Risky sexual behaviour and HIV testing uptake among male college students: a cross-sectional study in China.
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ABSTRACT: Objective
To understand the sexual behaviours and HIV testing uptake of sexually experienced male college students in China.Design
A cross-sectional study was conducted between September and November of 2020 among male college students.Setting
Hangzhou, China.Participants
Male students who had sexual experience in the previous year were investigated.Outcome measures
Sexual risk behaviour was defined as having multiple sexual partners or having unprotected sex.Results
More than half of the sexually experienced male students (556, 53.2%) had their first sexual intercourse under the age of 18 years old. Among participants, 32.82% (343/1045) had causal sex in the last 6 months; 4.21% (44/1045) had paid sex; 37.32% (390/1045) had sex with other men and had two or more sexual partners in last half year; and 33.33% (130/390) used psychoactive drugs during same-sex intercourse. Only 33.5% (350/1045) of male students had undertaken an HIV test before.Conclusion
Male college students especially men who have sex with men were at risk because they tended to be sexually adventurous, have sex at an early age, have sex with multiple sexual partners and practice unprotected sex. Furthermore, they had a low HIV testing uptake. This highlights the importance of carrying out targeted and timely HIV risk education towards college students.
SUBMITTER: Zhao G
PROVIDER: S-EPMC9189814 | biostudies-literature | 2022 Jun
REPOSITORIES: biostudies-literature
Publications
Risky sexual behaviour and HIV testing uptake among male college students: a cross-sectional study in China.
Zhao Gang G Luo Yan Y Xu Junfang J
BMJ open 20220610 6
<h4>Objective</h4>To understand the sexual behaviours and HIV testing uptake of sexually experienced male college students in China.<h4>Design</h4>A cross-sectional study was conducted between September and November of 2020 among male college students.<h4>Setting</h4>Hangzhou, China.<h4>Participants</h4>Male students who had sexual experience in the previous year were investigated.<h4>Outcome measures</h4>Sexual risk behaviour was defined as having multiple sexual partners or having unprotected ...[more]
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Project description:BackgroundAs a young subgroup, college students have become the main users of mobile social networks. Considering that people can indiscriminately access explicit sexual content on the internet, coupled with the increase of HIV infections in male college students, the role of the internet in meeting sexual partners and its correlation to risky sexual behavior has become an important topic.ObjectiveThe aim of this study is to explore the effects of internet exposure on sexual partners and sexual risk behavior among sexually experienced male college students.MethodsAn institution-based cross-sectional study design was used to collect data through a paper-based questionnaire administered to male college students recruited from colleges and gay organizations in Hangzhou, Zhejiang Province, China. A total of 1045 sexually experienced male students were incorporated in our analysis, with the following information collected: sociodemographic characteristics, sexual intercourse-related behaviors, and sexually transmitted disease (STD) knowledge. Mann-Whitney U and Kruskal-Wallis tests were used to examine differences regarding basic characteristics and sexual risk behaviors between male college students who meet sexual partners via the internet and those who do not. Sequential logistic regression models were employed to examine the influence of meeting sexual partners via the internet on risky sexual behaviors after controlling for other factors.ResultsThe mean age of the sexually experienced male students was 21.6 (SD 2.0) years. The likelihood of risky sexual behavior was varied, yet it was the highest for those who aim to meet paid sexual partners (145/192, 75.5% to 19/22, 86.4%), followed by those seeking partners for love or romance (258/435, 59.3%). Compared to non-internet partner seekers, internet partner seekers tended to have more casual intercourse (292/542, 53.9% versus 51/503, 10.1%), paid intercourse (32/542, 5.9% versus 12/503, 2.4%), and intercourse with same-sex partners (349/542, 64.4% versus 41/503, 8.2%); they were also more likely to use psychoactive drugs (125/349, 35.8% versus 5/41, 12.2%) and have more than 2 partners. With the increase of HIV and STD knowledge, the probability of having unprotected intercourse decreased for non-internet partner seekers. However, it increased for internet partner seekers with a rising HIV knowledge score. Sequential logistic regression showed that meeting sexual partners on the internet was statistically associated with sexual risk behaviors with multiple sexual partners (odds ratio 4.434; P<.001).ConclusionsMeeting sexual partners via the internet is a common behavior among sexually experienced male college students, and those who meet partners on the internet exhibited higher levels of risky sexual behaviors although they had sufficient HIV and STD knowledge; this is especially true for students who aimed to find partners for sexual intercourse. Thus, more attention should be paid to young adults to address the risky sexual behaviors that may contribute to STD spread among this population.
