Population size estimation of men who have sex with men in Hainan colleges based on geosocial networking App, South China

Population size estimation of men who have sex with men in Hainan colleges based on geosocial networking App, South China | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Population size estimation of men who have sex with men in Hainan colleges based on geosocial networking App, South China Shi Chen, Xin Chen, Rui Feng, Guihua Chen, Chunyun Lu, Donghui Zhao, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5940102/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Men who have sex with men (MSM) have historically been a high-risk group for sexually transmitted diseases. In Hainan, the incidence of HIV and syphilis among MSM has increased rapidly. Additionally, there is a growing number of young students being diagnosed with HIV, with MSM identified as the primary demographic affected. However, the size of the MSM population within colleges and universities in Hainan Province, as well as the distribution of active MSM users, remains unknown. Methods In this study, the Blued App was employed to collect data on online users within Hainan colleges and universities from May 9 to May 18, 2023. A capture-recapture model was utilized to estimate MSM numbers, and uni-variate and geographic density analyses integrating survey data were used to uncover regional disparities among the MSM community at colleges and universities in Hainan. Results The findings indicated that the estimated MSM size in colleges across Hainan Province was 3130 (95%CI: 3025–3235), with 1833 (95%CI: 1754–1911) being active users. A questionnaire survey revealed that 89.28% of student MSM reported using the Blued App, and 57.14% of the individuals utilized it for seeking sexual partners. Among the 25 campuses in Hainan Province, A1 had the largest number of students using the Blued App, with a population size of 275 (95% CI:243–307), followed by A6 (207, 95%CI: 185–229). Among the male students, A2 (6.67%, 59/884) and A3 (6.16%, 130/2099) demonstrated a high proportion of MSM. A6 (47.04%, 119/253) and B2 (38.46%, 80/208) displayed a significant proportion of active users. Conclusions The proportion of MSM in male students of colleges across Hainan is moderate, with A City and B City identified as significant hotspots. Particular attention should be directed towards sexual health education, and sexually transmitted disease surveillance in specific colleges. student MSM capture-recapture model Blued App geosocial network Hainan Figures Figure 1 Background The role of men who have sex with men (MSM) in the sexually transmitted diseases (STDs) epidemic is considerable. In China, the national prevalence of HIV among MSM from 2001 to 2018 was estimated to be 5.7% ( 1 ). The prevalences of HIV and syphilis among student MSM were 4.4% and 5.7%, respectively ( 2 ). A comprehensive study of male college students throughout Northeast China identified an HIV-positive prevalence of 3.8% and an incidence rate of 2.9 per 100 person-years among college MSM ( 3 ). Additionally, a meta-analysis reported that the HIV prevalence among MSM in high schools and colleges across China was 3.8% (95%CI: 2.5%-5.1%) ( 4 ). Moreover, the prevalence of HIV among MSM who had heterosexual sex was significantly higher, at 9% ( 5 ). In the United States, MSM comprised 53% and 67% of new HIV cases in 2006 and 2014, respectively ( 6 , 7 ). Additionally, France reported over 40% of HIV-positive MSM cases among those living with HIV from 2015 to 2018 ( 8 ). Globally, MSM are experiencing an escalating risk of HIV infection, with the number of cases rising ( 9 , 10 ). Furthermore, the death rate among MSM is much higher (8%) ( 11 ). The HIV epidemic among Chinese college students has worsened due to technological advancements ( 3 , 12 ). The utilization of online platforms and social media may elevate the risk of STDs by facilitating the search for sexual partners ( 13 ). In Germany, MSM represented 45.6% of users on online dating and social networking platforms ( 14 ). In the USA, Rosenbaum et al. demonstrated that mobile social apps can facilitate the spread of syphilis and gonorrhea ( 15 ). In South China, Guo reported that 63.8% of MSM utilized social software to seek sexual partners, emphasizing the geosocial app's significance in MSM communities ( 16 ). Song's study showed that 53.7% of MSM reported having used gay apps to find sexual partners ( 12 ). Additionally, those studies accurately estimated the number of HIV-infected MSM in China by aggregating multiple data sources, such as the Internet and social software. Hong et al. reported an HIV prevalence of 7.9% among gay app users and demonstrated that HIV infection was significantly associated with app users ( 17 ). A behavior associated with