Reduced sexual activity and increased sexually transmitted infections risk among left-behind women in rural China

Abstract

Spousal migration creates a unique situation for "left-behind women" in rural China, who face challenges to their sexual and reproductive health and rights (SRHR). Using the Chinese Health and Family Life Survey 2000 dataset, we compare SRH outcomes of left-behind women and non-migrant counterparts. While reporting significantly lower sexual activity, left-behind women are disproportionately affected by chlamydia, despite no increase in risky behaviors. This, coupled with their higher prevalence of unwanted sex, suggests unwanted encounters as a potential contributor to their higher sexually transmitted infections risk. These findings highlight the complex SRH challenges faced by left-behind women and emphasize the need for tailored interventions, including promoting safer sex practices and addressing the risk of unwanted encounters. Furthermore, understanding the situation in China can inform interventions for left-behind women in other contexts with high spousal migration, such as parts of Africa. (Afr J Reprod Health 2025; 29 [2]: 78-85).