Objective: The purpose of this study was to explore the situations and factors influencing casual sexual behavior among male college students, in order to provide scientific evidences and measures of the prevention and control for HIV/AIDS. Method: Using the stratified cluster sampling method, male college students who self-reported sexual behavior were selected as survey subjects in 13 colleges and universities in 11 cities of Zhejiang Province from October to November 2018. We used a custom online questionnaire to collect information on the demographic characteristics, sexual attitudes, sexual behaviors, and HIV interventions of the respondents. The χ² test was performed on the composition ratios between different groups. With the occurrence of casual sexual behavior as the dependent variable, logistic regression was used to analyze the factors influencing casual male sexual behavior. Results: A total of 2734 male college students were surveyed, aged 20.20±1.41 years, of which 595 had casual sex, accounting for 21.7%. The rate of HIV prevention awareness among the participants was 85.1%. Multivariate analysis showed that receiving a self-assessment of HIV risk conducted by the school (Ajusted OR = 1.45, 95% CI = 1.14–1.84), knowing that HIV self-test kits were available at school (Ajusted OR = 2.02, 95% CI = 1.56–2.62), accepting one-night stands (Ajusted OR = 2.82, 95% CI = 2.18–3.66), accepting commercial sex (Ajusted OR = 1.95, 95% CI = 1.53–2.48), being a man who has sex with men (Ajusted OR = 1.81, 95% CI = 1.37–2.39), being a senior (Ajusted OR = 0.46, 95% CI = 0.30–0.71), having knowledge of HIV/AIDS prevention and treatment (Ajusted OR = 0.66, 95% CI = 0.51–0.86), and knowing that the CDC provides HIV testing services (Ajusted OR = 0.56, 95% CI = 0.41–0.77) were factors influencing male college students’ casual sexual behavior. Conclusion: Male college students who have causal sexual behaviors have a high degree of openness in sexual attitudes, insufficient knowledge of AIDS prevention, and knowledge of HIV testing-related information but low testing rates. For male college students’ HIV prevention education intervention, it is necessary to emphasize the establishment of correct sexual attitudes and concepts and promote safe sexual behaviors to prevent the spread of HIV.

Background: Men who have sex with men (MSM) constitute a significant population of patients infected with HIV. In recent years, several efforts have been made to promote HIV testing among MSM in China. Objective: This study aimed to assess HIV testing coverage and factors associated with first-time HIV testing among MSM to provide a scientific basis for achieving the goal of diagnosing 95% of patients infected with HIV by 2030. Methods: This cross-sectional study was conducted between July 2023 and December 2023. MSM were recruited from the “Sunshine Test,” an internet platform that uses location-based services to offer free HIV testing services to MSM by visiting the WeChat official account in Zhejiang Province, China. Participants were required to complete a questionnaire on their demographic characteristics, sexual behaviors, substance use, and HIV testing history. A logistic regression model was used to analyze first-time HIV testing and its associated factors. Results: A total of 7629 MSM participated in the study, with 87.1% (6647) having undergone HIV testing before and 12.9% (982) undergoing HIV testing for the first time. Multivariate logistic regression analysis revealed that first-time HIV testing was associated with younger age (adjusted odds ratio [aOR] 2.55, 95% CI 1.91-3.42), lower education (aOR 1.39, 95% CI 1.03-1.88), student status (aOR 1.35, 95% CI 1.04-1.75), low income (aOR 1.55, 95% CI 1.16-2.08), insertive anal sex role (aOR 1.28, 95% CI 1.05-1.56), bisexuality (aOR 1.69, 95% CI 1.40-2.03), fewer sex partners (aOR 1.44, 95% CI 1.13-1.83), use of rush poppers (aOR 2.06, 95% CI 1.70-2.49), unknown HIV status of sex partners (aOR 1.40, 95% CI 1.17-1.69), lack of awareness of HIV pre-exposure prophylaxis (aOR 1.39, 95% CI 1.03-1.88), and offline HIV testing uptake (aOR 2.08, 95% CI 1.80-2.41). Conclusions: A notable 12.9% (982/7629) of MSM had never undergone HIV testing before this large internet survey. We recommend enhancing HIV intervention and testing through internet-based platforms and gay apps to promote testing among MSM and achieve the target of diagnosing 95% of patients infected with HIV by 2030.

