A national survey of HIV knowledge, sexual practices and attitude towards homosexuality for HIV elimination among young people in China
Luanqi Ruan
A B C * , Rui Zhao D * , Jason J. Ong B D E F , Xiaoxing Fu G , Ying Xiong H , Yan Chen H , Da He H , Yujia Chen A , Xun Zhuang A I and Lei Zhang B C D F I
+ Author Affiliations
- Author Affiliations
A Department of Epidemiology and Biostatistics, School of Public Health, Nantong University, Nantong, Jiangsu, PR China.
B Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.
C Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
D China–Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi, PR China.
E Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
F Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Vic., Australia.
G School of Sociology and Population Studies, Renmin University of China, Beijing, PR China.
H Delan Bright Charity Foundation, Changsha, Hunan, PR China.
I Corresponding authors. Emails: ntzhuang@163.com; lei.zhang1@monash.edu
Sexual Health 18(1) 64-76 https://doi.org/10.1071/SH20122
Submitted: 15 July 2020 Accepted: 4 September 2020 Published: 26 February 2021
Abstract
Background: Elimination of HIV is a public health priority in China, but there has been reports of an upsurge in HIV among young people. A nationwide cross-sectional survey was conducted to assess the awareness of HIV knowledge, attitudes towards homosexuality and practice of sexual behaviours among Chinese aged 15–24 years. Methods: The face-to-face survey was conducted from June to August 2017, collecting data on sociodemographic characteristics, HIV-related knowledge, attitudes towards homosexuality and practice of sexual behaviours among Chinese senior high school and university students. A generalised linear model (GLM) was used to assess the different levels of HIV knowledge between groups, and identify the key contributors to HIV knowledge scores. Results: The survey was completed by 73.6% (1355/1840) of the students approached. The overall level of HIV-related knowledge was low (58.9%, 10.6/18); 48.0% (650/1355) supported same-sex marriage; and 6.9% (93/1355) self-identified as homosexual or bisexual. The major factors associated with higher scores [mean ± standard deviation (s.d.)] in HIV knowledge among students included: having received school-based HIV education (11.47 ± 3.51 vs 9.02 ± 4.14, P < 0.05); support for same-sex marriage (11.69 ± 3.33 vs 9.49 ± 4.29, P < 0.05) and older age (11.61 ± 2.78 vs 9.87 ± 4.17, P < 0.05). Compared with females, males were significantly more likely (all P < 0.05) to report masturbation (60.7% vs 7.6%), pornography experiences (77.4% vs 35.3%), sexual encounters (24.6% vs 12.3%), casual sex (37.0% vs 18.1%) and sex under the influence of alcohol (29.5% vs 12.8%). Conclusions: There is is still much room for improvement in terms of HIV/AIDS prevention and health education for Chinese young people, and more comprehensive and diverse models of education for HIV prevention are urgently needed.
Keywords: attitudes, Chinese young people, HIV knowledge, homosexuality, sexual behaviours.
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