Purpose: Culture is believed to shape people’s values and beliefs, which influence their behavior; thus, acculturation may help to explain health behavior among ethnic-minority youth. To develop culturally-relevant sexual health education programs, we need to assess how culture influences adolescent sexual behavior. The purpose was to examine associations between levels of acculturation and prevalence of sexual behavior among East Asian youth in British Columbia, Canada.
Methods: Secondary analysis of 2003 British Columbia Adolescent Health Survey, a province-wide, school-based survey using cluster-stratified sampling. For this study, we used data from East Asian youth (e.g., Chinese, Korean, Japanese) in grades 7 to 12; weighted N = 50,312 (47.4% female). Acculturation was measured by using two items: length of stay in Canada and language spoken at home. Outcome variables included ever having sexual intercourse, and among sexually-experienced youth only, early sexual debut, multiple sexual partners, contraceptive use, and a history of pregnancy involvement. Analyses were performed using logistic regressions, controlling for age and sexual abuse experience, and separately by gender.
Results: Nearly 12% of East Asian youth reported ever having sexual intercourse. The least acculturated males and females (recent immigrants speaking non-English at home) were less likely than the most acculturated groups (Canadian-born youth speaking English at home) to have ever had sex (adjusted odds ratio [AOR] = 0.30-0.46). However, sexually-experienced youth in the least acculturated group were more likely than the most acculturated peers to report some risky sexual behaviors. Compared to the most acculturated groups, the least acculturated females were more likely to initiate sexual intercourse before age of 14 (AOR = 2.46); the least acculturated males were more likely to report multiple sexual partners in the past year (AOR = 2.39). The least acculturated youth had lower odds of using effective contraceptive method at last intercourse such as condoms (AOR = 0.35 for males; n.s. for females) and birth control pills (AOR = 0.26-0.33). While the least acculturated males were less likely to report getting someone pregnant (AOR = 0.18), the least acculturated females were more likely to report a history of pregnancy (AOR = 2.29).
Conclusions: Recent immigrant youth still may require sexual health education, perhaps in their first language, to help prevent risky sexual behaviors among the youth who do become sexually active. To better understand the links between acculturation and sexual behavior, we need to further explore the nature of acculturation among East Asian youth.