| S-EPMC9112083 | biostudies-literature
Project description:ObjectiveImpulsivity and extraversion have demonstrated associations with risky sexual behavior (RSB) and potentially traumatic events (PTEs). In addition, interpersonal trauma appears to be associated with RSB, but research on the relationship between RSB and noninterpersonal PTEs (e.g., accidental) is lacking. The current study aims to investigate the relationships between personality (i.e., impulsivity, extraversion), RSB and multiple types of PTEs (i.e., accidental, physical, or sexual).MethodPersonality and demographic characteristics were assessed during participants' (N = 970) first semester of college, past-12 month PTEs and RSB were assessed during the second semester of participants' junior year. Multiple linear regression was used to examine the relationship between PTEs, personality factors, and RSB. Analyses were also conducted to examine the potential mediating effect of interpersonal PTEs on the relationship between personality and RSB.ResultsImpulsivity and extraversion were significantly positively associated with RSB. Both physical and sexual PTEs, but not accidental PTEs, were also significantly positively associated with RSB. Sexual PTEs significantly mediated the relationship between impulsivity and RSB.ConclusionsThis is the first study to date to simultaneously examine the relationship between personality, RSB, and types of PTEs in a large sample of young adults. Exposure to interpersonal trauma appears to be a salient factor in the relationship between personality, specifically impulsivity, and RSB. These results indicate that college students may benefit from education regarding the potential negative outcomes of RSB, and that individuals with a history of interpersonal PTEs may be at increased risk for sexual risk taking. (PsycINFO Database Record
| S-EPMC5191997 | biostudies-literature
Project description:ObjectiveThe purpose of this study was to explore the situations and factors influencing casual sexual behavior among male college students, in order to provide scientific evidences and measures of the prevention and control for HIV/AIDS.MethodUsing the stratified cluster sampling method, male college students who self-reported sexual behavior were selected as survey subjects in 13 colleges and universities in 11 cities of Zhejiang Province from October to November 2018. We used a custom online questionnaire to collect information on the demographic characteristics, sexual attitudes, sexual behaviors, and HIV interventions of the respondents. The χ2 test was performed on the composition ratios between different groups. With the occurrence of casual sexual behavior as the dependent variable, logistic regression was used to analyze the factors influencing casual male sexual behavior.ResultsA total of 2734 male college students were surveyed, aged 20.20±1.41 years, of which 595 had casual sex, accounting for 21.7%. The rate of HIV prevention awareness among the participants was 85.1%. Multivariate analysis showed that receiving a self-assessment of HIV risk conducted by the school (Ajusted OR = 1.45, 95% CI = 1.14-1.84), knowing that HIV self-test kits were available at school (Ajusted OR = 2.02, 95% CI = 1.56-2.62), accepting one-night stands (Ajusted OR = 2.82, 95% CI = 2.18-3.66), accepting commercial sex (Ajusted OR = 1.95, 95% CI = 1.53-2.48), being a man who has sex with men (Ajusted OR = 1.81, 95% CI = 1.37-2.39), being a senior (Ajusted OR = 0.46, 95% CI = 0.30-0.71), having knowledge of HIV/AIDS prevention and treatment (Ajusted OR = 0.66, 95% CI = 0.51-0.86), and knowing that the CDC provides HIV testing services (Ajusted OR = 0.56, 95% CI = 0.41-0.77) were factors influencing male college students' casual sexual behavior.ConclusionMale college students who have causal sexual behaviors have a high degree of openness in sexual attitudes, insufficient knowledge of AIDS prevention, and knowledge of HIV testing-related information but low testing rates. For male college students' HIV prevention education intervention, it is necessary to emphasize the establishment of correct sexual attitudes and concepts and promote safe sexual behaviors to prevent the spread of HIV.
