Dominance Analysis of the Relative Importance of Socio-Ecological Factors in Risky Sexual Behavior Among Chinese Adolescents in Shandong Province

The study aimed to explore the relative importance of socio-ecological predictors of risky sexual behavior among Chinese adolescents based on the socio-ecological systems theory. A total of 1,781 adolescents (mean age 17.76 years, range 15-21) were recruited from Shandong Province using a multistage cluster stratified sampling method. Participants included 400 males (22.46%) and 1381 females (77.54%). Dominance analysis was used to examine the relative importance of socio-ecological factors in predicting adolescent risky sexual behavior. Adolescents had a lower prevalence of sexual behavior (9.8%) but a higher prevalence of risky sexual behavior (87.36%). There were correlations among the socio-ecological predictors. Binary logistic regression showed that peer influence resistance had the strongest association with risky sexual behavior, but dominance analysis indicated that the strongest predictor was social norms cognition, followed by family support, peer influence resistance, self-efficacy, and sexual knowledge, accounting for 66.0%, 13.9%, 9.6%, 8.6%, and 1.9% of the predicted variance, respectively. Socio-ecological factors played different predictive roles in adolescent risky sexual behavior. To prevent risky sexual behaviors, related interventions need to focus on improving social norms cognition, emphasize the influence of family and peers, and mitigate the negative impact of high self-efficacy and sexual knowledge on risky sexual behavior.