Zhuang Yiyi, Kwang Cheol Kim, Botabara-Yap Mary Jane, Zhao Kuan, Ramos Rowena Imelda A, Cao Wenming
Health Industry Department, College of Health Industry, Xiamen Donghai Vocational and Technical College, Xiamen, Fujian, China.
Yonsei University, Seoul, Republic of Korea.
Front Public Health. 2025 Sep 1;13:1627669. doi: 10.3389/fpubh.2025.1627669. eCollection 2025.
To investigate sociodemographic determinants of reproductive health disparities and health education participation among Chinese female college students (CFCs).
A nationally representative sample of 1,013 students from 12 provinces (October to November 2024) completed validated questionnaires. Multilevel logistic regression analyzed clustered data (school-level ICC = 0.19).
Significant associations were observed between sociodemographic factors education level, household registration, only child status, academic major and reproductive health outcomes ( < 0.05). Key findings include pronounced urban-rural inequities, with urban students demonstrating 4.3-fold higher HPV vaccination rates than rural peers (78.5% vs. 45.7%, aOR = 4.3, 95% CI: 3.2-5.8), alongside elevated dysmenorrhea prevalence among rural students (56.9% vs. 43.5%, aOR = 1.8, 95% CI: 1.4-2.3). Academic stressors significantly impacted health outcomes, as postgraduate students exhibited a 60% higher dysmenorrhea risk versus undergraduates (60.9% vs. 50.8%, aOR = 1.6, 95% CI, 1.2-2.1), while paradoxically, medical students showed lower HPV vaccination uptake than non-medical peers (58.0% vs. 74.3%, aOR = 2.1), attributed to clinical skepticism about vaccine safety. Furthermore, health education engagement was limited (46.1% participation), with 52.4% relying on online platforms for health information-highlighting critical gaps in institutional health promotion and digital misinformation risks. Therefore, addressing these multifaceted socioeconomic, educational, and structural barriers is essential for improving reproductive health equity in this population.
Multifaceted strategies addressing socioeconomic barriers, health education gaps, and digital misinformation are critical to improving reproductive health in female college students.
调查中国女大学生（CFCs）生殖健康差异和健康教育参与情况的社会人口学决定因素。
2024年10月至11月，从12个省份抽取了1013名具有全国代表性的学生样本，完成了经过验证的问卷。多水平逻辑回归分析了聚类数据（学校层面的组内相关系数ICC = 0.19）。
观察到社会人口学因素教育水平、户籍、独生子女身份、专业与生殖健康结果之间存在显著关联（P < 0.05）。主要发现包括明显的城乡不平等，城市学生的HPV疫苗接种率比农村同龄人高4.3倍（78.5%对45.7%，调整后比值比aOR = 4.3，95%置信区间CI：3.2 - 5.8），同时农村学生痛经患病率更高（56.9%对43.5%，aOR = 1.8，95% CI：1.4 - 2.3）。学业压力源对健康结果有显著影响，研究生痛经风险比本科生高60%（60.9%对50.8%，aOR = 1.6，95% CI，1.2 - 2.1），而矛盾的是，医学生的HPV疫苗接种率低于非医学专业同龄人（58.0%对74.3%，aOR = 2.1），这归因于对疫苗安全性的临床怀疑态度。此外，健康教育参与度有限（参与率为46.1%），52.4%的人依靠在线平台获取健康信息——凸显了机构健康促进方面的关键差距和数字错误信息风险。因此，解决这些多方面的社会经济、教育和结构障碍对于改善该人群的生殖健康公平性至关重要。
应对社会经济障碍、健康教育差距和数字错误信息的多方面策略对于改善女大学生的生殖健康至关重要。
