How Does Migration Affect HIV Sexual Risk Behaviors Among Involuntary Bachelors? The Mediating Roles of Neighborhoods and Social Networks.

The sex ratio imbalance in China since the 1980s has resulted in a large number of involuntary bachelors in rural China. Previous studies have found an association between migration and HIV sexual risk behaviors among involuntary bachelors, but how migration affects these bachelors' HIV sexual risk behaviors remain poorly understood. Using data from a cross-sectional survey in 2017 (a sample of 740 male respondents who had rural household registration, had never been married, and were aged 28-49 years), we investigated the relationship between migration and HIV sexual risk behaviors. Logistic regressions show that migration, neighborhood characteristics, and social networks were significantly associated with commercial sex and multiple sex partners, whereas only neighborhood characteristics and social networks were positively correlated with sexual partnership concurrency. Neighborhood characteristics and social networks mediated the relationships of migration with commercial sex and migration with multiple sex partners. Social networks mediated the association between neighborhood characteristics and concurrency. Multiple-step mediation analysis showed that the indirect effect of migration on commercial sex and multiple sexual partners through neighborhood characteristics and social networks was significant. Our findings suggest that further interventions should address neighborhood characteristics and social networks together.

Migration, Social Networks, and HIV Sexual Risk Behaviors Among Involuntary Bachelors in Rural China.

In rural China there is an abnormally high male-biased sex ratio. The result is a large number of involuntary bachelors. This study examines how migration and social networks relate to bachelors' sexual risk behaviors. Data are from a cross-sectional questionnaire survey in which 740 male respondents who had rural household registration, had never married, and were aged 28 or older were interviewed in 2017. Logistic regression reveals that both migration and social networks place the bachelors at an especially high risk of HIV transmission by increasing the chance that they engage in commercial sex, whereas only social networks are significantly associated with sexual partnership concurrency. Additionally, social networks mediate the association between migration and commercial sex. This suggests that social networks play an important role in bachelors' risk of HIV transmission and that further intervention should address their social networks.