Perceived gender inequality, sexual communication self-efficacy, and sexual behaviour among female undergraduate students in the Mekong Delta of Vietnam

Abstract

Background: Worldwide, the literature on sexual behaviour has documented associations between gender-based relationship inequality and sexual communication ability and the actual use of condoms or other contraceptives among young women. This study aimed to examine these associations among undergraduate female students in the Mekong Delta of Vietnam.

Methods: A cross-sectional survey of 1181 female third-year students from two universities in the Mekong Delta was conducted. Latent variable modelling and logistic regression were employed to examine the hypothesised associations.

Results: Among the 72.4% of students who had ever had boyfriends, 44.8% indicated that their boyfriends had asked for sex, 13% had had penile-vaginal sex and 10.3% had had oral sex. For those who had had penile-vaginal sex, 33% did not use any contraceptive method, including condoms, during their first sexual intercourse. The greater a student's perception that women were subordinate to men, the lower her self-efficacy for sexual communication and the lower her actual frequency of discussing safer sex matters and asking her partner to use a condom. Sexual communication self-efficacy was associated with actual contraceptive use (P=0.039) but only marginally with condom use (P=0.092) at first sexual intercourse.

Conclusion: Sexual health promotion strategies should address the influence of gender relations on young women's sexual communication self-efficacy and the subsequent impact on actual contraceptive and condom use.

Fig. 1

Model of hypothesised relationships among perceived subordination, sexual communication self-efficacy and actual sexual communication. Note: All items’ scores of sexual communication self-efficacy were reversed. Q indicates an item with corresponding question number. lg_Q denotes a base-10 logarithm transformation of the reversed score due to the score’s slightly non-normal distribution. r_S stands for residual; e stands for error terms.

Fig. 2

Path coefficients of hypothesised relationships among perceived subordination, sexual communication self-efficacy and actual sexual communication. (a) Actual sexual communication assessed as the frequency of discussing safe-sex matters. (b) Actual sexual communication assessed as the frequency of discussing contraceptive use. (c) Actual sexual communication assessed as the frequency of asking for condom use. Note: *, P < 0.05; **, P < 0.001; ^†, reversed score: the higher the score, the lower the self-efficacy.