Parallel to its economic revolution, China is undergoing changes in sexual concepts, particularly among the youth. One of its main manifestations is the increase in the number of teenage pregnancies in the country.

The social mechanisms put in place during this change in sexual behavior will determine whether young people will be able to overcome serious problems that are having far-reaching consequences on their health and quality of life.

Since feudal times, sex has been a taboo subject in China. Even today, despite significant progress in many areas, many Chinese, particularly the older generations refuse to talk about it. Meanwhile, young people differ greatly from their parents in their views of sexual activity and both sexes are becoming sexually mature and active at a younger age.

It is estimated that China now has more than 260 million people between 15 and 24, and every year more than 20 million more enter adolescence. This constitutes an important segment of the population whose need for information - particularly with regard to sexual matters - should be addressed. However, only in recent years have the first textbooks on sex education been published and distributed in schools.

An increasing number of Chinese adolescents engage in premarital and unprotected sexual activity. As a result, there has been a parallel increase in unwanted pregnancies and abortions, as well as in sexually transmitted infections (STIs), including HIV/AIDS. Some experts warn China is now in the early stages of a major HIV/AIDS epidemic.

According to Chinese law, there must be approval from a parent or guardian before an abortion can be performed on a woman under 19. But many young women will resort to an abortion when confronted with an unwanted pregnancy. And because many pregnant young women fear their parents' reaction, they go to back-street abortionists or quacks that put the women's lives in jeopardy as the complications from unsafe abortions are more frequent and more severe in adolescents compared to older women.

Even, if the decision is made not to have an abortion, a pregnancy can have devastating effects on an adolescent because it can delay or halt an individual's personal development. There is a loss of autonomy as they become much more dependent on parents, and there is an interruption of group relations as pregnant adolescents cannot continue their school or social activities.

Education continues to be one of the most effective ways of teaching young people how to develop an optimal state of physical and mental health. For this to be effective, though, educational materials on sexual issues must be reviewed periodically and their message adapted to suit various social and cultural groups.

Because of the taboo on sex in Chinese society for so long, parents should also be educated, not only on sexual issues, but also on how to have a productive and ongoing dialogue with their children, so that they keep open the channels of communication with them.

Open communication is important, not only between parents and children, but also through the mass media, which can help remove taboos regarding adolescent sexuality, redefine social norms, and thus modify attitudes and behaviors. There should be constant discussion among parents, teachers and health and social workers regarding adolescent behavior.

Equally important, young people should be active participants in the design of programs that affect their health and quality of life.

The author is a global health consultant.