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Original article
Spatial distribution and cluster analysis of risky sexual behaviours and STDs reported by Chinese adults in Guangzhou, China: a representative population-based study
  1. Wen Chen1,2,
  2. Fangjing Zhou1,2,
  3. Brian J Hall2,3,4,
  4. Yu Wang5,
  5. Carl Latkin4,
  6. Li Ling1,2,
  7. Joseph D Tucker2,6,7
  1. 1Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
  2. 2Sun Yat-sen Center for Migrant Health Policy, Guangzhou, People's Republic of China
  3. 3Faculty of Social Sciences, Department of Psychology, University of Macau, Taipa, Macau, People's Republic of China
  4. 4Department of Health Behavior and Society and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5Department of Global Health, School of Public Health, Peking University, Beijing, People's Republic of China
  6. 6UNC-Project China, Guangzhou, People's Republic of China
  7. 7UNC Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Li Ling, Sun Yat-sen Center for Migrant Health Policy, School of Public Health, Sun Yat-sen University, #74, Zhongshan Road II, Guangzhou 510080, People's Republic of China; lingli{at}


Objectives To assess associations between residences location, risky sexual behaviours and sexually transmitted diseases (STDs) among adults living in Guangzhou, China.

Methods Data were obtained from 751 Chinese adults aged 18–59 years in Guangzhou, China, using stratified random sampling by using spatial epidemiological methods. Face-to-face household interviews were conducted to collect self-report data on risky sexual behaviours and diagnosed STDs. Kulldorff's spatial scan statistic was implemented to identify and detect spatial distribution and clusters of risky sexual behaviours and STDs. The presence and location of statistically significant clusters were mapped in the study areas using ArcGIS software.

Results The prevalence of self-reported risky sexual behaviours was between 5.1% and 50.0%. The self-reported lifetime prevalence of diagnosed STDs was 7.06%. Anal intercourse clustered in an area located along the border within the rural–urban continuum (p=0.001). High rate clusters for alcohol or other drugs using before sex (p=0.008) and migrants who lived in Guangzhou <1 year (p=0.007) overlapped this cluster. Excess cases for unprotected sex (p=0.031) overlapped the cluster for college students (p<0.001). Five of nine (55.6%) students who had sexual experience during the last 12 months located in the cluster of unprotected sex.

Conclusions Short-term migrants and college students reported greater risky sexual behaviours. Programmes to increase safer sex within these communities to reduce the risk of STDs are warranted in Guangzhou. Spatial analysis identified geographical clusters of risky sexual behaviours, which is critical for optimising surveillance and targeting control measures for these locations in the future.


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