Knowledge, attitudes, behaviors, and perceptions of risk related to HIV/AIDS among Chinese university students in Hunan, China

Evaluation of a mobile-application educational intervention on the knowledge, attitude, and practice of patients in postoperative care for lumbar disk herniation surgery: A randomized control trial

Objective

We aimed to evaluate the impact of a mobile-based educational program on patients' postoperative care for lumbar disk herniation surgery.

Methods

A randomized controlled trial was conducted at Fayaz-Bakhsh Hospital, Tehran, Iran. Patients with lumbar disc herniation surgery experience were randomized to the intervention and control groups (learning with the LUmbar CAring Training-app). Participants' knowledge, attitudes, and practices of postoperative care for lumbar disc herniation surgery were assessed using a validated questionnaire at three-time points: pre-test (baseline), post-test one (immediately after program completion), and post-test two (8 weeks after program completion). The primary outcome measures were knowledge, attitudes, and practices scores variations. Secondary outcomes were not considered in our study.

Results

In total, 150 patients were enrolled, with 75 patients in each group. Patients in the intervention group demonstrated increased knowledge, modified attitudes, and practice than those in the control group (p < 0.05). The post-test knowledge, attitudes, and practices scores in the intervention group were significantly higher than those in the control group (p < 0.05).

Conclusion

Mobile-application-based education was a practical and feasible approach to improve patients' postoperative care for lumbar disc herniation surgery in Iran.

Association between childhood sexual abuse and early sexual debut among Chinese adolescents: The role of sexual and reproductive health education

Background

Despite accumulating evidence of the long-term impacts of childhood sexual abuse (CSA), few studies have investigated the association between CSA and early sexual debut among adolescents. In this study, we examine the relationship between CSA and early initiation of sexual intercourse among Chinese youth, and the role of school-based sex education in this association, based on a nationally representative survey.

Methods

Data were collected from the Survey of Youth Access to Reproductive Health in China (YARHC) conducted in 2009. Multivariable logistic regression models were used to investigate the association between CSA experience and early sexual debut, and the interaction terms between sexual and reproductive health education and CSA were included to examine the role of education in the association between CSA and early sexual debut.

Results

Among 4,907 sexually experienced youth, 1,062 (21.6%) made their early sexual debut. After adjusting for sociodemographic characteristics, it was found that CSA experience was significantly associated with early sexual debut, with an adjusted odds ratio of 3.13 (95% CI: 1.67-5.87). Receiving any type of sexuality education (reproductive health, sexually transmitted disease (STD) and HIV prevention, or contraception use) was not associated with a decreased risk of early sexual debut.

Conclusion

Our results indicate a greater risk of early sexual debut among Chinese adolescents with a history of CSA, and only 46.7% sexually experienced youth had received prior sex education, which suggested an inadequacy of school-based sexuality education. To reduce this risk, targeted intervention with timely and adequate sexuality education for both early starters of sexual intercourse and CSA victims is warranted in China.

A Latent Class Analysis of Sexual Behavior and Associations with Sex Education, Smoking, Drinking, and Pornography Use Among Chinese Youth

The incidence of sexually transmitted diseases has alarmingly increased among Chinese youth in the past decade, and newly diagnosed cases of AIDS have almost doubled between 2010 and 2015. However, little is known about classes of sexual behavior among Chinese youth and associations with their other health behavior or experience of sex education. This study aimed to first identify classes of sexual behavior using latent class analysis and then to examine their associations with sex education, smoking, alcohol drinking, and pornography use. Data were from 13,865 unmarried youth aged 18-24 from the 2009 National Youth Reproductive Health Survey. Six indicators were used: timing of the first sexual intercourse, the number of past-year sexual partners, sex outside of a relationship, incidence of pregnancy, and contraceptive use at the latest and the first sexual intercourse. Four classes were identified: no sex (Class 1, 69%), safer sex (Class 2, 13%), early risk (Class 3, 13%), and multiple risk (Class 4, 5%). Smoking, drinking, and regular pornography use were associated with increased odds of being in the multiple risk class relative to the safer sex class. Sex education, smoking, and pornography use were associated with decreased odds of being in the no sex class relative to the safer sex class. The findings revealed qualitatively different classes of sexual behavior among Chinese youth and important roles of sex education, substance use, and pornography use. Reproductive health service providers can offer individually tailored services to serve youth with different profiles and needs.

Positive attitudes towards persons living with HIV in North Kosovo: The university students' perspective

HIV-related stigma could delay the identification and treatment of persons living with HIV (PLHIV), particularly in regions affected by ethnic conflicts. The aims of this study were to assess attitudes towards PLHIV and examine factors associated with stronger positive attitudes towards PLHIV among university students in the Serbian province of Kosovo. A cross-sectional study was conducted at the University of Pristina temporarily settled in Kosovska Mitrovica during the academic year 2013-2014. A total of 1,017 first- and fourth-year students completed an anonymous questionnaire about socio-demographic characteristics, PLHIV, high-risk groups for acquiring HIV and health behaviour. The main outcome measure was the Attitude Score (ATS), calculated as a sum of points awarded for all attitude-related items. The majority of students (84%) expressed positive attitudes towards PLHIV, while others were indecisive. Most students held negative opinions about persons who use drugs (64%), homosexual persons of both genders (50%) and sex workers (42%). Being female (odds ratio [OR] = 1.49, 95% confidence interval [CI] 1.05-2.09) and older (OR = 1.13, 95% CI 1.03-1.24), not doing paid work while studying (OR = 3.35, 95% CI = 1.63-6.84), studying health-related disciplines (β = -0.113, 95% CI = -0.085 to -2.747), having stronger positive attitudes towards homosexual persons of both genders (OR = 0.77, 95% CI = 0.64-0.94) and not using illicit drugs (β = 2.08, 95% CI = 1.03-4.20) were associated with stronger positive attitudes towards PLHIV. Social inclusion of PLHIV and individuals at high risk for acquiring HIV could help reduce the HIV-related stigma.

