OBJECTIVETo explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model.

METHODSA total of 3,081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model.

RESULTSAmong the participants, 1,387 (46.7%) were male, 1,586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r = 0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r = 0.40) and intention to engage in premarital sex (r = -0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was -0.06). Furthermore, attitude toward HIV health education (r = 0.49) and intent-to-premarital-sex (r = -0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students.

CONCLUSIONThe integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention.

Adolescent ; Asian Continental Ancestry Group ; Condoms ; utilization ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Models, Theoretical ; Risk Factors ; Self Efficacy ; Sexual Behavior ; Students ; Universities ; Young Adult

OBJECTIVETo understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODSFace to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTSAmong the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONSRisk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; psychology ; statistics & numerical data ; Sexual Behavior ; psychology ; statistics & numerical data ; Surveys and Questionnaires

OBJECTIVETo analyze willingness and influencing factors for usage of pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM).

METHODS887 men who were older than 18 years old and used to have sex with men were recruited through internet between November 27 and December 17, 2013. Data were collected through self designed questionnaire, which was designed to collect information including demography features, willingness of usage of PrEP and associated factors.

RESULTSTotally 760 qualified questionnaires were collected. The ages of surveyed MSM were between 18 and 60, 58.2% (442) were single, 78.9% (600) of them have received college education, 60.4% (459) received annual income less than 60 000 yuan, 73.3% (557) only had sex with men and 77.2% (587) self reported being gay. 32.1% (243/758) of the respondent MSM said they would like to use PrEP. 61.0% (305/500) would like or possibly to take PrEP orally each day. 70.9% (354/499) would keep the same condom using frequency as current situation after using PrEP. In the univariate analysis, the willingness of taking PrEP was ('(2) = 27.61, P < 0.001) lower among those annual income less than 60 000 yuan (27.7% (127/458)) than those annual income higher (44.7% (116/260)); the willingness was significantly ('(2) = 10.99, P = 0.001) higher among those understanding PrEP (35.4% (196/554)) than those not understanding (22.8% (44/206)). In multivariate logistic regression analysis, it suggested that annual income under 60 000 yuan (OR = 0.64 (95% CI: 0.45-0.92)) and understanding PrEP (OR = 1.98 (95% CI: 1.36-2.88)) were influencing factors for usage of PrEP among MSM.

CONCLUSIONMSM didn't understand the PrEP sufficiently currently, economic consideration and worries about the side effects will affect their willingness of using PrEP.

Adolescent ; Adult ; Condoms ; utilization ; HIV Infections ; prevention & control ; Health Knowledge, Attitudes, Practice ; Homosexuality, Male ; Humans ; Male ; Middle Aged ; Patient Acceptance of Health Care ; Pre-Exposure Prophylaxis ; utilization ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo estimate the relationship between migration and HIV risky behavior when controlling for gender, age, and educational levels and to evaluate the gender differences in migration, HIV knowledge, and HIV risky behaviors among rural youth in China.

METHODSA cross-sectional, anonymous, investigative questionnaire for 1710 unmarried, out-of-school rural youth, aged between 15 and 24 years, was handed out in Gongzhuling county of Jilin province, China.

RESULTS58.5% of participants had a history of migration, irrespective of gender. There were gender differences observed in other factors such as drug abuse (4.3% for males and 5.5% for females, P<0.01), multiple sexual partners (24.1% for males and 44.1% for females, P<0.01), and HIV knowledge rate (35.2% for males and 25.5% for females, P<0.001). While controlling for gender, age, and educational levels, the relationships between migration and drug abuse, selling sex, and non usage of condoms during last instance of sexual activity were found to be significant. The cases of premarital sex and multiple sexual partners were both not found to be related to migration.

CONCLUSIONAmong rural youth, the HIV risky behavior such as drug abuse, selling sex, and lack of condom use, is significantly related to migration, while premarital sex and multiple sexual partners seem unrelated to migration.

Adolescent ; China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; complications ; epidemiology ; transmission ; Health Knowledge, Attitudes, Practice ; Human Migration ; statistics & numerical data ; Humans ; Male ; Risk-Taking ; Rural Population ; statistics & numerical data ; Sex Factors ; Sex Work ; statistics & numerical data ; Substance-Related Disorders ; complications ; epidemiology ; Surveys and Questionnaires ; Transients and Migrants ; psychology ; statistics & numerical data ; Unsafe Sex ; psychology ; statistics & numerical data ; Young Adult

OBJECTIVETo understand the trends on HIV and syphilis infections, as well as on risk behaviors and intervention among MSM in China from 2010 to 2013 so as to provide information for the development of intervention strategies for MSM.

