Prevalence of unprotected anal intercourse and associated factors among male students who have sex with men in Qingdao, China: A cross-sectional study.

Content Provider	Europe PMC
Author	Yang, Xuebin Yu, Yingying Song, Xin He, Lili Fu, Yong Zhang, Jianwen Wang, Xiaojun Zhang, Huaqiang
Copyright Year	2023
Abstract	The significant rise of human immunodeficiency virus (HIV) epidemic among young students has become a new feature of acquired immune deficiency syndrome in China, and unprotected anal intercourse (UAI) among male students who have sex with men (SMSM) played a central role in this process. The aim of this study was to investigate the prevalence of UAI, as well as analyze the factors associated with UAI among SMSM in Qingdao, China. From May 2021 to April 2022, men who aged 15 to 30, studied in a high school or college in Qingdao and had anal sex with men in the past 6 months were recruited through snowball method relying on the nongovernmental organization. An anonymous electronic questionnaire was administrated to collect information on socio-demographic characteristics, sexual behaviors, substance use before sex, HIV prevention services and self-esteem. Univariate and multivariate logistic regressions were used to assess factors related to UAI. Among the 341 SMSM included in the study, 40.5% engaged in UAI in the past 6 months. Being migrants from other provinces [odds ratios (OR) = 2.04, 95% confidence intervals (CI): 1.10–3.78], failing to use condoms for the first anal intercourse (OR = 3.38, 95% CI: 1.85–6.18), drinking alcohol before sex (OR = 2.31, 95% CI: 1.25–4.28) and being low level self-esteem (OR = 1.77, 95% CI: 1.09–2.87) were positively associated with UAI. SMSM who had homosexual intercourse more than once a week (OR = 1.76, 95% CI: 1.03–3.00) or had multiple male sex partners (OR = 1.99, 95% CI: 1.20–3.30) were more likely to engage in UAI. Received peer education in the past 12 months (OR = 0.48, 95% CI: 0.27–0.86) was associated with lower odds of UAI. The situation of UAI among SMSM in Qingdao was a public health issue of concern. It is necessary to take targeted measures, such as focusing on first-time sex, advancing sexual health education, expanding peer education, implementing alcohol use screening and maintaining the self-esteem of SMSM, so as to reduce the occurrence of high-risk behaviors among SMSM and curb the spread of HIV on campus.
ISSN	00257974
Journal	Medicine
Volume Number	102
PubMed Central reference number	PMC9981382
Issue Number	9
PubMed reference number	36862866
e-ISSN	15365964
DOI	10.1097/md.0000000000033180
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2023-03-01
Publisher Place	Hagerstown, MD
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
Subject Keyword	China men who have sex with men students unprotected anal intercourse
Content Type	Text
Resource Type	Article
Subject	Medicine