A mobile-based educational intervention on STI-related preventive behavior among Iranian women

While rates of sexually transmitted infections (STIs) in Iran are alarming, little is known about preventive sexual behaviors. The purpose of this article was to assess the effect of a mobile-based educational program to promote preventive behaviors regarding STIs in Iranian women. Using Roger's protection motivation theory, the following measures were developed as the study's conceptual framework: STI knowledge, STI vulnerability, STI prevention self-efficacy and STI prevention intentions. These variables were measured by the Persian version of a valid Korean four-scale tool. Data from 76 women were analyzed: 37 women in the smartphone application (Experimental) group and 39 in the control group. Health Education Sexually Transmitted Infections Application was developed as a smartphone application training program. Participants were tested at three-time points: pre-test (baseline), post-test 1 (immediately after the program's completion) and post-test 2 (16 weeks after the program's completion). Significant group differences were found at different times in STI knowledge, vulnerability, prevention self-efficacy and prevention intentions. The smartphone application was effective in sustaining the effects of the educational program in the experimental group. The development of appropriate teaching materials on sensitive public health issues, such as STIs to promote individual self-learning skills is suggested.

Sexual Knowledge, Attitudes and Behaviours among Undergraduate Students in China-Implications for Sex Education

BACKGROUND

Despite rapid modernization and improving gender equity in China in recent decades, traditional values prevail in many areas of life, including sexual behavior. This study aimed to explore gender differences in sexual knowledge, sexual attitudes and sexual behaviors, as well as preferences for sex education among undergraduates in China.

METHODS

A cross-sectional study surveyed 5965 undergraduates (62.8% females), aged 15 to 24 years from nine universities in Zhejiang, Henan and Yunnan provinces, from September to November 2019.

RESULTS

Of the total sample, 158 (2.6%) self-identified as homosexual, 287 (4.8%) as bisexual and 324 (5.4%) stated they were unclear about their sexual identity. The mean sexual knowledge score out of 12 was 6.16 ± 2.54 points. Ever having sexual intercourse was reported by 18.7% (27.0% males, and 13.9% females). Students from urban backgrounds, and those with homosexual and bisexual orientation were more likely to have had sexual intercourse. Most students (72.5%) reported that they would prefer to receive sex education from on-line sources.

CONCLUSIONS

Female students are significantly more conservative in sexual attitudes and sexual behaviors. Low levels of sexual knowledge contribute to risk behaviors among Chinese adolescents. China needs to develop and widely disseminate on-line sex education, with practical, age-appropriate content.

HIV/AIDS related perception and behavior: A comparative study among college students of different majors in China

Objective

In order to carry out proper education and intervention of AIDS based on different features and demands of different majors, this study aimed to compare the difference of college students from six majors in China in the aspects of AIDS-related knowledge, attitudes and behaviors.

Methods

A questionnaire survey was carried out among 18,644 students in 30 colleges/universities from 9 provinces of China, who were recruited through stratified cluster sampling. AIDS-related knowledge, attitude, condom-use intention, self-efficacy and sexual behavior of these students were investigated.

Results

AIDS-related knowledge level of students majoring in education was the lowest while that of medical students was the highest as well as highest self-efficacy of condom use. Students of music or fine arts had the strongest intention to use condoms, while the students majoring in education had the weakest. The sexually active percentages of male students from different majors ranked as follows: music or fine arts (29.5%), minority nationality (12.2%), science & tech (10.9%), medicine (10.6%), education-major (10.0%), and liberal arts (8.2%). Among female students, the rank was music or fine arts (11.0%), science & tech (6.2%), education-major school (4.5%), minority nationality (4.5%), liberal arts (4.1%), and medicine (2.8%).

Conclusion

It is urgent to enhance proper AIDS-related education and intervention based on the features and demands of students from different majors or universities, for example, to enhance comprehensive AIDS prevention education among students major in education and to increase behavioral skills to prevent sexually transmitted diseases among students from colleges or faculty of music or fine arts.

Pleasure and Risk: A Qualitative Study of Sexual Behaviors Among Chinese Methamphetamine Users

In China, the number of methamphetamine (meth) users has increased dramatically in recent years. This issue has caused researchers to consider the association of meth use with public health concerns, such as the spread of sexually transmitted infections (STIs). Despite the potential outcomes of meth use, qualitative research has not as yet explored Chinese meth users' sexual experiences and feelings associated with meth use. To contribute to the literature, this study employed semistructured interviews to collect data from 19 female and 16 male Chinese meth users (mean age = 31) who were predominantly heterosexual and were recruited from seven compulsory drug treatment institutions in Eastern China. Most participants had completed nine or fewer years of education. Gender similarities and differences were observed in the participants' pursuits of sexual pleasure while using meth. Meth use can enhance the likelihood of high-risk sexual behaviors in both genders and therefore increases the number of public health issues. Men largely dominated the discussion of unprotected sex, while women reported transactional sex in their interviews. Based on research findings, we suggest policymakers strengthen safer-sex educational programs. Policymakers should also enhance prevention methods targeting meth use among women who may engage in transactional sex.

Interventions to improve the HIV continuum of care in China

PURPOSE OF REVIEW

To describe HIV epidemic and interventions for improving HIV continuum of care in China.

RECENT FINDINGS

The reported HIV epidemic has been continuously increasing, partially due to the expansion of active HIV testing campaign. Public health intervention programs have been effective in containing HIV spread among former plasma donors and people who inject drugs (PWID), but more infections occur among heterosexual men and women and young men who have sex with men. Of 1.25 million Chinese people are living with HIV, one-third do not know their status. About two-thirds of diagnosed individuals have used antiretroviral therapy (ART) and two-thirds of those on ART have achieved viral suppression, but some risk groups such as PWID have lower rates. The national free ART program has reduced adult and pediatric mortality and reduced heterosexual transmission. China faces great challenges to reduce HIV sexual transmission, improve the HIV continuum of care, and close the gaps to the UNAIDS Three "90" Targets.

