Objective To understand the prevalence of high-risk sexual behaviors among international students who reported having sex in China and the influencing factors,and to provide them with targeted sex education and knowledge of AIDS and sexually transmitted diseases,so as to reduce the incidence of high-risk sexual behaviors and the risk of sexually transmitted infection.Methods A cross-sectional survey was conducted from April to October 2021 using stratified cluster sampling,involving international students from four regions in China.The survey included questionnaires on HIV/AIDS knowledge and sexual behaviors.Factors influencing high-risk sexual behaviors were analyzed using statistical tests and multivariable Logistic regression models.Results A total of 1 709 international students were surveyed,of whom 672 self-reported having engaged in sexual activity.Among them,40.5%(272/672)reported high-risk sexual behaviors.The occurrence of high-risk sexual behaviors was significantly associated with age,region of origin,length of stay in China,gender of sexual partners,history of HIV testing in China,and HIV infection status(x2=7.64,15.23,11.09,19.63,4.40 and 5.27,P=0.006,0.002,0.004,<0.001,0.036 and 0.022).Logistic regression analysis revealed that factors such as being older than 24 years(OR=1.535,95%CI:1.081-2.179),originating from Africa(OR=1.620,95%CI:1.002-2.619),Europe,South America,or North America(OR=4.252,95%CI:1.776-10.183),other regions(OR=4.915,95%CI:1.114-21.684),staying in China for 2-3 years(OR=1.513,95%CI:1.016-2.252),more than 3 years(OR=1.695,95%CI:1.149-2.500),and having homosexual partners(OR=8.151,95%CI:2.963-22.422)were significant risk factors for high-risk sexual behaviors.Conclusions High-risk sexual behaviors are prevalent among international students in China,with a high incidence of multiple sexual partners,commercial sex,and casual sex.The rate of condom use is low,and knowledge of HIV/AIDS is insufficient.It is essential to focus on international students over 24 years old,from regions outside Asia,with a stay of more than 2 years,and with homosexual partners.Targeted health education should be provided to reduce the risk of HIV infection and STD among international students in universities in China.
International studentsAIDSHigh-risk sexual behaviorsImpact factors