeing, research exploring the factors associated with sexual behaviour among Asian adolescents in New Zealand is sparse. Understanding the relationships and connectedness that young people have with their families, peers, schools, and neighbourhoods, may provide an opportunity to identify targets for interventions that improve the sexual health among Asian adolescents in New Zealand. Aim: This study, focusing on Asian adolescents in secondary schools, aims to describe their sexual behaviour, to develop scales to assess social connectedness to families, peers, schools, and neighbourhoods, and to investigate the associations between each type of social connectedness and adolescents’ sexual behaviour. Methods: This thesis has two parts. Part I is a systematic review of published studies conducted among Asian adolescents to examine the available epidemiological evidence quantifying the association of social connectedness and sexual behaviour. Scopus, PsychInfo, and Medline (Ovid) were used to search for articles between the years 2008 and 2016. Part II involves analyses of the national Youth’12 survey data. Four separate scales were developed for all students who participated in the Youth’12 survey to measure social connectedness (family, peer, school, and neighbourhood). Each scale was developed by adding scores of the selected questions where higher score denoted higher connectedness. The associations between social connectedness and the main outcome of interest: sexual experience and condom use, were examined using logistic regression models for all Asian students who participated in the Youth’12 survey. Results: Nineteen articles that met the inclusion criteria were included in the systematic review. The findings varied, but many studies revealed that family connectedness, school connectedness, peer support and good neighbourhood values were protective against the risky sexual behaviour. The evidence also suggested that negative peer influence and violence in the neighbourhood were risk factors for sexual initiation. The Youth’12 survey data analyses indicated, Asian secondary school students (n=1136) to have lower family, peer, and neighbourhood connectedness but higher school connectedness compared to their non-Asian peers (n=6027). Compared to their non-Asian peers, Asian students were less likely to have sex (14.5% vs 25.1%) and among who have had sex, were less likely to use condoms (76.3% vs 83.3%). Logistic regression models showed that for Asian students in New Zealand, family connectedness (OR=0.91, 95% CI: 0.88 – 0.94) and school connectedness (OR=0.93, 95% CI: 0.8 - 0.98) were protective against sexual initiation. Peer connectedness acted as a risk factor for sexual initiation (OR=1.2, 95% CI: 1.07 – 1.34). No association was identified between neighbourhood connectedness and sexual initiation. Similarly, no association was identified between all types of social connectedness and condom use. Conclusion: The evidence suggests significant associations between some aspects of social connectedness (family, peer, and school) and sexual experience among Asian students in New Zealand. This study highlights the need for in-depth studies and interventions relating to social connectedness that could serve as an important pathway through which to improve sexual health of Asian students in New Zealand.