China’s ancient history is rich in erotic literature and art. Indeed, the earliest known sex manuals, produced in China sometime around 2500 BCE, portrayed sexual techniques and a great variety of intercourse positions. In ancient China, Taoism (dating from around the second century BCE) actively promoted sexual activity—oral sex, sensual touching, and intercourse—for spiritual growth and harmony in addition to procreation (Brotto et al., 2005). The sexual connection of man and woman during intercourse was believed to join the opposing energies of yin (female) and yang (male), thereby balancing the essences of the two in each individual. Men were encouraged to ejaculate infrequently to conserve yang energy; orgasm for women helped create more yin energy and was sought after.
These liberal Taoist attitudes were replaced by a much stricter sexual propriety that emerged during a renaissance of Confucianism around 1000 CE. Sexual conservatism
increased further after the Communist victory in 1949, and the government attempted to eliminate "decadent" Western sexual behaviors of pornography and prostitution. Under Communist rule, romantic gestures—even holding hands in public—put people at risk of persecution (Fan, 2006). Sex outside marriage was considered a bourgeois transgression, and sex within marriage more than once a week was deemed a counterproductive diversion of energy. A positive result of these measures and attitudes was that China all but eradicated sexually transmitted infections (Wehrfritz, 1996).
Since China’s economic reform and the Open Door policy of the 1980s, China’s government has eased its control over individual lifestyle choices (Yuxin et al., 2007). As the government has grown more permissive toward sexuality, people’s attitudes and behaviors have changed, including a slightly more open attitude toward homosexuality (Lowenthal, 2010). Sexual behaviors, including masturbation, use of pornography, and premarital intercourse, have increased significantly, particularly among men and women in their 20s and 30s (Wong, 2010). In 2005,70% of residents in Beijing reported having had sexual relations before marriage, in contrast to 15.5% in 1989 (Beech, 2005). However, virginity before age 20 has remained the norm in rural China, and in all of China, for both men and women, the median interval between first sexual intercourse and marriage is a year or less (Parish et al., 2007).
Unfortunately, sexual knowledge and safe-sex skills have not kept up with the loosening of restrictions on sexual behavior, as shown by an increase in the number of single women obtaining abortions and by the rapidly growing rates of HIV infection, especially among Chinese 15 to 24 years old (Beech, 2005). Young men, both single and recently married, have significantly increased their contacts with sex workers.
Combined with minimal condom use, this trend places young men—and the women they date and marry—at high risk for HIV (Parish et al., 2007).