Disparities Between HIV Testing Levels and the Self-Reported HIV-Negative Status of Sexually Active College Students

The methodological issues of using self-reported human immunodeficiency virus (HIV) testing history to determine HIV infection status are understudied. This study aimed to assess the disparities between HIV testing history and self-reported HIV status, with a specific objective of estimating the prevalence of self-reported HIV-negative status in sexually active students who had never had an HIV test (inaccurate self-disclosure). Participants were recruited from four Hong Kong universities; 255 students were included in the analysis, with 16.1% of participants being men who have sex with men (MSM). Overall, 81.6% of participants reported they never had been tested for HIV, with inaccurate self-disclosure by 65.9% of participants. Among participants who used condoms inconsistently, only 20.2% had had HIV tests, with inaccurate self-disclosure by 66.7% of subjects. Among MSM students, only 36.6% had had HIV tests, with inaccurate self-disclosure by 61.0% of participants. Among MSM students who used condoms inconsistently, only 35.1% had had HIV tests, with inaccurate self-disclosure by 62.2% of participants. The findings raise concerns about the use of self-reported HIV status in clinical practice and research. The low prevalence of HIV testing found suggests that interventions to promote HIV testing should be continued.

Self-identified sexual orientations and high-risk sexual behaviours among Chinese youth

PURPOSE

High-risk sexual behaviour is a factor affecting the health of sexual minority students, yet few related studies have been completed among Chinese students. This article explores the distribution of sexual minority groups and its association with high-risk sexual behaviours and symptoms of sexually transmitted infections(STIs) among Chinese college students.

METHODS

An internet-based questionnaire was applied, and a sample of 17 966 surveys from 130 Chinese colleges was collected. Based on their self-reports, participants were classified into the following groups: homosexual male or female, heterosexual, bisexual, and sexual orientation unknown. High-risk sexual behaviours were defined as having sexual intercourse before the age of 18 years, having one's sexual debut with a non-regular partner, having had more than four sexual partners before investigation, and having mostly had sexual intercourse without using condoms. Logistic regression models were constructed to analyse the associations.

RESULTS

The proportions of the homosexual males and females, and the bisexual groups were 1.62%, 0.88% and 5.07%, respectively. Homosexual males were more likely to have their sexual debut with a non-regular partner (OR 4.79, 95% CI 3.38 to 6.78), having more than four sexual partners (OR 5.81, 95% CI 4.06 to 8.32), having their sexual debut before the age of 18 years (OR 1.92, 95% CI 1.34 to 2.76), and not using condoms for most episodes of sexual intercourse (OR 1.47, 95% CI 1.00 to 2.17). Similar associations also existed among homosexual females. A positive association between sexual orientation and having symptoms of STIs (OR 1.49, 95% CI 1.02 to 2.18) was found among homosexual males.

CONCLUSIONS

Sexual minority groups among Chinese college students had a greater risk of engaging in high-risk sexual behaviours and having STI symptoms. Future studies and interventions should focus on this population.

Is Repeat Abortion a Public Health Problem among Chinese Adolescents? A Cross-Sectional Survey in 30 Provinces

The Chinese Family Planning (FP) programme mainly focuses on married couples, and young unmarried women have limited access. This cross-sectional study aims to identify risk factors related to repeat abortions in Chinese adolescents receiving abortions. Data were collected using a questionnaire for all women seeking abortions within 12 weeks of pregnancy during a period of 2 months in 297 participating hospitals randomly selected across 30 provinces of China in 2013. Only the adolescents (younger than the minimum legal married age of 20 years) were included in this study. Of the 2370 adolescents who were receiving abortions, 927 (39%) were undergoing repeat abortions. The primary reason for the current unintended pregnancies was non-use of contraception (68%). Adolescents receiving abortions who had an increased risk of repeat abortions were those who had children (OR 2.57, 95% CI 1.80⁻3.67), those who resided in a middle-developed region (OR 1.81, 95% CI 1.30⁻2.50), those who resided in a relatively poor region (OR 2.40, 95% CI 1.78⁻3.23), and those who had used contraception during the 6 months preceding the survey (OR 1.38, 95% CI 1.12⁻1.71 for condom use). The occupation as a student was a protective factor for adolescents (OR 0.64, 95% CI 0.50⁻0.83). Adolescents should be offered equal access to FP to that of married women in China to reduce unintended pregnancies and repeat abortions. Correct and consistent contraception practice should be promoted.

Influence of Access to HIV/AIDS Information on the Knowledge of Federal University Undergraduates in Nigeria

Information and knowledge are the foremost tools in fighting the scourge of HIV/AIDS. Previous studies have focused more on HIV/AIDS and Nigerian undergraduates’ attitudes, beliefs and protective practices than how information factors influence their knowledge of the pandemic. This study, therefore, investigated the influence of access to HIV/AIDS information on its knowledge among undergraduates of federal universities in Nigeria. The study adopted the descriptive survey research design, with a combination of the purposive, proportionate and stratified random sampling technique used to select 1,679 undergraduates from five universities across five geopolitical zones of Nigeria. Questionnaire was the instrument used for collecting data, which were analyzed using Pearson’s product moment correlation and multiple regression. The most accessible sources of HIV/AIDS information among undergraduates were television (94.5 %), radio (93.0 %) and the Internet/ICT centers (90.5 %). The types of HIV/AIDS information frequently assessed were information on how to refuse sex (Mean=3.15), how to be faithful to one partner (Mean=3.12), sharing of sharp objects (Mean=3.12), blood transfusion (Mean=3.11), unprotected sexual intercourse (Mean=3.10) and how to use condoms correctly (Mean=3.09). Access to HIV/AIDS information (r=0.15) resulted in positive significant relationships with HIV/AIDS knowledge, thus access to HIV/AIDS information has a positive influence on the promotion of knowledge of HIV/AIDS among undergraduates. The level of study was also a predictor of HIV/AIDS knowledge, which was not the case for factors of age, discipline, gender, marital status, tribe and religion. The AIDS service organizations and program developers should come up with strategies that would strengthen and improve the content, accuracy and ease of understanding of HIV/AIDS information that students have access to in order to facilitate its use.

Factors associated with stigma attitude towards people living with HIV among general individuals in Heilongjiang, Northeast China

BACKGROUND

HIV-related stigma always is major obstacles to an effective HIV response worldwide. The effect of HIV-related stigma on HIV prevention and treatment is particularly serious in China. This study was to examine stigma attitude towards people living with HIV/AIDS (PLWHA) among general individuals in Heilongjiang Province, Northeast China and the factors associated with stigma attitude, including socio-demographic factors and HIV/AIDS Knowledge.