higher-risk sexual practices and potential HIV infections, attributed to the rapid growth of internet technology ( 18 ). The Blued, a leading MSM mobile geosocial network App in China ( 19 ), facilitates healthy gay relationships and HIV prevention, such as "Internet + HIV" models ( 20 ). Users create profiles with photos and details. Internet and mobile apps revolutionize MSM dating, introducing discreet platforms ( 21 , 22 ). Online partner search is simplified, with real-time anonymity reducing stigma ( 23 , 24 ). According to a survey results, 98.2% of MSM in China have used gay apps at some point in their lives, with Blued being the most popular (97.5% penetration rate). This is far higher than the penetration rate of other platforms like Finka (18.4%), making Blued about 5.3 times more prevalent than other single platforms ( 25 ). However, the lack of comprehensive data in China presents significant challenges to the development and implementation of effective STDs prevention strategies. The utilization of big data derived from social media platforms may offer a solution to this challenge, as technological advancements transform the socialization and partner-seeking behaviors of MSM. Hainan Province, located in the southernmost region of China, is a key tourism and population hub near Southeast Asia. Between 2011 and 2019, young students in Hainan Province accounted for 5.99% of the annual HIV/AIDS cases. Notably, 91.38% of HIV-positive male students in higher education institutions acquired HIV through homosexual contact ( 26 ). As a tourism province, Hainan has high population mobility and complex temporary social networks, which may exacerbate the anonymous sexual behavior of MSM groups. This trend indicated a potential uncontrolled transmission of HIV among college MSM students in Hainan. Accurately estimating the size of the MSM population within colleges is essential for calculating the incidence of STDs in this group. However, the scarcity of comprehensive studies focusing on MSM among college students in Hainan Province hinders our ability to thoroughly understand and effectively address the prevalence of STDs in this demographic. To address STDs transmission among MSM in Hainan colleges, we assessed the risks by analyzing MSM numbers, distribution, and behavior through Blued App to improve disease control. Methods Study colleges and universities In Hainan Province, a total of 21 colleges and universities with 25 campuses, are enrolling students in 2023. These higher education institutions include 8 undergraduate colleges and 13 junior colleges, with disciplines spanning financial colleges (five), science and engineering colleges (four), comprehensive universities (four), medicine colleges (three), normal colleges (two), language and literature colleges (one), political science and law colleges (one), and sports colleges (one). The geographical distribution of the 25 campuses is as follows: 15 are located in A City, six in B City, and one each in D, F, C, and E City. Capture-recapture methods Recently, the capture-recapture (CRC) method, including two-source CRC (2S-CRC) and three-source CRC (3S-CRC), has been used in many countries to estimate the sizes of hard-to-reach populations, such as MSM and people who inject drugs (PWID) ( 27 , 28 ). This method addresses the under-reporting of cases by utilizing recapture information, specifically the intersection or overlap of sources, to estimate the number of unreported cases under appropriate assumptions ( 29 ). Briefly, the estimation process is predicated on the observation or "capture" of individuals within a population across two separate occasions. During the initial capture event, individuals are assigned a unique identifier or "mark." In the subsequent capture, referred to as "recapture," both marked and unmarked individuals are enumerated. The data collected, particularly the number of marks distributed during the first capture and the counts of marked and unmarked individuals during the recapture, are employed to estimate the total population size. Data collection and management This study employed Blued App to examine MSM students across all colleges and universities in Hainan Province. ArcGIS 10.8.1 was utilized to produce density distribution maps of MSM populations at colleges and universities across various institutions in Hainan. These maps were correlated with the active usage of the Blued App to examine the impact of MSM populations in colleges and universities across different regions. In 2023, we collected data on Blued online users across colleges and universities in Hainan over ten consecutive days from May 9 to May 18 between 10:30 to 11:30 every night. Briefly, the Blued App was employed to locate the central location of the target campus and identify the radius according to