青年学生性健康知信行的自我分类偏差对相关问题求助意愿的影响

目的 探讨青年学生性健康知信行自我分类偏差对相关问题求助意愿的影响,为精准实施青年学生性健康促进提供科学依据。方法 2019年3-4月性健康和HIV感染风险评估干预微信小程序（"熊探"）测试期间的青年学生使用者纳入为研究对象。根据研究对象性健康知信行的自我分类和系统分类结果差异划分为3组,包括分类一致组、自我分类偏低组（自评比实际性资讯获取更少、性态度更传统、性经历更少）和自我分类偏高组（自评比实际性资讯获取更多、性态度更开放、性经历更多）。采用logistic回归分析3组研究对象的性健康相关问题求助意愿差异。结果 2 009名研究对象的年龄（19.2±1.1）岁,女性占54.7%（1 099/2 009）,大专及以上者占98.4%（1 976/2 009）。性健康知信行自我分类一致、偏低和偏高者分别占49.0%（984/2 009）、10.9%（219/2 009）和40.1%（806/2 009）。与分类一致者相比,自我分类偏低青年学生的HIV自愿咨询检测服务接受意愿更低（aOR=0.65,95%CI：0.43~0.99）,自我分类偏高青年学生的性相关疾病求助意愿更低（aOR=0.76,95%CI：0.59~0.98）。结论 性健康知信行自我分类偏差会降低青年学生对相关问题的求助意愿,尤其自我分类偏低会使青年学生低估HIV感染风险,接受咨询检测意愿下降,引起青年学生艾滋病疫情加速扩散。在性健康教育中需加强引导,提高青年学生群体自我评估能力、客观感知和应对风险。

Influence of self-categorized deviation in knowledge, attitude and practice for sexual health on the willingness to seek help for corresponding problems among young students

Objective To evaluate the effect of "self-categorization" on decision of health preference and the influence of self-categorized deviation in knowledge, attitude and practice (KAP) on the willingness of seeking help for sexual health among young students. Methods From March to April 2019, young students who used a WeChat applet for sexual health and HIV infection risk assessment, which is called "Detective Bear" were recruited and investigated. According to the consistency between the self-categorization of KAP for sexual health and the systematic categorization from their honest answers, the participants were allocated into three groups:consistent, low or high status, according to their judgment on sexual information acquisition, sexual attitude, and the actual number of sexual experiences. Logistic regression was used to analyze the differences in the willingness to seek help for sexual health problems between the three groups.Results 2 009 students with an average age of (19.2±1.1) were included. 54.7% (1 099/2 009) were female, and 98.4% (1 976/2 009) were college, undergraduate or postgraduate students. 49.0% (984/2 009) were in the consistent group, 10.9% (219/2 009) had a lower self-categorization, 40.1% (806/2 009) had a higher self-categorization. Compared with the consistent group, students with lower self-categorization of KAP for sexual health were less likely to assess HIV voluntary counseling and testing (aOR=0.65, 95%CI:0.43-0.99). However, students with higher self-categorization seemed to dislike seeking help for sexually transmitted diseases (aOR=0.76, 95%CI:0.59-0.98). Conclusions Deviation in self-categorization of KAP for sexual health will reduce the young students'' willingness to seek help for related problems. Especially those with lower self-categorization, lack of risk consciousness, and refuse to assess counseling and testing may increase the HIV/AIDS epidemic among this population. It is necessary to strengthen the capacity of self-assessment for young students while promoting sex education.