METHODS

A cross-sectional survey was carried out in Heilongjiang Province, China. A total of 4050 general individuals with age 15-69 years in four villages in rural areas and two communities in urban areas were drawn using stratified cluster sampling. Standardized questionnaire interviews were administered. Univariate and multivariate log-binomial regression were performed to assess factors affecting stigma attitude towards PLWHA.

RESULTS

The proportions of participants holding stigma attitude towards PLWHA were 49.6% among rural respondents and 37.0% among urban respondents (P < 0.001). Multivariate log binomial regression analysis among both rural participants (RR = 0.89, 95% CI: 0.87-0.91, P < 0.001) and urban participants (RR = 0.89, 95% CI: 0.87-0.91, P < 0.001) showed that greater knowledge of HIV transmission misconceptions was significantly associated with lower stigma attitude towards people living with HIV. And among urban participants, higher education level (high school vs. primary school or less: RR = 0.73, 95%CI: 0.62-0.87, P < 0.001; middle school vs. primary school or less: RR = 0.83, 95%CI: 0.71-0.97, P = 0.018) were also significantly associated with lower stigma attitude towards PLWHA.

CONCLUSIONS

The level of stigma attitude towards PLWHA is higher in rural areas than in urban areas in Heilongjiang. Meanwhile, individuals who better were aware of HIV/AIDS transmission misconceptions may hold lower stigma attitude toward PLWHA whether among rural or urban residents.

Comparison of Sexual Knowledge, Attitude, and Behavior between Female Chinese College Students from Urban Areas and Rural Areas: A Hidden Challenge for HIV/AIDS Control in China

Currently, research in sexual behavior and awareness in female Chinese college students (FCCSs) is limited, particularly regarding the difference and the influencing factors between students from rural areas and urban areas. To fill the gap in available data, a cross-sectional study using anonymous questionnaires was conducted among 3193 female students from six universities located in Beijing, Shanghai, and Guangzhou, China, from February to June, 2013. Of the 2669 respondents, 20.6% and 20.9% of the students from urban and rural areas, respectively, reported being sexually experienced. The proportion of students who received safe-sex education prior to entering university from rural areas (22.4%, 134/598) was lower (P < 0.0001) than the proportion from urban areas (41.8%, 865/2071). Sexual behavior has become increasingly common among FCCSs, including high-risk sexual behavior such as unprotected commercial sex. However, knowledge concerning human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) transmission and the risks is insufficient, particularly for those from rural areas, which is a challenge for HIV/AIDS control in China. The Chinese government should establish more specific HIV/AIDS prevention policies for Chinese young women, strengthen sex education, and continue to perform relevant research.

Association between college health services and contraceptive use among female students at five colleges in Wuhan, China: a cross-sectional study

Background

College students have a high incidence of unplanned pregnancies in China, which has highly raised public attention. As such, numerous reproductive health services are provided to college students. This study examined whether health services in college lead to contraceptive use among female college students in heterosexual relationships.

Methods

A self-administered questionnaire survey with cross-sectional design was administered among female students in four colleges in Wuhan, China to identify health service factors associated with contraceptive use in the past 6 months.

Results

The analysis revealed that younger female students had lower odds of contraception use, whereas students who reported availability of health-related web sites were more likely to use contraceptives. Female students who reported that contraceptives and birth control counselling were accessible from college health services had greater odds of contraceptive usage. Finally, provision of contraceptives and birth control counselling from school were associated with greater odds of contraceptive use.

Conclusions

Contraceptive-related health services play an important role in reducing unintended pregnancies by directly addressing the contraceptive needs of female students. Programs that provide targeted services may help to reduce high rates of unexpected pregnancies among female students in China.

Association between age at first sexual intercourse and knowledge, attitudes and practices regarding reproductive health and unplanned pregnancy: a cross-sectional study

BACKGROUND

Age at first sexual intercourse (AFSI) is decreasing among adolescents in developed nations. An early sexual debut has been associated, to some extent, with multiple sexual partners, infrequent use of condoms, unplanned pregnancy, unsafe abortion, and sexually transmitted disease and human immunodeficiency virus infection. Unplanned pregnancy among adolescents has both physical and social adverse effects.

METHODS

In total, 78,400 self-administered anonymous questionnaires were distributed to college students in seven cities in China to determine the age at which Chinese college students first engage in sexual activity, and the association between AFSI and knowledge, attitudes and practices (KAP) regarding reproductive health and unplanned pregnancy.

RESULTS

Approximately 10,164 students reported that they were sexually active, and most reported that they had engaged in sexual intercourse for the first time during college. The average AFSI was 20.14 [standard deviation (SD) 2.98] years, and the average AFSI by gender was 19.97 (SD 2.97) years for males and 20.41 (SD 2.97) years for females. The unplanned pregnancy rate among the participants was 34.03%. Participants lacked knowledge about contraception and reproductive health, although most believed that it is necessary to have this knowledge. Participants' attitudes towards premarital sex were varied. Factors that were found to be associated with unplanned pregnancy were AFSI, contraceptive methods used for first sexual act, and whether contraceptive methods were used for every sexual act.

CONCLUSIONS

The college period is a key time for Chinese students in terms of becoming sexually active. As such, comprehensive and informative reproductive health education should be provided before and during the college period. Furthermore, reproductive health education should include appropriate sexual morality education and comprehensive sex education. Gender traits and needs should be considered in sex education.

Gender Differences in Factors Associated With Anal Intercourse Among Heterosexual Adolescents in Singapore

Using a cross-sectional survey, we examined the gender differences in prevalence of and factors associated with anal sex among adolescents attending the only public STI clinic in Singapore. Data were collected from 1035 sexually active adolescents aged 14 to 19 and analyzed using Poisson regression. Prevalence of anal intercourse was 28%, with significantly more females (32%) than males (23%) ever engaged in it. On multivariate analysis, the factors associated with anal intercourse for both genders were oral sex and the nonuse of contraception at last sex. For males, anal intercourse was associated with younger age of sexual debut and greater perceived external control. Among females, it was associated with higher rebellious scores and lack of confidence to resist peer pressure to engage in sex. Consistent condom use for anal sex was 22% and 8% for males and females, respectively. STI prevention programs for adolescents should address anal sex, be gender-specific, and take into consideration individual personality characteristics.

Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China

This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9%) of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge.

Mass Media and HIV/AIDS Prevention Among Female Sex Workers in Beijing, China

The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.

Turkish and American Undergraduate Students' Attitudes Toward HIV/AIDS Patients: A Comparative Study

BACKGROUND

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a complex healthcare problem. Research has demonstrated that negative attitudes affect healthcare provision.

AIMS

The purpose of this study was to compare nursing students' attitudes using the AIDS Attitude Scale (AAS).

SETTINGS

A descriptive, cross-sectional study was conducted in nursing schools in Istanbul, Turkey, and in Upstate New York (NY).

PARTICIPANTS

Baccalaureate nursing students (n = 613) from both countries completed the questionnaire.

METHODS

Demographic data, overall AAS attitudes, and attitudes within each subscale were compared. Analyses included frequency and percentages of the grouped variables, arithmetic means and standard deviations, t-test for independent samples, and multiple analysis of variance.

RESULTS

Upstate NY students' mean total AAS scores were significantly more positive toward HIV+ patients than Turkish students'. Scores for Professional Resistance and Emotions subscales were significantly more positive for the Upstate NY students, but Fear of Contagion was not. Upstate NY students had more negative attitudes in the contexts of job risk and eating in a restaurant where the chef has AIDS; more professional resistance to referring patients and training specialists for HIV/AIDS patients; and lower tender feelings for people with HIV/AIDS (p < .01 for each).

CONCLUSIONS

Improvement in students' attitudes is beneficial for promoting nonjudgmental, compassionate care for the HIV+ population.

Prevalence and Sex-Related Risk Factors of Premarital Pregnancy and Reproductive Tract Infections Among Female Undergraduates in Wuhan, China

In China, more and more female college students engage in premarital sex. Few seek reproductive health services, increasing their risk for unintended pregnancy and reproductive tract infections (RTIs). The present study aims to explore the prevalence and sex-related risk factors of premarital pregnancy and RTIs among female undergraduates in China. A total of 4769 females were recruited using randomized cluster sampling and anonymously completed questionnaires. Of the 4,769 females, 863 (18.1%) reported ever having sexual intercourse, 17.5% of which had become pregnant, and 22.7% had contracted RTIs. Younger age or not using a condom at first sex and having multiple sex partners contributed to premarital pregnancy. Majoring in arts, being from less-developed regions of China, having multiple partners, and self-reported pregnancy contributed to RTIs. Findings suggest importance of sexual health education among undergraduates, especially women from less-developed regions of China and/or majoring in arts.

Hierarchical multiple regression modelling on predictors of behavior and sexual practices at Takoradi Polytechnic, Ghana

Introduction:

Various psychosocial studies on health related lifestyles lay emphasis on the fact that the perception one has of himself as being at risk of HIV/AIDS infection was a necessary condition for preventive behaviors to be adopted. Hierarchical Multiple Regression models was used to examine the relationship between eight independent variables and one dependent variable to isolate predictors which have significant influence on behavior and sexual practices.

Methods:

A Cross-sectional design was used for the study. Structured close-ended interviewer-administered questionnaire was used to collect primary data. Multistage stratified technique was used to sample views from 380 students from Takoradi Polytechnic, Ghana. A Hierarchical multiple regression model was used to ascertain the significance of certain predictors of sexual behavior and practices.

Results:

The variables that were extracted from the multiple regression were; for the constant; β=14.202, t=2.279, p=0.023, variable is significant; for the marital status; β=0.092, t=1.996, p<0.05, variable is significant; for the knowledge on AIDs; β= 0.090, t=1.996, p<0.05, variable is significant; for the attitude towards HIV/AIDs; β=0.486, t=10.575, p<0.001, variable is highly significant. Thus, the best fitting model for predicting behavior and sexual practices was a linear combination of the constant, one’s marital status, knowledge on HIV/AIDs and Attitude towards HIV/AIDs.,

Y (Behavior and sexual practices) = β₀ + β₁ (Marital status) + β₂ (Knowledge on HIV AIDs issues) + β₃ (Attitude towards HIV AIDs issues)

β₀, β₁, β₂ and β₃ are respectively 14.201, 2.038, 0.148 and 0.486; the higher the better.

Conclusions:

Attitude and behavior change education on HIV/AIDs should be intensified in the institution so that students could adopt better lifestyles.

HIV/AIDS knowledge and attitudes among Chinese college students in the US

This study assessed knowledge and attitudes about HIV/AIDS and sources of HIV/STI information among Chinese college students living in the USA and explored specific factors associated with knowledge levels and types of sources of information. We surveyed 133 Chinese students enrolled in three US universities. About 41.4 % believed that HIV could be contracted through mosquito bites, and 22.6 % were unaware that condoms could prevent HIV. Sources of HIV/STI information were the mass media. Males were more likely to demonstrate a higher HIV/AIDS knowledge level than females. Graduate students were more likely to cite television as a source of information, and less likely to mention school teachers, than were undergraduate students. These ethnic minority immigrant students held misconceptions about HIV transmission and prevention, and possibly utilized information of varying quality. Accordingly this study identifies specific objectives for education, including basic biology and diversity issues from evidence-based sources.

Sexual experience and HIV-related knowledge among Belgian university students: a questionnaire study

Background

Adolescents are a risk group for acquiring sexually transmitted diseases, including HIV. Correct knowledge about transmission mechanisms is a prerequisite to taking appropriate precautions to avoid infection. This study aimed at assessing the level of HIV-related knowledge among university students as a first step in developing targeted interventions. We used a self-developed HIV knowledge questionnaire, supplemented with socio-demographic and sexual behaviour questions. The questionnaire was composed of 59 items from different existing questionnaires. It included general statements and statements about prevention, transmission and treatment of HIV.

Results

There were 357 (79.7%) female and 93 (20.3%) male participants and their median age was 20 (IQR 19–21). On average 42/59 (71.2%) questions were answered correctly, 5/59 (8.5%) were answered incorrectly and 12/59 (20.3%) were unknown . The best and worse scores were seen on the prevention questions and the treatment questions, respectively. HIV-related knowledge is higher in older students and in students with a health-related education. Students with sexual experience, with five or more partners and students who have been tested on STDs have a higher HIV-related knowledge.

