浙江省大学生拒绝无保护性行为的信心评价及其相关因素分析

目的 分析浙江省大学生拒绝无保护性行为的信心状况及其相关因素。方法 采用分层整群抽样的方法,于2018年10-11月,在浙江省13所高校选取有过性行为的大学生3 718名作为研究对象,评价其拒绝无保护性行为的信心。采用χ²检验法分析大学生拒绝无保护性行为信心的一般人口学特征、性态度、性行为及相关干预情况,采用多因素logistic回归模型分析大学生有信心拒绝无保护性行为的相关因素。结果 共调查3 718名大学生,年龄（20.17±1.38）岁,男生占70.5%（2 620/3 718）。有信心拒绝无保护性行为的男生为74.9%（1 963/2 620）,女生为77.9%（896/1 098）。有信心拒绝无保护性行为的多因素logistic回归分析结果显示,男生的相关因素包括不接受临时性行为（与接受的相比,OR=2.247,95% CI：1.828~2.762）、不接受男男性行为（与接受的相比,OR=1.810,95% CI：1.302~2.516）、最近1年发生临时性行为（与未发生的相比,OR=1.345,95% CI：1.051~1.721）、知道学校有HIV自检试剂（与不知道的相比,OR=1.381,95% CI：1.011~1.887）、接受过学校开展HIV感染风险自我评估（与未接受的相比,OR=1.707,95% CI：1.374~2.121）;女生的相关因素包括来自城市（与来自农村的相比,OR=1.816,95% CI：1.225~2.693）、≥ 21岁（与≤ 20岁的相比,OR=1.469,95% CI：1.075~2.007）、接受过学校开展HIV感染风险自我评估（与未接受的相比,OR=1.597,95% CI：1.093~2.333）。结论 男生和女生拒绝无保护性行为的信心均较高。有信心拒绝无保护性行为的保护因素,男生为不接受临时性行为、不接受男男性行为、接受过学校开展HIV感染风险自我评估、知道学校有HIV自检试剂、最近1年发生临时性行为;女生为来自城市、≥ 21岁、接受过学校开展HIV感染风险自我评估。高校应加强大学生性健康教育,减少无保护性行为,推广HIV感染风险自我评估。

Evaluation on the confidence of refusing unprotected sex behavior and related factors among college students in Zhejiang province

Objective To understand the confidence-related factors of refusing unprotected sex behavior among college students in Zhejiang province. Methods Stratified cluster random sampling method was conducted among college students from 13 colleges and universities in Zhejiang province, from October to November, 2018. A total of 3 718 students who self-reported "ever having had sexual contacts" were enrolled. Chi-square test was used to compare the confidence of rejecting unprotected sex under different demographic characteristics, sexual attitude/behaviors and different intervention approaches. Multivariate logistic regression model was used to analyze the related factors. Results A total of 3 718 college students were involved in this study with average age as (20.17±1.38) years old and 70.5% (2 620/3 718) were male. The proportions of having confidence to refuse unprotected sex behavior were 74.9% (1 963/2 620) of male and 77.9% (896/1 098) of female students, respectively. According to the results from multivariate logistic regression analysis, factors that related to the confidence of refusing unprotected sex behavior in male students would include, did not accept casual sex behavior (compared with accepted students, OR=2.247, 95% CI:1.828-2.762),did not accept homosexual behavior (compared with accepted students, OR=1.810, 95% CI:1.302-2.516), having casual sex behavior in the past one year (compared with having no sex behavior, OR=1.345, 95% CI:1.051-1.721), aware of the availability of HIV self-test reagents service in college (compared with did not knew, OR=1.381, 95% CI:1.011-1.887), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.707, 95% CI:1.374-2.121). In female students, the factors would include:being urban resident (compared with rural residence, OR=1.816,95% CI:1.225-2.693), 21 years old or above (compared with 20 years old or below, OR=1.469, 95% CI:1.075-2.007), having taken the HIV infection risk self-assessment in college (compared with did not take, OR=1.597, 95% CI:1.093-2.333), etc. Conclusions Both male and female college students had higher confidence in refusing unprotected sex behavior. For male students, refusing casual or homosexual contacts, having casual sex in the recent year, knowing HIV self-test reagents service and having had HIV-related risk self-assessment in college as related factors. However, for female students; city residence, 21 years old and above, and having a HIV infection risk self-assessment in college appeared as related factors. Sexual health education should be strengthened to reduce unprotective sex behavior and to promote HIV infection risk self-assessment among the college students.