HIV-related risky sexual behaviors and associated factors among college students in Wenzhou, China: Cross-sectional Questionnaire Study (Preprint)

BACKGROUND College students are at-risk populations of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) and risky sexual behaviors (RSBs). However, little literature focuses on the comprehensive influence factors of RSB in China. OBJECTIVE This study aims to describe the RSB among college students in Wenzhou and explore potential influencing factors of RSB to provide references for HIV prevention and control. METHODS A cross-sectional survey was conducted from November to December 2020 in Wenzhou university city. Self-administered questionnaires were used to collect data anonymously. Some demographic questions, AIDS-related health education, sexual attitudes, condom use effectiveness, HIV awareness, HIV testing awareness and behavior, HIV self-perceived risk, and sexual behavior were investigated and analyzed. Chi-square test and logistic regression were used to analyze the factors associated with RSB. We also performed some sensitivity analyses, such as subgroup analyses according to gender. P-values <.05 were considered significant. RESULTS A total of 5627 college students were included in this survey. Of all participants, 353 (6.3%) had sexual behaviors, of which 79 (22.4%) students were engaged in RSB mainly including same-sex sex, casual sex, and unprotected sex. In the multivariable logistic regression analysis, higher-risk sexual attitudes (P <.001, aOR=6.654, 95% CI 3.192-13.874), good knowledge of HIV awareness (P =.001, aOR=0.322, 95% CI 0.163-0.640), and HIV self-perceived (P <.001, aOR=5.232, 95% CI 2.306-11.873) were significantly associated with RSB. For female college students, living in rural areas was a positive predictor of RSB (P =.03, aOR=3.873, 95% CI 1.123-13.356). CONCLUSIONS Prevalence of RSB among college students is on the rise. The prevalence of AIDS will increase dramatically if these RSBs persist. More comprehensive and specific education on HIV knowledge and RSB-related knowledge should be designed and offered to college students on campus.