Conclusions

Knowledge on prevention and transmission of HIV is fairly good among university students and knowledge is higher among students with more sexual experience. They still have some misconceptions (e.g. HIV is spread by mosquitoes) and they are ignorant of a substantial number of statements (e.g. risk for infection through oral sex).

A study of the perception of health risks among college students in China

The present survey was designed to investigate the perception of health risks among college students in China. The data are the responses of a sample of 3,069 college students at one university to surveys that include measures of several dimensions of public judgments about fifteen specific hazards. Chinese college students conveyed their concerns as falling into three broad categories: Environmental (e.g., global warming, natural catastrophes, the ozone hole, air pollution, chemical pollution, pesticides in food), Technological (e.g., nuclear power stations, thermal power, genetically modified food, medical X-rays), and Social (cigarette smoking, drinking alcohol, overtime study or work, mental stress, motor vehicle accidents). The data were collected with a self-report questionnaire. Descriptive statistics were used to illustrate the levels of perceived risk according to the percent of "high risk" responses as well as the mean response values. Generally, the hazards that were perceived as posing the greatest health risk were those belonging to the social health risks; items related to technology risks received the lowest percentage of "high health risk" rankings. Traditional environmental risks such as natural catastrophes, pollution issues (chemical pollution, air pollution), and pesticides in food were ranked as being relatively high risks. The respondents were less concerned about new emerging issues and long-term environmental risks (global warming). In this survey, motor vehicle accidents were considered to be a "high health risk" by the greatest percentage of respondents. Generally speaking, the female respondents' degree of recognition of health risks is higher than that of male respondents. Only for the item of smoking was the male respondents' degree higher than that of females. There is also a geographic imbalance in the health risk perceptions. The degree of recognition of health risks from respondents in municipalities is generally lower than that of respondents from other areas except for items such as natural disasters, smoking, medical X-rays, and mental stress, which are exceptions.

A blind area of family planning services in China: unintended pregnancy among unmarried graduate students

BACKGROUND

Status of premarital sex, unintended pregnancy and associated factors among Chinese graduate students remain unclear. And unmarried graduate students' needs of family planning services seem to be ignored. In the present study, we ascertained the prevalence rate of premarital sex and unintended pregnancy, as well as estimated the possible factors associated with unintended pregnancy among unmarried Chinese graduate students, and evaluated their reproductive health needs.

METHODS

We obtained the representative sample of graduate students using a multistage, stratified, cluster design, and collected data using a questionnaire.

RESULTS

We obtained 11936 responders. Premarital sexual intercourse was acknowledged by 24.2% of responders; unintended pregnancy was acknowledged by 4.8% of responders (19.8% of students active in premarital sex); and abortion was acknowledged by 4.6% of responders (96.7% of pregnant students). In multivariate analysis, the identified risk factors for unintended pregnancy among both genders that were active in premarital sex were: (1) having no steady lover [for males: odds ratio (OR), 1.96, 95% confidence interval (CI), 1.41-2.70; for females: OR, 2.65; 95%CI, 1.56-4.84]; (2) younger age at the first sexual intercourse (for males: OR, 1.62, 95% CI, 1.22-2.15; for females: OR, 2.57; 95% CI, 1.64-4.02); (3) lack of condom use at the first sex (for males: OR, 1.13, 95% CI, 1.09-1.37; for females: OR, 2.81; 95% CI, 1.81-4.39); (4) unaware of the conditions of conception (for males: OR, 1.69, 95% CI, 1.31-2.19; for females: OR, 1.75; 95% CI, 1.16-2.65); and (5) unaware that abortion endangers women's future pregnancy (for males: OR, 2.98, 95% CI, 2.15-4.14; for females: OR, 2.34; 95% CI, 1.23-4.46). Medical graduates were not less likely to have unintended pregnancy than nonmedical graduates for both genders.

CONCLUSIONS

The avoidable risk of being unintended pregnancy among graduate students in China indicates that an urgent need to take action on how to delay the age of first sex, promote condom use at first sex, and acquire accurate contraceptive information, as well as improve skills to use reliable contraception among graduate students.

Factors associated with condom use among male college students in Wuhan, China

Background

Using condoms consistently could prevent unintended pregnancy among young people. This study highlights multiple domains of influence on condom use among male college students in China, including knowledge, attitudes, health services utility on condom use and reproductive health information sources.

Methodology/Principal Findings

To identify factors associated with condom use in Chinese male college students, we examined a sample of 870 sexually experienced male students in seven colleges in Wuhan, China, 2009. 535 (61.5%) of 870 male students reported condom use during their most recent sexual encounter. Male students with steady partners were more likely to use condoms than students with casual partners (adjusted OR = 3.11, 95%CI 2.30–4.20). And positive attitudes toward contraceptive responsibility were associated with greater odds of condom use (adjusted OR = 1.40, 95%CI 1.02–1.92). Only 54(6.2%) and 83(9.5%) of respondents reported that free condoms and reproductive health counseling were available at the student health center. Providing free condoms and reproductive health counseling at the student health central were associated with increased condom use among college students (both P<0.05). In addition, students who gained reproductive health information mainly through websites, television and radio programs were more likely to use condoms than through school education (all P<0.05).

Conclusions

Improving attitudes of male students toward contraceptive responsibility, providing proper reproductive health information through mass media and making free condoms and reproductive health counseling available in school may help increase condom use among college students in China.

Correlates of condom use among chinese college students in hunan province

A cross-sectional survey was conducted to test an integrated model of condom use with a sample of 490 sexually active Chinese college students. A number of variables in the integrated model were predictors of condom use, explaining 33.4% of the variance in use. Partner communication was the strongest predictors (β = .317, SE = .038, p < .001). Self-efficacy (β = .252, SE = .076, p < .001), positive attitudes (β = .150, SE = .060, p < .001), and social norms (β = .207, SE = .080, p < .001) were also significant predictors of condom use. Additionally, peer communication marginally significantly predicted condom use (β = .089, SE = .039, p = .055). This study provides evidence of the utility of the theories of reasoned action and planned behavior as an effective underlying theoretical framework for HIV prevention and safe sex intervention programs in a non-Western culture. The study also provides evidence that communication with sexual partners about condom use should be one of the most important factors to be considered in the development of HIV prevention and safer sex education programs for Chinese youth.

