STI and HIV testing: examining factors that influence uptake among domestic Australian-born, domestic overseas-born and international tertiary students studying in Australia

Abstract

Objectives Sexual health knowledge among international students in Australia is lower than domestic students, however, little is known about what factors affect the uptake of STI testing, nor if there are differences for overseas-born domestic students. Methods We included sexually active respondents from a survey of university students in Australia (N = 3,075). Multivariate regression and mediation analyses investigated associations of STI and HIV testing with STI and HIV knowledge respectively, sexual risk behaviour and demographics, including comparisons among: domestic Australian-born, domestic overseas-born, and international students. Results STI and HIV knowledge was positively associated with STI and HIV testing respectively (STI OR = 1.13, 95% CI: 1.09, 1.16; HIV OR = 1.37, 95% CI: 1.27, 1.48). STI knowledge was significantly lower for international than domestic Australian-born students (10.8 vs. 12.2 out of 16), as was STI testing (32% vs. 38%); the difference in knowledge accounted for half the difference in STI testing rates between these two groups. International students from Southern Asia, and Eastern Asia reported the lowest STI testing rates. HIV testing was highest amongst international students from Africa and North America. Higher sexual risk behaviour, younger age, and identifying as gay or bisexual were positively associated with higher STI and HIV testing rates. Conclusions Our study supports greater investment and commitment by universities for the provision of sexual health education that can promote access to testing to improve the health of their students.

A systematic literature review on bi+ college students using an ecological lens.

“…Most often, studies explored a vast array of risk factors related to physical health, including bi+ students’ experiences with substance use, drinking, nonmedical prescription drug use, tobacco use, interpersonal violence, sexual violence, sexual harassment, sexual activity, lack of counseling, and weight-related behaviors (Coulter et al, 2016; Duryea et al, 2015; Laska et al, 2015; Li et al, 2018; Lindley et al, 2008; McAleavey et al, 2011; Viohl et al, 2019). Related to outcomes for bi+ populations, Kerr, Ding, and Thompson (2013) and Engstrom et al (2023) found positive outcomes related to sexual health for bi+ people (i.e., higher rates of sexually transmitted infection testing and condom use), whereas Stokłosa et al (2021) found bisexual people to have the riskiest sexual behaviors. Second most common, the literature overviewed an array of risk factors related to mental health, including bi+ students’ greater rates of suicidal ideation, higher diagnoses of mental health concerns (e.g., anxiety, posttraumatic stress disorder, and depression), and lower life satisfaction.…”

Lightweight federated learning for STIs/HIV prediction

“…Many cultures perceive STIs/HIV as stigmatised conditions 16 – 18 , including among health professionals 19 and especially where there is intersectional identity 20 – 22 . FL allows for the development of models that can generalise across different populations, which is crucial for the prediction of STIs and HIV, which disproportionately affects specific groups, such as men who have sex with men (MSM) and people from higher endemic countries 23 .…”