Differences in contraceptive practice between Chinese and non-Chinese international students in an Australian university

BACKGROUND: Use of contraceptive among international university students remains under-explored. This study examined contraceptive use at last sex among international students in Australia, comparing Chinese (the largest source-country group) with non-Chinese students. METHODS: Prevalences of types of contraceptive method used at last sex were examined for unmarried sexually active international students aged 18-34 years in an Australian university-based cross-sectional survey. Univariable and multivariable logistic regression models were used to identify international students' socio-demographic factors associated with types of contraceptive use at last sex. RESULTS: Of 442 Chinese and 651 non-Chinese international students, 97.7% and 96.3%, respectively reported using any contraceptive at last sex. Most Chinese international students reported using a condom at last sex (91.6%) compared with 69.3% of their non-Chinese peers. Compared with non-Chinese students, Chinese international students were less likely to use short-acting contraceptives (10.9% vs 27.8%), long-acting reversible contraceptives (LARC) (0.2% vs 8.8%), provider-dependent contraceptives (11.1% vs 36.1%), and concurrent contraceptives (13.1% vs 29.5%) at last sex. Among all international students, accessing more sex education sources in the past was associated with higher odds of short-acting, provider-dependent, LARC, and concurrent contraceptive use at last sex. Higher perceived social support was associated with increased odds of LARC and provider-dependent contraceptive use at last sex. CONCLUSIONS: There are substantial differences in use of the more effective contraceptives between Chinese and non-Chinese international students. Ensuring equitable access to contraceptive information and culturally tailored services represents a significant opportunity for universities to support international students' reproductive autonomy and wellbeing.