| S-EPMC8092760 | biostudies-literature
Project description:BackgroundRisky sexual behavior (RSB), the most direct risk factor for sexually transmitted infections (STIs), is common among college students. Thus, identifying relevant risk factors and predicting RSB are important to intervene and prevent RSB among college students.ObjectiveWe aim to establish a predictive model for RSB among college students to facilitate timely intervention and the prevention of RSB to help limit STI contraction.MethodsWe included a total of 8794 heterosexual Chinese students who self-reported engaging in sexual intercourse from November 2019 to February 2020. We identified RSB among those students and attributed it to 4 dimensions: whether contraception was used, whether the contraceptive method was safe, whether students engaged in casual sex or sex with multiple partners, and integrated RSB (which combined the first 3 dimensions). Overall, 126 predictors were included in this study, including demographic characteristics, daily habits, physical and mental health, relationship status, sexual knowledge, sexual education, sexual attitude, and previous sexual experience. For each type of RSB, we compared 8 machine learning (ML) models: multiple logistic regression (MLR), naive Bayes (BYS), linear discriminant analysis (LDA), random forest (RF), gradient boosting machine (GBM), extreme gradient boosting (XGBoost), deep learning (DL), and the ensemble model. The optimal model for both RSB prediction and risk factor identification was selected based on a set of validation indicators. An MLR model was applied to investigate the association between RSB and identified risk factors through ML methods.ResultsIn total, 5328 (60.59%) students were found to have previously engaged in RSB. Among them, 3682 (41.87%) did not use contraception every time they had sexual intercourse, 3602 (40.96%) had previously used an ineffective or unsafe contraceptive method, and 1157 (13.16%) had engaged in casual sex or sex with multiple partners. XGBoost achieved the optimal predictive performance on all 4 types of RSB, with the area under the receiver operator characteristic curve (AUROC) reaching 0.78, 0.72, 0.94, and 0.80 for contraceptive use, safe contraceptive method use, engagement in casual sex or with multiple partners, and integrated RSB, respectively. By ensuring the stability of various validation indicators, the 12 most predictive variables were then selected using XGBoost, including the participants' relationship status, sexual knowledge, sexual attitude, and previous sexual experience. Through MLR, RSB was found to be significantly associated with less sexual knowledge, more liberal sexual attitudes, single relationship status, and increased sexual experience.ConclusionsRSB is prevalent among college students. The XGBoost model is an effective approach to predict RSB and identify corresponding risk factors. This study presented an opportunity to promote sexual and reproductive health through ML models, which can help targeted interventions aimed at different subgroups and the precise surveillance and prevention of RSB among college students through risk probability prediction.
