背景:中国西南地区的学生中报告的人类免疫缺陷病毒(HIV)病例越来越多。然而,艾滋病毒/性相关知识的数据,对性的态度,性行为,在这一领域的大学生中,暴露前预防(PrEP)-合格行为的相关性仍然有限。这项研究旨在评估艾滋病毒/性相关知识的流行程度,性态度,性行为,以及与大学生PrEP合格行为相关的因素。
方法:对西南地区大学生进行了基于多阶段分层和整群抽样方法的2020年至2021年的在线调查,和一个精心设计的调查问卷收集数据。倾向得分匹配(PSM),logistic,和对数二项回归用于确定PrEP合格行为的决定因素。
结果:共有108,987名学生参加了调查,和92,946提供了有效的答复。91.6%(85,145/92,946)具有良好的艾滋病相关知识,而只有26.0%(24,137/92,946)报告意识到了性相关知识。此外,超过一半的参与者(64.5%)对参与“一夜狂欢”持负面立场,58.9%(617/1,047)报告了符合PrEP的行为。对数二项回归分析显示不了解HIV相关知识(aPR=1.66,95%CI:1.22-2.26,P=0.001),不与父母讨论性别(APR=1.16,95%CI:1.01-1.33,P=0.021),未在学校接受性相关教育(aPR=1.24,95%CI:1.07-1.45,P=0.005),过去一年未参加艾滋病毒/艾滋病预防活动(aPR=1.32,95CI:1.09-1.60,P=0.004),经历强迫性行为(APR=2.08,95%CI:1.19-3.63,P=0.010),药物滥用(aPR=22.21,95%CI:5.59-88.31,P<0.001)与符合PrEP的行为几率增加显著相关。
结论:中国西南地区的大学生表现出不理想的HIV/性相关知识,接受过有限的性教育,据报道,人们对随意性行为持保守态度,和显著的PrEP合格行为。这些发现表明,有性经验的大学生不知道艾滋病毒相关知识,缺乏性教育,经历过强迫性行为,报告的药物滥用是评估PrEP启动资格的关键人物,和旨在提高对艾滋病毒/性相关知识的认识的干预措施,促进性教育的参与,解决与强迫性行为相关的问题和解决药物滥用问题可能有助于降低大学生中符合PrEP标准行为的发生率.
BACKGROUND: There 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.
METHODS: An 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.
RESULTS: A 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.
CONCLUSIONS: College 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.