Perceived Environment and HIV Sexual Risk Behaviors Among Male Migrants Under Gender Imbalance in China: Does Sex With Online Partner Play a Mediating Role?

The large-scale migration and significant gender imbalance over the decades are expected to elevate HIV sexual risk behaviors substantially in China. However, the mechanisms underlying these behaviors among male migrants in the context of gender imbalance remain poorly understood. This study explores the relationship between perceived environmental factors and HIV sexual risk behaviors, as well as the mediating role of sex with online partners. The data used in this study were obtained from a 2017 cross-sectional survey of 870 male migrants. We found that both peer norms and neighborhood characteristics were associated with sexual risk behaviors among male migrants. Furthermore, sex with online partners was a significant mediator, explaining 22.50% and 20.13% of the associations between peer norms, neighborhood characteristics, and HIV sexual risk behaviors. Notably, the mediating effect was only significant for unmarried male migrants, not for married migrant males. The findings suggest that sex with online partners plays an important role in unmarried male migrants' HIV sexual risk behaviors and that further prevention and intervention should enhance internet-based sex education.