Objective. The objective of this study was to understand multiple sexual partners and related factors among male college students who exhibited sexual behaviour to provide a scientific basis for formulating HIV/AIDS prevention measures among college students. Methods. A stratified cluster random sampling method was conducted among 2665 male students who had sexual behaviour and were informed of the number of sexual partners from 13 colleges/universities in 11 cities in Zhejiang Province in 2018. Demographic characteristics, sexual attitudes, sexual behaviour, interventions, and related information were collected using a homemade online questionnaire. The chi‐square test or univariate logistic regression in different groups was conducted for multiple sexual partners, and a logistic regression model was used in the related factor analysis. Results. A total of 2665 college students who engaged in sexual behaviour were involved in the research; among them, 485 students (18.20%) had multiple sexual partners. The results of multivariate analysis showed that the participants whose sexual orientation was homosexual (adjusted OR = 4.10, 95%CI = 2.89 − 5.80), those who had received school education about HIV testing in the previous year (adjusted OR = 1.55, 95%CI = 1.20 − 1.99), those who had accepted one‐night stands (adjusted OR = 3.29, 95%CI = 2.43 − 4.47), those who had accepted commercial sex (adjusted OR = 1.89, 95%CI = 1.44 − 2.48), and those who were very confident in a condom use measure of self‐efficacy (adjusted OR = 1.78, 95%CI = 1.31 − 2.41) were more likely to have multiple sexual partners. The participants who were senior students (adjusted OR = 0.51, 95%CI = 0.31 − 0.84), those whose monthly living expenses were 1001‐1500 renminbi (adjusted OR = 0.69, 95%CI = 0.51 − 0.93), those who had known that “daily life and study contact cannot spread HIV” (adjusted OR = 0.59, 95%CI = 0.43 − 0.80), and those who knew that the CDC provides HIV testing (adjusted OR = 0.66, 95%CI = 0.46 − 0.95) were less likely to have multiple sexual partners. Conclusion. Multiple sexual partners were quite common among male college students who engaged in sexual behaviour. They had a separation of HIV/AIDS knowledge and action and a low rate of HIV testing. Further health education and intervention, including informing friends of strategies, are needed to guide students in correct sexual attitudes, safe sexual behaviour, and prevention of the spread of disease.

Objective. This study explored the characteristics and associated factors of commercial sex behavior among male college students who engaged in temporary heterosexual behaviors in Zhejiang Province, China. Methods. The participants were male college students with temporary heterosexual behaviors. We developed an online questionnaire to collect information on demographic characteristics, sexual attitudes, sexual behaviors, and HIV/AIDS interventions through stratified cluster sampling. Chi‐square (χ²) tests were performed for the different groups of participants. The occurrence of commercial sex behavior among participants was taken as the dependent variable, and logistic regression was used to analyze the factors associated with the participants’ commercial sex behavior. Results. This study investigated the temporary heterosexual behavior of 424 male college students. Among them were 112 students who reported commercial sex behavior (26.42%), whose average age was 20.25 ± 1.27 years, and whose household registration of Zhejiang Province accounted for 63.39%. The results of the multivariate logistic regression analysis indicated that acceptance of commercial sex behavior (Adjusted (a) OR = 3.53, 95% CI = 1.94~6.40) and feeling at risk of contracting HIV (aOR = 6.44, 95% CI = 2.98~13.94), seeking temporary sexual partners through the Internet (aOR = 2.58, 95% CI = 1.27~5.25), consistently using condoms during sex (aOR = 0.34, 95% CI = 0.16~0.70), or using condoms sometimes/frequently during sex (aOR = 0.30, 95% CI = 0.13~0.68) were independent factors associated with male college students with temporary heterosexual behavior engaging in commercial sex behavior. Conclusion. Open sexual attitudes, seeking temporary sexual partners through the Internet, high awareness of HIV infection risk, and low condom use are associated factors for male college students engaging in commercial sex behavior. For college students’ HIV/AIDS prevention and education interventions, it is necessary to strengthen the prevention of network influence, increase peer education, increase teacher participation in education, enhance college students’ risk awareness, advocate for the use of condoms, and promote HIV/AIDS prevention and treatment.