METHODSStudy population involved MSM who were recruited for the national HIV sentinel surveillance between 2010 and 2013. Demographic information, HIV related risk behaviors, and results on HIV and syphilis infections were described and trend analysis was performed.

RESULTSBetween 2010 and 2013, the total number of MSM under survey was 149 848. As for sources of the studied population, 12.3% of them were from public bathrooms (Group A), 30.1% from internet (Group B), and 57.5% were others (Group C). Proportions of three groups were similar between 2010 and 2013. The proportion of always using condom in the last six months increased from 30.2% to 37.8%, from 34.7% to 42.9% and from 35.3% to 43.1% in group A, B or C (trend:P < 0.01), from 2010 to 2013. The proportion of using condom in group A was the lowest among the three groups. The prevalence rate of HIV increased from 7.8% in 2010 to 9.2% in 2013 among group A, from 5.0% in 2010 to 6.8% in 2013 among group B, from 5.6% in 2010 to 6.5% in 2013 among group C(trend:P < 0.01). The prevalence rate of syphilis decreased from 13.2% in 2010 to 9.5% in 2013 among group A, from 6.1% in 2010 to 5.7% in 2013 among group B, from 8.7% in 2010 to 6.2% in 2013 among group C (trend:P < 0.01). In this MSM population, 77.1% of them were at age 21-40, 9.4% were at age 41-50 and 2.8% were older than 50 years of age. Both the prevalence rates of HIV and syphilis were the highest-10.1% and 13.6%, among age group of over 50s, respectively.

CONCLUSIONHIV prevalence among MSM increased rapidly in the last four years, especially in older age groups and from public bathrooms. More intervention efforts should be targeting on MSM with the above mentioned characters.

Adult ; China ; epidemiology ; Condoms ; utilization ; Cross-Sectional Studies ; HIV Infections ; epidemiology ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Risk Factors ; Unsafe Sex ; statistics & numerical data ; Young Adult

OBJECTIVE: To assess the association between condom use and oral contraceptive consumption and the risk of cervical intraepithelial neoplasia (CIN). METHODS: A cross-sectional study was conducted in Perth clinics. A total of 348 women responded to the structured questionnaire. Information sought included demographic and lifestyle characteristics such as the use of condom for contraception, consumption of oral contraceptive, and duration of oral contraceptive usage. Crude and adjusted odds ratio (OR) and associated 95% confidence interval (CI) were calculated using unconditional logistic regression models and reported as estimates of the relative risk. RESULTS: The prevalence of CIN was found to be 15.8%. The duration of oral contraceptive consumption among women with abnormal Papanicolaou (Pap) smear result indicating CIN was significantly shorter than those without abnormal Pap smear result (mean+/-SD, 5.6+/-5.2 years vs. 8.2+/-7.6 years; p=0.002). Comparing to < or =3 years usage, prolonged consumption of oral contraceptive for > or =10 years reduced the risk of CIN (p=0.012). However, use of condom for contraception might not be associated with a reduced risk of CIN after accounting for the effects of confounding factors (adjusted OR, 0.52; 95% CI, 0.05 to 5.11; p=0.577). CONCLUSION: Use of oral contraceptives, but not condoms, for contraception appeared to be inversely associated with CIN. Prolonged use of oral contraceptive demonstrated its benefits of reducing the risk of CIN.
Adult ; Cervical Intraepithelial Neoplasia/epidemiology/*prevention & control ; Condoms/*utilization ; Contraception Behavior/*statistics & numerical data ; Contraceptives, Oral/*administration & dosage ; Cross-Sectional Studies ; Drug Administration Schedule ; Drug Utilization/statistics & numerical data ; Female ; Humans ; Middle Aged ; Prevalence ; Risk Assessment/methods ; Socioeconomic Factors ; Western Australia/epidemiology

INTRODUCTIONSexually transmitted infections have increased sharply among adolescents both locally and internationally in recent years. Parents play an important role in their children's sexual health development. An integral part of this includes effective parent-child sexuality communication.

MATERIALS AND METHODSA nationwide cross-sectional community-based household survey was conducted in Singapore between August 2008 and March 2009 to assess parents'/caregivers' attitudes and practices regarding caregiver-child sexuality communication. With an overall response rate of 81.4%, 1169 questionnaires from parents/caregivers of children aged 10 to 17 years were analysed.

RESULTSAlmost all (94.2%) the caregivers were parents. A majority (>80%) of caregivers considered talking to their children about sexuality issues such as abstinence, consequences of premarital sex and condom use as important. However, a significantly lower percentage (about 60%) felt comfortable and confident doing so. Only 8.3% among them discussed sexual health issues with their children very often, 37.2% sometimes, 22.0% seldom/hardly ever (once or twice) and 32.5% never, in the past year. In the multivariate analysis, caregiver-child sexuality communication was significantly associated with caregivers' relationship to children, ethnicity, educational level, and their perceived levels of comfort and confidence in sexuality communication.

