Chengdu Center for Disease Control and Prevention, Chengdu, China.
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
AIDS Res Ther. 2024 Jul 26;21(1):46. doi: 10.1186/s12981-024-00636-1.
Males have accounted for a significant share of new HIV infections among young people in the recent years. This study aimed to identify the factors associated with risky sexual behaviors, including early sexual debut, multiple sexual partnership and condomless sex, among sexually active male college students and provide implications for tailored health interventions.
The cross-sectional study was conducted from December 2020 to December 2021 in 16 colleges that were located in Sichuan Province, one of the high-risk areas in China. Overall 1640 male college students who reported sexually experienced were analyzed in this study. Multivariable logistic regression analysis was applied to determine factors associated with early sexual debut, multiple sexual partnership and condomless sex.
The average age of included male students was 19.95 ± 1.56. Of them, 27.74% initiated sexual behavior early, 48.60% reported multiple sexual partnership, and 16.52% did not use condoms at the latest sexual intercourse. Students who were younger (age ≤ 19, AOR = 7.60, 95%CI: 4.84-11.93; age20-21, AOR = 3.26, 95%CI: 2.04-5.21) and self-identified as sexual minorities (AOR = 2.38, 95%CI: 1.69-3.36) were more likely to have early sexual debut. The odds of having multiple sexual partners were higher among those who were ethnic minorities (AOR = 1.79, 95%CI: 1.33-2.41) and accepted extramarital sex (AOR = 1.33, 95%CI: 1.03-1.71). The likelihood of engaging in condomless sex at the latest sexual intercourse was lower among those who had sufficient knowledgeable about HIV (AOR = 0.63, 95%CI: 0.44-0.89), were very confident in condom use efficacy (AOR = 0.26, 95%CI: 0.16-0.43) and confident (AOR = 0.48, 95%CI: 0.34-0.69). Early sexual debut was positively associated with multiple sexual partnership (AOR = 3.64, 95%CI: 2.82-4.71) and condomless sex at the latest intercourse (AOR = 1.53, 95%CI: 1.07-2.20), respectively.
Early sexual debut, multiple sexual partnership and condomless sex were of considerable concern among male college students. Comprehensive sex education curricula were advised by developing customized information on HIV prevention, sexuality and empowering students with assertiveness and negotiation skills with regard to condom use during and before college.
近年来，男性在年轻人中的新 HIV 感染中占很大比例。本研究旨在确定与性活跃的男大学生的危险性行为相关的因素，包括初次性行为早、多个性伴侣和无保护性行为，并为有针对性的健康干预措施提供依据。
本横断面研究于 2020 年 12 月至 2021 年 12 月在四川省 16 所高校进行，四川省是中国高危地区之一。本研究共分析了 1640 名报告有性经历的男大学生。应用多变量逻辑回归分析确定与早期性开始、多个性伴侣和无保护性行为相关的因素。
纳入男学生的平均年龄为 19.95±1.56 岁。其中，27.74%的人较早开始性行为，48.60%的人报告有多个性伴侣，16.52%的人在最近一次性交中没有使用安全套。年龄较小（年龄≤19 岁，OR=7.60，95%CI：4.84-11.93；年龄 20-21 岁，OR=3.26，95%CI：2.04-5.21）和自我认同为性少数群体（OR=2.38，95%CI：1.69-3.36）的学生更有可能较早开始性行为。少数民族（OR=1.79，95%CI：1.33-2.41）和接受婚外性行为（OR=1.33，95%CI：1.03-1.71）的学生发生多个性伴侣的可能性更高。最近一次性交中使用安全套的可能性较低，那些对 HIV 有足够了解（OR=0.63，95%CI：0.44-0.89）、对安全套使用效果非常有信心（OR=0.26，95%CI：0.16-0.43）和有信心（OR=0.48，95%CI：0.34-0.69）的人。早期性开始与多个性伴侣（OR=3.64，95%CI：2.82-4.71）和最近一次性交时无保护性行为（OR=1.53，95%CI：1.07-2.20）呈正相关。
男大学生中，初次性行为早、多个性伴侣和无保护性行为是值得关注的问题。建议通过制定关于 HIV 预防、性行为和增强学生在大学期间和之前使用安全套的自信和谈判技能的定制信息，开展全面的性教育课程。