| S-EPMC9909517 | biostudies-literature
Project description:BackgroundIn Nepal, as in other Asian countries, the issue of sexuality still remains a taboo. Despite this fact, an increasing number of sexual activities is being reported by Nepalese students. This trend warrants serious and timely attention. Due to the sensitivity of the topic of premarital sexuality, youth receive inadequate education, guidance and services on reproductive health. The main objectives of this paper are to explore the sexual behavior especially focusing on prevalence of premarital sex among college men and to investigate the factors surrounding premarital sexual behavior.MethodsA cross-sectional survey of college students was conducted in April-May 2006. A self-administered questionnaire was completed by 573 male students. Association between premarital sex and the explanatory variables was assessed in bivariate analysis using Chi-square tests. The associations were further explored using multivariate logistic analysis.ResultsDespite the religious and cultural restrictions, about two-fifths of survey respondents (39%) reported that they have had premarital sex. The study has also shown that substantial proportions of students indulge in sexual activities as well as risky sexual behavior. Sex with commercial sex workers, multiple sex partners, and inconsistence use of condom with non-regular partner was common among the students. Less than two in five male students (57%) had used condom at the first sexual intercourse.The prevalence of premarital sex varied on different settings. Older students aged 20 and above were more likely to have premarital sex compared with younger students aged 15-19. Men who had liberal attitude towards male virginity at marriage were almost two times more likely to have engaged in premarital sex compared to their counterparts who have conservative attitude towards male virginity at marriage. Moreover, those students who believe in Hindu religion were more than two times (OR = 2.5) more likely to have premarital sex compared with those who follow other religions. Furthermore, those men who have close unmarried friends who have experienced premarital sexual intercourse were eight times (OR = 8.4) more likely to be sexually active compared to those who did not have such sexually active friends.ConclusionPrevalence of premarital sexual intercourse and risky sexual behavior are not uncommon in Nepal. Young people are exposed to health hazards due to their sexual behavior; hence sex education should be provided. School or college based sexuality education could benefit even out-of-school youths, because their partners often are students.
| S-EPMC2717085 | biostudies-literature
Project description:BackgroundThe prevalence of human immunodeficiency virus (HIV) is becoming more common among college students in China. However, latest data on the prevalence and correlates of HIV testing among sexually experienced college students is rarely.MethodsAn online survey was conducted among college students aged 18 years or older using multistage stratified cluster sampling from 16 colleges. Data on socio-demographic, HIV testing, HIV-related awareness, attitudes, sexual education and behaviors were collected. Propensity score matching (PSM) and logistic regression model were used to identify factors associated with HIV testing.ResultA total of 108,987 students participated the survey, of which 13,201 sexually experienced college students were included in this study. 1,939 (14.69%) college students with sexual experience reported uptake of HIV testing in the preceding year. The uptake of HIV testing increased for college students with a rising HIV knowledge score and sexual health knowledge. Being awareness of HIV-related knowledge (aOR = 1.15, 95%CI: 1.01-1.30), accepting one-night stands (aOR = 1.16, 95%CI:1.03-1.32), obtaining satisfactory sexual interpretation from parent(s) (aOR = 1.24, 95%CI: 1.07-1.43), ever had unintended pregnancy (aOR = 1.78, 95%CI: 1.32-2.38), ever had received HIV-related preventive service(s) (aOR = 1.37, 95%CI: 1.10-1.70), ever had participated HIV-related preventive services (aOR = 3.76, 95%CI: 2.99-4.75) and ever had anal sex (aOR = 2.66, 95%CI: 2.11-3.34) were positively associated with uptake of HIV testing. However, accepting premarital sex (aOR = 0.76, 95%CI: 0.66-0.88), accepting cohabitation (aOR = 0.75, 95%CI: 0.61-0.92), occasionally discussing sex with parent(s) (aOR = 0.68, 95%CI: 0.50-0.91), and being with moderate satisfaction of school sex courses (aOR = 0.74, 95%CI: 0.58-0.95) were negatively associated with uptake of HIV testing.ConclusionThe prevalence of HIV testing was relatively low. Participation in HIV-related services and high-risk sexual behaviors were important enablers for testing. Improving sex education for students, increasing HIV preventive services on campus, and improving family sex education are necessary to increase HIV testing among college sexually experienced students.
