摘要目的:了解全国自报告在华有性行为的留学生发生高危性行为现状及相关影响因素，为其提供有针对性的性教育和艾滋病性病预防知识，以降低高危性行为发生率和性传播疾病感染风险。方法:通过分层、整群抽样方法，于2021年4—10月对全国4个区域的留学生采用艾滋病知识问卷、性行为问卷进行横断面调查，并采取检验和多因素Logistic回归模型分析其影响因素。结果:共调查1 709名留学生，其中672名自报告有性行为，发生高危性行为的占40.5%（272/672）。是否发生高危性行为与年龄、生源地区、来华时间、性伴侣性别、是否在中国进行过HIV检测、是否感染HIV有关，且差异均有统计学意义（ χ 2=7.64、15.23、11.09、19.63、4.40和5.27， P=0.006、0.002、0.004、<0.001、0.036和0.022)。Logistic回归分析结果显示，>24岁（ OR=1.535, 95% CI:1.081~2.179），生源地区为非洲（ OR=1.620，95% CI:1.002~2.619）、欧美洲（欧洲、南美洲及北美洲）（ OR=4.252，95% CI:1.776~10.183）和其他大洲（ OR=4.915，95% CI:1.114~21.684），来华时间为2~3年（ OR=1.513，95% CI:1.016~2.252）、大于3年（ OR=1.695，95% CI:1.149~2.500），有同性性伴侣（ OR=8.151，95% CI:2.963~22.422）是留学生发生高危性行为的危险因素。 结论:留学生在华发生高危性行为问题严重，多性伴侣、商业性行为、临时性行为现象在留学生群体中发生率高，安全套使用率低，艾滋病知识掌握不足。未来应重点关注来华留学生中>24岁、来源于亚洲以外的地区、来华时间超过2年、同性性伴侣的群体，为其提供有针对性的健康教育，从而降低高校留学生艾滋病性病的感染风险。

abstractsObjective:To understand the prevalence of high-risk sexual behaviors among international students who reported having sex in China and the influencing factors, and to provide them with targeted sex education and knowledge of AIDS and sexually transmitted diseases, so as to reduce the incidence of high-risk sexual behaviors and the risk of sexually transmitted infection.Methods:A cross-sectional survey was conducted from April to October 2021 using stratified cluster sampling, involving international students from four regions in China. The survey included questionnaires on HIV/AIDS knowledge and sexual behaviors. Factors influencing high-risk sexual behaviors were analyzed using statistical tests and multivariable Logistic regression models.Results:A total of 1 709 international students were surveyed, of whom 672 self-reported having engaged in sexual activity. Among them, 40.5% (272/672) reported high-risk sexual behaviors. The occurrence of high-risk sexual behaviors was significantly associated with age, region of origin, length of stay in China, gender of sexual partners, history of HIV testing in China, and HIV infection status ( χ 2=7.64, 15.23, 11.09, 19.63, 4.40 and 5.27, P=0.006, 0.002, 0.004, <0.001, 0.036 and 0.022). Logistic regression analysis revealed that factors such as being older than 24 years ( OR=1.535, 95% CI: 1.081-2.179), originating from Africa ( OR=1.620, 95% CI: 1.002-2.619), Europe, South America, or North America ( OR=4.252, 95% CI: 1.776-10.183), other regions ( OR=4.915, 95% CI: 1.114-21.684), staying in China for 2-3 years ( OR=1.513, 95% CI: 1.016-2.252), more than 3 years ( OR=1.695, 95% CI: 1.149-2.500), and having homosexual partners ( OR=8.151, 95% CI: 2.963-22.422) were significant risk factors for high-risk sexual behaviors. Conclusions:High-risk sexual behaviors are prevalent among international students in China, with a high incidence of multiple sexual partners, commercial sex, and casual sex. The rate of condom use is low, and knowledge of HIV/AIDS is insufficient. It is essential to focus on international students over 24 years old, from regions outside Asia, with a stay of more than 2 years, and with homosexual partners. Targeted health education should be provided to reduce the risk of HIV infection and STD among international students in universities in China.