JMIR Publications

ABSTRACT

Background:

Considering the increasing trend of migration worldwide including China, which has attracted a lot immigrants under the rapid economic development in the recent years. Inevitably, it has become a challenge for public health system to prevent infectious diseases including sexually transmitted diseases caused by risk sexual behaviors with rising number of international immigrants.

Objective:

To explore the risk sexual behaviors of international immigrants living in China in order to provide evidence on the built of localized public health service system for the significant number of international immigrants under the globalization.

Methods:

A cross-sectional web-based study was designed to collect sexual behaviors and knowledge data among international immigrants in China with snowball sampling method. Risk sexual behaviors in our study were divided into multiple sexual partners and unprotected sexual behaviors. Descriptive analysis was used to analyze the basic characteristics, sexual knowledge and behaviors of international immigrants using frequency, percentage, mean and standard deviation. Multivariate logistic regression analyses were used to identify the factors for having risk sexual behaviors among international immigrants; and demographic characteristics, risk behaviors and their associations with HIV test and intention to test for HIV.

Results:

In total, 1433 international immigrants were incorporated in the study. There were 61.8% of the participants have never heard of sexually transmitted infections (STIs), and the mean knowledge score of HIV were 5.42±2.138. Among participants, 8.2% (118) of them had been diagnosed with one of the STIs before. 20.4% of international immigrants with homosexual sex never use condom followed by 17.6% for stable sex, 16.5% for commercial sex, 12.2% for group sex and 9.6% for casual sex. For the number of sexual partners, 8.3% of international immigrants had more than 3 sex partners. We also found that individuals aged 31-40 (AOR 2.809; 95% CI 1.387-5.687) were more likely to have multiple sexual partners. Individuals aged 31-40 (AOR 2.648; 95% CI 1.387-5.687) and married ones (AOR 2.376; 95% CI 1.365-4.137) were more likely to have unprotected sexual behaviors. For HIV testing, females tended to have HIV test before (AOR 1.476; 95% CI 1.145-1.903). Those who were unemployed (AOR 0.699; 95%CI 0.492-0.995), annual disposable income > 150000 yuan (AOR 0.505; 95%CI 0.295-0.867), people who considered themselves impossible to infect with HIV (AOR 0.416; 95%CI 0.232-0.745) and homosexuals (AOR 0.663; 95%CI 0.463-0.949) were less likely to have HIV test. Moreover, people who had multiple sexual partners were more likely to have HIV test before (AOR 2.159; 95%CI 1.542-3.023) and more intention to test HIV (AOR 1.797; 95%CI 1.324-2.438).

Conclusions:

Risk sexual behaviors exists among international immigrants including multiple sexual partners and unprotected sexual behaviors especially for the immigrants aged 31-40 years and homosexuals. In addition, the level of cognition of HIV related knowledge were not high among the international immigrants. Therefore, health intervention, such as targeted, tailored programming including education and test is urgent to prevent HIV new infections and transmission among these international immigrants and local population.