University students' knowledge of, and attitudes towards, HIV and AIDS, homosexuality and sexual risk behaviour: a questionnaire survey in two Finnish universities

This study describes Finnish university students' knowledge and attitudes towards HIV and AIDS, homosexuality and sexual risk behaviour. Finnish-speaking students were randomly selected from all registered students at two universities in Finland (N = 9715, n = 950). The data were collected by using a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire on sexual risk behaviour developed by Held and Chng. The total response rate was 35% (n = 333). The data were analysed using quantitative statistical methods. Normally distributed data were analysed by t-test and one-way ANOVA, with Bonferroni corrections. Non-normally distributed data were analysed using the Mann-Whitney U-test and Kruskal-Wallis test, followed by a post-hoc test. The majority of students were familiar with HIV and AIDS, including its mode of transmission. However, there were still some misconceptions concerning HIV and AIDS. The oldest students and women had a more positive attitude towards people living with HIV and AIDS (PLWHA). Of patients with HIV or AIDS, intravenous drug users were perceived most negatively. Male students had more homophobic attitudes. Students who reported that religion had an important role in their lives had significantly stricter attitudes towards sexual risk behaviour. Students' knowledge correlated positively with general attitudes towards HIV and AIDS. Knowledge about HIV and AIDS will lead to more positive attitudes towards HIV and AIDS as a disease, towards those infected as well as homosexual people. There is a need to focus on preventive health care and sexual health promotion by educating young people and changing their attitudes towards sexual risk behaviour.

Sexual behaviors, decisional balance, and self-efficacy among a sample of Chinese college students in the United States

OBJECTIVES

To assess sexual behaviors and condom use including perceived benefits, barriers, and self-efficacy among Chinese college students in the United States.

PARTICIPANTS

One hundred thirty-three Chinese undergraduate and graduate students studying at 3 US universities.

METHODS

Self-report Internet questionnaire grounded in the Transtheoretical Model (TTM) framework analyzed with multivariate linear regression.

RESULTS

More than half (57.9%) have initiated sex. Only 27.3% used condoms every time. Frequent reasons for not using condoms were trust in partner, reduced pleasure, and partner dislike for condoms. Participants in the earlier TTM stages (precontemplation, contemplation, preparation) reported more worry about making partners angry if condoms were used and lower self-efficacy in situations involving alcohol or drug use and perceived low-risk scenarios.

CONCLUSIONS

Interventions should increase condom availability to students and should also make condom use more acceptable, more often expected, and easier to discuss.

Stigma against HIV-infected persons among migrant women living in Shanghai, China

We examined the characteristics of 601 female migrants in Shanghai regarding stigmatizing attitudes toward people living with HIV/AIDS (PLWHA). A community-based cross-sectional study was conducted July and August 2008, using an anonymous questionnaire. Most participants (88%) were married, 9.2% reported multiple sexual partners, 19.1% knew about voluntary counseling and testing clinics, and 3.7% had been tested for HIV. About half (56.4%) agreed that people who acquire HIV/AIDS through sex or drug use deserve it. About 80% admitted that they were afraid of PLWHA. Low knowledge of HIV/AIDS, being older, low levels of education, and longer duration in Shanghai were correlates for having stigmatizing attitudes, while having premarital sex and/or multiple sex partners correlated with less stigma. HIV-related stigma among female migrants in Shanghai is common. Future stigma reduction prevention and intervention programs among female migrants should target those who are older, less educated, and have lived in Shanghai relatively longer.

Stigmatization of persons with HIV/AIDS in Saudi Arabia

Data about the stigmatization of persons living with HIV/AIDS in Saudi Arabia are scarce. Recent statistics from Saudi Ministry of Health showed that 77% of HIV-positive Saudis were males. The present study analyzed data from 162 Saudi male college students. The findings suggest that students who knew less about HIV/AIDS were more likely to stigmatize persons living with HIV/AIDS than those who knew more. Neither degree of religiosity nor worry about HIV infection was related to AIDS stigma. However, AIDS-related shame was the best predictor of AIDS stigma. The findings of this study point to important suggestions for AIDS prevention programs in Saudi Arabia.

Adapting and applying a multiple domain model of condom use to Chinese college students

This study adapts a multiple domain model (MDM) to explain condom use among a sample of sexually active Chinese college students. A cross-sectional survey was conducted and structural equation modeling was used to test the proposed model. Preparatory behaviors, theory of reasoned action (TRA)/theory of planned behavior variables, impulsivity, length of relationship, and alcohol use were significant direct predictors of condom use. The results suggest that MDM can provide a better understanding of heterosexual condom use among Chinese youth, and help in the design of HIV-preventive and safer sex interventions in China.

Relationship between HIV/AIDS knowledge and attitude among student nurses: a structural equation model

With the rising incidence of HIV/AIDS in China, nurses will increasingly be caring for patients with HIV/AIDS. Thus, it is necessary that they have enough knowledge to reduce the risk of occupationally acquired HIV infection and that they change their attitude to care for HIV/AIDS patients. The objective of this study is to explore the relationship between student nurses' HIV/AIDS knowledge and their attitude using a structural equation model (SEM). A cross-sectional survey was conducted in January 2008 among 528 student nurses at the technical secondary school of the China Medical University. An SEM is proposed to determine the direction and magnitude of the interdependent effects between the latent factors. The SEM was built using LISREL version 8.5. The measurement properties of the latent factors underlying the questionnaire were based on a confirmatory factor analysis (CFA). Our results as following, HIV/AIDS knowledge and attitude may be measured by seven underlying constructs, namely, preventive knowledge, knowledge of transmission routes, specialty knowledge, knowledge of nontransmission routes, positive attitude toward HIV/AIDS, negative attitude toward HIV/AIDS, and occupational attitude. The SEM fits the data well. The interdependent relationships between these constructs identified the factors of preventive knowledge, specialty knowledge, and attitude toward HIV/AIDS as having both direct and indirect effects on occupational attitude. In conclusions, our results represent an initial effort to assess the relationship between student nurses' HIV/AIDS knowledge and their attitude toward the disease. CFA and SEM analysis have demonstrated their usefulness in evaluating multifactor complex constructs.