CONCLUSIONCaregivers generally felt it was important but were significantly much less comfortable and confident talking about sexuality issues with their children, which leads to a lower frequency of caregiver-child sexuality communication. Educational programmes on adolescent sexual health targeting parents/caregivers are needed. They must be equipped with skills and provided with resources to enable them to talk to their adolescent children about sexuality.

Adolescent ; Adolescent Behavior ; Communication ; Condoms ; utilization ; Cross-Sectional Studies ; Data Collection ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Parenting ; psychology ; Residence Characteristics ; Sex Education ; methods ; Sexual Abstinence ; Sexuality ; Singapore ; Statistics as Topic

OBJECTIVEThis study was to investigate the condom use and its factors on sex workers in Shandong province, and to provide effective suggestions for AIDS prevention strategies and interventions.

METHODSFrom April to July in 2009, 4732 female sex workers were investigated through anonymous questionnaires from 11 cities which were selected based on the AIDS epidemic, geographic location, economic conditions in Shandong province. Serum samples were collected and antibodies were tested by ELISA and TPPA from 4641 people.

RESULTS4732 female sex workers who were 15 - 58 years old were investigated and the majority belonged to the low age group (≤ 24 years old) which accounted for 61.5% (2912/4732). Among the 4732 female sex workers, the unmarried, the divorced, or the widowed females accounted for 72.8% (3441/4725) and 72.0% (3403/4726) of them were poorly educated.42.3% (1994/4719) of them were found from other provinces. The right answers for knowledge of AIDS accounted for 45.7% (2164/4732). 80.6% (3416/4236) of these females were found to used condoms in the most recent commercial sex activity. The rate of consistently using condoms in sex activity during the last month was 58.4% (2467/4221). In this survey, 7.3% (337/4637) of investigated females had been diagnosed with sexually transmitted diseases, 30.7% (1449/4726) of them had received HIV antibody test, 70.4% (3323/4732) of these people had received the AIDS intervention services, and 3.6% (167/4668) of them had ever used drug. Multivariate logistic regression analysis showed that high education level (junior high school or lower vs senior high school or higher, adjusted OR = 0.77, 95%CI: 0.67 - 0.90), having received the HIV intervention (received vs unreceived, adjusted OR = 1.36, 95%CI: 1.17 - 1.58), antibody detection (done vs not done, adjusted OR = 1.33, 95%CI: 1.15 - 1.55), and good knowledge about AIDS (low score group vs high score group, adjusted OR = 0.37, 95%CI: 0.32 - 0.44) were independent factors that increased safe sex behavior; while using drug (drug vs not drug, adjusted OR = 0.22, 95%CI: 0.15 - 0.31) was a negative factor.

CONCLUSIONThe prevalence rate of HIV infection among female sex workers was low in Shandong province. However, the low rate of condom use and the high prevalence of self-reported STD-related symptoms suggested that more attentions should be paid to the factors of risk behaviors, and more targeted interventions are critically needed.

Acquired Immunodeficiency Syndrome ; prevention & control ; Adolescent ; Adult ; China ; Condoms ; utilization ; Female ; Humans ; Middle Aged ; Population Surveillance ; Prevalence ; Safe Sex ; statistics & numerical data ; Sex Workers ; statistics & numerical data ; Sexually Transmitted Diseases ; prevention & control ; Surveys and Questionnaires ; Young Adult

Acquired Immunodeficiency Syndrome ; prevention & control ; China ; epidemiology ; Condoms ; utilization ; Humans ; Surveys and Questionnaires ; Transients and Migrants

OBJECTIVETo explore whether condom use is influenced by power relation in commercial sex behaviors.

METHODSVariables were designed to measure the power relation in commercial sex behaviors based on the theory of gender and power relation and data were collected from male sexually transmitted diseases (STD) patients and female commercial sex workers (FSWs) working at recreation centers or being detained in a women education center to identify the relationship between condom use and power relation in male and female respondents using bivariate and multiple regression analysis.

RESULTSA significant relationship was identified between power relation and female condom use, the higher the score of power relations, the higher frequency the condom use, but no similar result was found in males. Females got a higher score of power relation than males.

CONCLUSIONSPower relation is one of the factors that influence condom use, which should be considered when relevant theories are used to study the rate of condom use. It is worthwhile exploring the relationship between safe sex and power relation in spouses and regular sex partners when interventions are adopted to prevent HIV/AIDS spreading from high risk groups to the general population.

Adolescent ; Adult ; Condoms ; utilization ; Female ; Humans ; Male ; Power (Psychology) ; Sexual Behavior