Changes and correlates in multiple sexual partnerships among Chinese adult women--population-based surveys in 2000 and 2006.

The sexual transmission of HIV and STI is becoming a major public health concern in China. However, studies on sexuality in China remain scant, particularly those that analyze female sexuality. This study is to investigate the prevalence of multiple sexual partnerships (MSP) among adult women, and to examine trends and correlates for having more than one lifetime sexual partner. MSP, coded as having one or none vs. two or more lifetime sexual partners, was the key binary outcome measure. The data were from two national probability surveys on sexual behaviors in China carried out in 2000 and 2006. The sample size of adult women was 1899 in 2000 (total sample n=3812), and 2626 in 2006 (n=5404). Overall prevalence of MSP increased from 8.1% in 2000 to 29.6% in 2006 (chi-square test, significance = 0.000). The most rapid changes took place among women with less education, those who worked in blue-collar jobs and lower social-status positions, and those living in rural areas or small towns. Women who were better educated, lived in big cities, and held management-level occupations exhibited less change but had a higher baselines prevalence of MSP, suggesting that changes in MSP behavior may occur initially among women of higher socioeconomic status. Based on the 2006 data-set, significant positive correlates of MSP included more years of education, being in a long-term relationship, being middle aged, having a lower-status job, going out dancing at entertainments venues, and being a state of overall health in the past 12 months. The significant recent increase in MSP among women reinforces the need to examine China's sexual revolution in the context of a rapidly transitioning society. Findings regarding female sexuality also raise new questions to be explored in further sexuality studies, in order to better understand population sexual behaviors and to inform future HIV-prevention efforts.