HIV/AIDS awareness, attitudes and risk behavior among university students in Wuhan, China

Background:

In China, the estimated number of HIV positives in 2007 was 700,000 and the epidemic continues to expand. Because of their attitudes towards sexual behavior, young people are considered to be a group at high risk.

Methods:

Eight hundred sixty-eight undergraduate students at Wuhan University were selected through stratified cluster sampling, to answer a questionnaire. They were divided into three main groups: Chinese medical students, foreign medical students and Chinese students from other faculties. Fourteen interviews were conducted in addition.

Results:

Ninety-nine percent of the students had heard of HIV/AIDS and 76% of the students could distinguish HIV from AIDS. The main route of transmission was believed by the Chinese students to be blood transfusion and sexual intercourse by the foreign medical students. The female students knew more about the routes of transmission than the male students. Medical students had a higher level of knowledge than non-medical students, and among the medical students, the foreign students were more knowledgeable than the Chinese students. Only 8 % of the students were sexually active.

Conclusion:

The students had an accepting attitude towards people living with HIV and no extensive risk behavior. Overall, the knowledge level was found to be moderate.

Multiple sex partner behavior in female undergraduate students in China: a multi-campus survey

Background

China is realizing increases in women engaged in premarital sex and multiple sex partner behavior. Our aim was to examine prevalence and determinants of multiple sex partner behavior among female undergraduates in China.

Methods

Anonymously completed questionnaires were received from 4,769 unmarried female undergraduates, recruited using randomized cluster sampling by type of university and students' major and grade. Items captured demographic, family, peer and work influence, and student factors (major, academic performance, and sex-related knowledge and attitudes). To examine risk factors for sexual behaviors, we used multi-level logistic regression, yielding odds ratios (OR) and 95% confidence intervals (95% CI).

Results

Of 4,769 female students, 863 (18.10%) reported ever having sexual intercourse, and 5.31% reported having multiple sex partners (29.32% of all women having sexual intercourse). Several demographic, family, peer and work influences, and student factors (including major, performance, knowledge, and attitude toward sex) were risk factors for ever having sex. However, risk factors for multiple sex partners only included working in a place of entertainment, having current close friends that were living with boyfriends, poor academic performance, and positive attitudes toward multiple partners. These women also were more likely to practice masturbation, start having sex at a younger age, have sex with married men and/or men not their "boyfriends" at first coitus, and not use condoms consistently.

Conclusion

A small but important subset of Chinese female undergraduates is engaged in unprotected sex with multiple sex partners. Interventions need to target at risk women, stressing the importance of consistent condom use.

Mass media and HIV/AIDS in China

Exposure to mass media related to HIV/AIDS has been linked to attitudinal and behavioral changes. This study aims to identify the source(s) of HIV information for the general Chinese population and examine their association with HIV transmission knowledge and stigmatizing attitude toward people living with HIV/AIDS (PLWHA). A total of 3,716 market workers in Fuzhou, China, participated in a face-to-face survey. Multiple regression models were used to describe correlations among respondents' HIV/STD information sources, HIV transmission knowledge, and stigmatizing attitude toward PLWHA. Mass media sources, such as television programs, newspapers, and magazines, were more frequently identified as the channels for HIV information than interpersonal sources, such as friends and service providers. Exposure to multiple sources of HIV information (where at least one source is mass media) was significantly related to HIV knowledge and less stigmatizing attitude toward PLWHA. Mass media in China has been a major source of HIV information to the public. Enhancing the content and penetration of HIV/AIDS campaigns within various channels of the media can be an important strategy in disseminating HIV knowledge and reducing HIV-related discrimination.

Effectiveness of peer education in HIV/STD prevention at different types of senior high schools in Shanghai, People's Republic of China

The epidemic of HIV/AIDS greatly threatens Chinese youth. Our study was intended to examine the effectiveness of the peer education method in HIV/AIDS prevention in different types of senior high schools in Shanghai. A peer education intervention was conducted in 10 different types of senior high schools, including three key senior schools, four ordinary senior schools and three vocational schools in Shanghai for three months. A cohort of 1910 students was surveyed (n=976 intervention group, n=934 control group) through anonymous questionnaires, both pre- and postintervention. There were significant differences in the results among these different types of senior schools. Peer education is an efficient method of increasing the knowledge of AIDS/sexually transmitted diseases in senior school students. However, the contents and the schedule should be different between different types of schools, and students in vocational schools require more health education.

HIV/AIDS awareness and risk behavior among students in Semey, Kazakhstan: a cross-sectional survey

BACKGROUND

Until recently, young people in Kazakhstan have been only moderately affected by the global HIV epidemic. Today, however, the HIV epidemic in Central Asia is one of the most rapidly increasing epidemics in the world. It is mainly concentrated to vulnerable groups such as intravenous drug users, sex workers, the purchasers of sexual services and the financially marginalized. Young, sexually active people may however be the gateway for the epidemic to the general population, and knowledge about their attitudes and behavior is therefore important in planning preventive measures.

METHODS

To gather information about young students and their attitudes and knowledge about HIV/AIDS, we collected 600 structured questionnaires and made 23 semi-structured interviews among three groups of students. Response rate was 99%.

RESULTS

Almost 99% of the respondents had heard of HIV/AIDS, and 89% could identify ways to protect oneself against sexually transmitted HIV/AIDS. The main routes of transmission, sexual contact without condom and intravenous drug use, were both identified by 97% of the students. Twenty-five percent of the female students and 75% of the male students had had one or more sexual partners. More than 30% of the young men had purchased sex, and homosexuality was widely stigmatized.

CONCLUSION

Risks for the spread of HIV/AIDS among young people in Kazakhstan include prostitution as well as stigmatization of the HIV positive and of homosexuals. Protective factors are good knowledge about risks and protection, and opportunities to talk and gather information about sexuality and HIV/AIDS.