| S-EPMC10476433 | biostudies-literature
Project description:BackgroundRisky sexual behavior (RSB) and its consequence among school adolescents and youths have been well understood. It is still a common practice among college and university students living away from their controlling families compounded with the ever-worsening khat chewing habits. However, the relation between khat chewing and RSB is not well studied particularly among college students in Ethiopia. Hence, this study contributes to the literature by examining disparities of RSB among khat chewer and non-chewer students in Southern Ethiopia with the purpose of improving adolescent and youth health.MethodsAn institution-based comparative cross-sectional study was conducted among 1211 college students at Arba Minch town in March 2015. Respondents were selected by employing a simple random sampling technique. Data was collected by using a pre-tested, structured, self- administered questionnaire. The data was entered into Epidata version 3.1 and analyzed using IBM SPSS statistics version 21. Level of statistical significance was declared at a p- value of < 0.05.ResultsThe prevalence of lifetime and current RSB among college students was 40.8 and 36.5% respectively. The lifetime and current prevalence of RSB among khat chewers (82.2 and 30.9%) was significantly higher than non-chewers (74.2 and 27.6%) respectively (P-value = 0.001). Male sex (AOR = 1.82; 95% CI = 1.28, 2.6), urban residence (AOR = 1.63,95% CI = 1.17, 2.28), age of students (AOR = 1.18; 95% CI = 1.09,1.28), living away from family (AOR = 2.45, 95% CI = 1.62,3.7), having high peer pressure (AOR = 2.58, 95% CI = 1.85-3.59), an increase in average grade point (AOR = 0.98, 95% CI = 0.96-0.99), regular attendance of religious institutions (AOR = 0.24, 95%CI = 0.12, 0.42), watching pornographic movies (AOR = 2.51, 95% CI = 1.79,3.51), khat chewing (AOR = 3.02, 95% CI:=1.91,4.76) and alcohol drinking (AOR = 2.26, 95% CI = 1.54,3.35) were factors associated with RSB.ConclusionsConsiderable proportions of students were engaged in khat chewing and RSB. RSB was significantly higher among khat chewers as compared to non- chewers. Comprehensive sexuality education was recommended to college communities and by extension to the ministry of health and education to address the identified factors so that RSB can be reshaped.
| S-EPMC5921970 | biostudies-literature
Project description:ObjectivesTo assess the prevalence of risky sexual behaviour (RSB) and its associated factors among Nepalese undergraduates residing in hostels of Kathmandu Metropolitan City, Nepal.DesignCross-sectional study SETTING: Hostels operating inside Kathmandu Metropolitan City were taken as the study setting.ParticipantA total of 361 undergraduate students residing in hostels in the Metropolitan City OUTCOME MEASURES: RSB was the outcome measure assessed using nine questions able to trace any risky sexual practice practiced by the participants within the past year prior to data collection. The question included participants' engagement in sexual activity before the age of consent, having unprotected vaginal sex even when pregnancy is not intended, engaging in vaginal sex with strangers without a condom, risky oral sex with a stranger and/or intimate partner, risky condom use, having multiple sex partners, having sex under the influence of alcohol and having sex with commercial sex workers. A positive response to any of these nine questions was considered indicative of RSB. Pearson's χ2 test and multivariable logistic regression analysis were performed to determine factors associated with RSB at the 5% level of significance.ResultsThe prevalence of RSB was found to be 35.7% (95% CI: 30.2 to 40.2). RSB was found to be associated with higher age (≥25 years) (aOR: 3.938; 95% CI: 1.707 to 8.673), male gender (aOR: 3.233; 95% CI: 1.623 to 6.439), being in relationships in the past/current (aOR: 3.914, 95% CI: 2.099 to 7.012), lower education of mother (aOR: 3.655; 95% CI: 1.189 to 9.237) and peer pressure to have a sexual relationship (aOR: 2.356; 95% CI: 1.260 to 4.349). Notably, bivariate analysis illustrated problematic pornographic consumption to have a statistical relation with RSB, which was weakened and became non-significant after accounting for other factors in the adjusted model (aOR:1.213, 95% CI: 0.331 to 4.442).ConclusionRSB is a concerning behaviour among undergraduate students and is linked with age, gender, relationship status, parental education and peer pressure. There is a need for comprehensive sex education programmes that equip students with the knowledge and skills needed to navigate healthy relationships, make safe choices and embrace responsible sexual practices.
