When unmarried youth in Vietnam have sex, they rarely use a condom or other means of protection from unwanted pregnancy and STIs (Gammeltoft 2002: 483-96). This sexual risk­taking, we argue, has moral roots. Socially dominant prescriptions for appropriate sexual relations — which circulate in families, neighbourhoods, schools, health clinics, and workplaces — tell young people that premarital sex should not occur. These moral dictates place particular demands on young women. A young woman, many people hold, should be ‘pure’ (trong trang) and sexually untainted on the day of her wedding, whereas for young men, some sexual adventurousness — even if not ideal — must be expected. These moral demands stem, scholars suggest, from the country’s Confucian heritage; placing primacy on sexual loyalty, Confucian doctrines ‘emphasize virginity as the single most important standard in evaluating a woman’s morality’ (Khuat et al. 2009: 35). In present-day party-state discourse, these long-standing sexual norms are projected into the realm of nationhood and national identity, the purity of youth being represented as a symbol of the nation’s traditional moral values and cultural coherence. At a seminar held in Hanoi in 2011, for instance, Deputy Prime Minister Nguyen Thien Nhan stated that ‘youth is a key force in preserving and promoting the nation’s cultural identity which has been nurtured for a thousand years’ (Voice of Vietnam 2011). Within this logic, young people — females in particular — become guardians of Vietnam’s cultural heritage, and practices that depart from ‘cultural tradition’ come to be seen as a betrayal of the country, its history, and its deepest moral values (Gammeltoft 2002: 483—96).

Societal efforts to prevent young people from having sex prior to marriage — and the expectation that they will comply with this demand — have important sexual health con­sequences. Vietnamese youth are offered very limited sexual health education and are not assumed to need sexual/reproductive health services such as contraception or abortion. Arguing that it is in young people’s own interest to stay sexually innocent until marriage, health care providers are often reluctant to offer information and services to youth (Klingberg-Allvin et al. 2006: 414—21); teachers feel uncomfortable delivering sexual health information to their students; and parents try to avoid talking to teenage children about sexuality (Kaljee et al. 2011: 268—74). In Vietnam today, therefore, the Internet seems to have become the most important source of sexual health information for youth (Ngo et al. 2008: S201-S213).

In recent years, the age of marriage has been rising in Vietnam, while the age of first sexual intercourse has been declining (General Office of Population and Family Planning 2010). Nevertheless, according to surveys, only a minority of unmarried youth is sexually active. A recent nationwide study, for instance, found that merely 10 per cent of married youth aged 15—24 reported having had premarital sex (General Office of Population and Family Planning 2010). These figures are, however, likely to be under-reported; given the stigmatisation of premarital sex, the moral risks for youth of disclosing such practices are considerable. Even though precise figures are hard to attain, there are strong indications that in Vietnam as elsewhere, many young people do begin their sexual lives well before they get married (Khuat et al. 2009). What dis­tinguishes Vietnam from most other countries is that a significant proportion of unmarried youth seem to agree with dominant moral opinion, expressing disapproval of premarital sex (Zuo et al. 2012: S18—S25). This confronts sexually active young people with the challenge of striking a balance between their own sexual practices and dominant moral standards; standards that, in many cases, they themselves strive to uphold.

Research has shown that youth tend to handle this ethical challenge by denying their own sexual activity. One study conducted in Hanoi found that even young people with well – established and routinised sexual lives tended to insist on their own innocence, telling themselves and each other that each sexual encounter was merely an exception (Gammeltoft 2002: 483—96). Since the use of modern methods of contraception demands that the user acknowledges his or her need for protection, young people’s denial of their own sexual activity renders it difficult for them to protect themselves and each other against unwanted pregnancy and STIs (Kaljee et al. 2007: 48—59). Nevertheless, most youth in Vietnam are not at high risk; STI rates are relatively low in the general population, and the HIV epidemic is still concentrated among high-risk groups, mainly injecting drug users, commercial sex workers, and men who have sex with men (WHO 2012).

Young people’s denial of their own sexual activity does, however, have significant sexual health consequences: many young women begin their sexual lives with an unwanted pregnancy which, in most cases, ends in an induced abortion. Induced abortion is legal in Vietnam and can be performed up to 22 weeks of pregnancy. Although most abortions are performed under safe circumstances, unsafe abortion is a common cause of maternal mortality, responsible for 11.5 per cent of maternal deaths in 2002 (Hoang et al. 2008: 145—50). Due to the stigma attached to premarital sex, many young women opt to either obtain their abortions from private sector health providers or claim that they are married when obtaining a public sector abortion. This makes it difficult to assess how many abortions are performed among unmarried youth, just as abortion statistics in general are shrouded in uncertainty. Since private sector abortions are not registered in Vietnam, and public sector statistics are not always reliable, exact abortion statistics do not exist. The available evidence indicates, however, that abortion rates in Vietnam are among the world’s highest (Sedgh et al. 2007: 106—16), and observers estimate that a significant proportion of these abortions are obtained by unmarried youth (WHO 1999; Klingberg-Allvin et al. 2006: 414—21). Qualitative studies have shown that many young women fear that pregnancy terminations may harm their future health and fertility, and that the experience of induced abortion is often associated with profound moral anguish (Belanger and Khuat 1999: 71—82; Gammeltoft 2003: 129-43).

Among unmarried youth, moral anxiety also arises from the intense cultural expectations surrounding women’s virginity. As mentioned above, young Vietnamese women are expected by others – and often expect themselves – to be virgins when they marry. The most precious thing that a woman can offer her husband, many people hold, is her virginity. By giving herself fully to her husband and only to him, she establishes a unique and lasting bond of belonging, love, and trust. Premarital sex, therefore, places a young woman at risk of being considered ‘loose’ and ‘worthless’. With the loss of her virginity, she has lost her most precious asset. Qualitative research has shown that when young women have sex prior to marriage, they are intensely concerned about the attendant moral-existential risks. If their relationship does not last, they fear, this may expose them to stigmatisation and social exclusion, compromising their chances of finding happiness in marriage and family life (Gammeltoft 2006: 589-605, Nguyen and Liamputtong 2007: 63-69). Among young men, the continued cultural emphasis on female virginity produces other forms of anxiety: as expanding biomedical possibilities allow young women to reconstruct broken hymens, it becomes more difficult for men to assess female virtue through physical evidence. This challenges traditional forms of masculine advantage, generating doubts and uncertainties among young men regarding their sexual relations and capacities (Martin 2010: S5-S18).