A total of 123 respondents (18 percent) reported experiencing at least one kind of CSA before they were 16 years old, with more boys reporting CSA than girls (21.5 percent compared to 14.2 percent). In addition, attending non-boarding schools, lower levels of self-esteem, and higher levels of perceived peer pressure for engagement in health-risk behaviors were associated with higher rates of CSA. Multivariate logistic regression analyses showed that CSA experience was significantly associated with cigarette smoking, binge drinking, suicidal ideation, and suicide attempt, after controlling for several demographic and psychological factors. The authors advise that more attention should be paid to the issues of CSA among rural children and adolescents in China. Effective CSA prevention intervention should address the vulnerabilities of the population, increase children's and parents' awareness of CSA, and ability of self-protection. A sample of 683 rural Chinese children and adolescents (8 to 18 years old) completed an anonymous questionnaire that assessed experiences of CSA and 5 health-risk behaviors. Data were also collected on several potentially confounding factors. 5 tables and 40 references