| S-EPMC11409375 | biostudies-literature
Project description:BackgroundMale circumcision (MC) has been shown to reduce the risk of female to male transmission of HIV. The goal of this survey was to explore MC's acceptability and the factors associated with MC among college students in medical universities in western China.MethodsA cross-sectional study was carried out in three provinces in western China (Guangxi, Chongqing and Xinjiang) to assess the acceptability of MC as well as to discover factors associated with the acceptability among college students in medical universities. A total of 1,790 uncircumcised male students from three medical universities were enrolled in this study. In addition, 150 students who had undergone MC were also enrolled in the survey, and they participated in in-depth interviews.ResultsOf all the uncircumcised participants (n = 1,790), 55.2% (n = 988) were willing to accept MC. Among those who accepted MC, 67.3% thought that MC could improve their sexual partners' hygiene, 46.3% believed that HIV and sexually transmitted diseases (STDs) could be partially prevented by MC. The multivariable logistic regression indicates that MC's acceptability was associated with three factors: the redundant foreskin (OR = 10.171, 95% CI = 7.629-13.559), knowing the hazard of having a redundant foreskin (OR = 1.597, 95% CI = 1.097-2.323), and enhancing sexual pleasure (OR = 1.628, 95% CI = 1.312-2.021). The in-depth interviews for subjects who had undergone MC showed that the major reason for having MC was the redundant foreskin (87.3%), followed by the benefits and the fewer complications of having MC done. In addition, most of these participants (65.3%) said that the MC could enhance sexual satisfaction.ConclusionsMC's acceptance among college students in medical universities is higher than it is among other populations in western China. An implementation of an MC programme among this population is feasible in the future.
| S-EPMC4577094 | biostudies-literature
Project description:BackgroundThere is an increasing number of human immunodeficiency virus (HIV) reported cases among students in Southwest China. However, the data on HIV/sex-related knowledge, attitude toward sex, sexual behaviors, and correlates of pre-exposure prophylaxis (PrEP)-eligible behaviors among college students in this area is still limited. This study aimed to assess the prevalence of HIV/sex-related knowledge, sexual attitudes, sexual behaviors, and factors associated with PrEP-eligible behaviors among college students.MethodAn online survey from 2020 to 2021 based on a multistage stratified and cluster sampling method was conducted among college students in Southwest China, and a well-designed questionnaire collected data. Propensity score matching (PSM), logistic, and log-binomial regression were used to identify the determinants of PrEP-eligible behaviors.ResultA total of 108,987 students participated in the survey, and 92,946 provided valid responses. 91.6% (85,145/92,946) had good HIV-related knowledge, while only 26.0% (24,137/92,946) reported awareness of sex-related knowledge. Furthermore, more than half of the participants (64.5%) held negative stances towards engaging in "one-night stand", and 58.9% (617/1,047) reported PrEP-eligible behaviors. Log-binomial regression analysis indicated that unaware of HIV-related knowledge (aPR = 1.66, 95% CI:1.22-2.26, P = 0.001), not discussing about sex with their parent(s) (aPR = 1.16, 95% CI:1.01-1.33, P = 0.021), not receiving sex-related education in school(aPR = 1.24, 95% CI: 1.07-1.45, P = 0.005), not participating in HIV/AIDS prevention activities in the past year (aPR = 1.32, 95%CI:1.09-1.60, P = 0.004), experiencing forced sex (aPR = 2.08, 95% CI: 1.19-3.63, P = 0.010), and having the drug abuse (aPR = 22.21, 95% CI:5.59-88.31, P < 0.001) were significantly associated with increased odds of PrEP-eligible behaviors.ConclusionCollege students in Southwest China exhibited suboptimal HIV/sex-related knowledge, received limited sex education, reported conservative attitudes towards casual sex, and significant PrEP-eligible behaviors. These findings suggest that sexually experienced college students who were unaware of HIV-related knowledge, lacked sex education, experienced forced sex, and reported drug abuse were the key individuals for evaluating eligibility for PrEP initiation, and interventions aimed at increasing awareness of HIV/sex-related knowledge, promoting participation in sex education, addressing issues related to forced sex and tackling drug abuse could contribute to reducing the incidence of PrEP-eligible behaviors among college students.
| S-EPMC11323675 | biostudies-literature