Background: Young students infected with HIV have become a significant public health issue in China, this study aimed to understand the factors influencing the choice of having multiple sexual partners among male college students who had casual heterosexual sex in Zhejiang Province and to scientifically justify developing HIV/AIDS intervention strategies among them. Methods: A stratified cluster sampling method was used for the survey of students from 13 colleges or universities in Zhejiang Province between October and November 2018. The questionnaire collected information on general demographic characteristics, knowledge of HIV/AIDS prevention and treatment, sexual attitudes and risk awareness, sexual behavioural characteristics, and acceptance of interventions. The univariable and multivariable analyses were conducted in this study. Results: Study participants included 362 male college students who exhibited casual heterosexual sex and were aware of the number of sexual partners they had. Among them, 222 students engaged in casual heterosexual sex with multiple sexual partners (61.33%). The results of the multivariable analysis revealed several factors associated with male students’ choice to have multiple sexual partners: monthly living expenses greater than or equal to 1501 CNY (adjusted OR = 2.24, 95% CI = 1.21–4.16), sexual behavior after consuming alcohol (adjusted OR = 2.19, 95% CI = 1.32–3.63), whose casual partner types were non-student (adjusted OR = 2.51, 95% CI = 1.45–4.22), and those who discussed using condoms during sexual intercourse (adjusted OR = 0.50, 95% CI = 0.28–0.89). Conclusion: The choice to engage in casual heterosexual sex with multiple partners was found to be associated with several factors among male college students, including economic status, engaging in sexual behavior after consuming alcohol, the type of the casual partner, and using condoms. These findings highlight the significance of implementing targeted interventions and comprehensive sexual health education programs within college settings in order to encourage safer sexual practices among students.

Objectives: To investigate the factors associated with voluntary HIV counseling and testing (VCT) among young students engaging in casual sexual activity and to establish a scientific rationale for developing targeted intervention strategies for preventing HIV/AIDS in this population. Methods: Stratified cluster sampling was used to conduct a survey using questionnaires to collect demographic and behavioral information for statistical analysis. Results: Data from 611 young students, who reported engaging in casual sexual activity, were included in the statistical analysis. Among these, 68 (11.13%) students underwent the VCT. Among young students who engaged in casual sexual activity, those who were non-Zhejiang residents (adjusted odds ratio [aOR]: 2.11; 95% Confidence Interval [CI]: 1.17–3.80), those who had received AIDS-themed lectures or health education courses from the school in the past year (aOR = 3.96, 95% CI = 1.49–10.50), those who had received HIV risk self-assessment conducted by the school in the past year (aOR = 2.31, 95% CI = 1.17–4.59), and those who had engaged in commercial sex activity in the past year (aOR = 1.98, 95% CI = 1.07–3.66) were more inclined to have undergone VCT. Male students (aOR = 0.37, 95% CI = 0.18–0.77) and those who used condoms consistently during casual sexual activity (aOR = 0.45, 95% CI = 0.21–0.97) were less likely to undergo VCT. Conclusion: Casual sexual activity was relatively prevalent among young students, posing a potential risk for HIV transmission. These findings will be instrumental in the development more effective HIV prevention and control strategies for young students. Additionally, it highlights the necessity of promoting and popularizing VCT among young students without Zhejiang province residency, who are involved in commercial sexual activity, and/or those who lacking HIV education. Moreover, additional research and implementation of refined HIV behavioral interventions specifically tailored to young students are necessary to enhance their awareness and knowledge of HIV prevention.