the size of the campus (ranging from 0.20 to 0.90 km). Then, detailed information on each software user, encompassing nickname, age, height, weight, gender role, and online status was recorded. Nicknames are unique in the Blued App. At the same time, we also gathered pertinent data regarding student numbers from the Hainan Statistical Yearbook 2022. Initially, data were collected from individual colleges, followed by integration into a comprehensive dataset. Subsequently, the dataset was scrutinized for potential errors or discrepancies. For quality control, data from 3128 MSM aged 18–24 were included, with significant outliers being excluded. Ultimately, 341 individuals were excluded due to anomalies such as prolonged inactivity, age discrepancies, being outside the capture range, and inaccurate personal information, to ensure the efficient processing of the survey data. To gain a deeper understanding of Blued App usage within the MSM population, a pertinent questionnaire survey was carried out to assess the reliability of utilizing Blued App in this study. Detailed information about the questionnaire survey is provided in the supplementary file. ( Supplementary File 1 ). The estimation of college MSM population size In this study, the capture-recapture method was employed to estimate the size of the college MSM population using two cross-sectional data sources. The first data source comprised information from individuals who logged into the Blued App on May 11, 2023 (Source 1), which included variables such as nickname, age, height, weight, gender role, and online status. The second data source was derived from individuals who logged into the Blued App on May 15, 2023 (Source 2). Utilizing the following formulas 1 and 2, the population size and the corresponding 95% confidence interval of college MSM were calculated ( 30 ). N =[(M + 1) (n + 1)/(m + 1)]-1 CI = N ± 1.96 \(\:\sqrt{Var\left(N\right)}\) (Var(N)=[(M + 1) (n + 1) (M-m) (n-m)]/[(m + 1) 2 (m + 2)]). Note N, crowd size; M, the number of online persons collected for the first time; n, the number of online persons collected for the second time; m, the number of first and second repeated marks; CI , Confidence interval of population size. The definition of the relevant indicators In this study, the users who were online for five or more days were defined as active users. The total number of male students enrolled in colleges in the same city of Hainan is summed, and the number of active users in this city is then divided by this total, and the ratio obtained indicates the online activity within the city. A secret user is someone whose online status is set to 'private' on Blued, making them unobservable for comparison. However, there were only 37 secret users in this study, so their impact on the results was minimal. Due to the uneven distribution of age groups, the population was divided into three categories: 18–19 years, 20–21 years, and 22–24 years. Furthermore, to examine the population characteristics, height and weight data were utilized to calculate Body Mass Index (BMI). The geographical characteristics and MSM population density analysis We performed a comprehensive analysis of the geographical characteristics associated with the estimated population data of MSM across all colleges in Hainan Province. Initially, the total number of college users of the Blued App within the same City was calculated. Subsequently, the 2S-CRC model was employed to estimate the population of MSM in these colleges. The MSM population density across colleges in various regions of Hainan Province was determined by dividing the estimated total MSM population by the number of male students enrolled in all colleges within the region. The MSM population density in colleges across different cities in Hainan Province was accurately mapped using ArcMap 10.8.1 to identify geographical hotspots. Statistical Analysis The dependent variable is a binary indicator of online activity status, where a value of 1 denotes online activity lasting five days or more, and a value of 0 signifies online activity lasting less than five days. The independent variables include age, BMI, college rank, university location, university classification, and university campus. Chi-square test was used in univariate analysis and binary logistic regression analysis was conducted in multivariate analysis using SPSS 27.0. The significance level is 0.05. A frequency analysis was carried out on the questionnaire survey to evaluate the usage of the Blued App among the MSM population in the specified context, thereby providing reliable scientific data. It also analyzed demographic information, sexual risk behaviors, and social media usage to explore an intervention mechanism for MSM at Hainan Colleges. Results The number and behavior dynamics of college Blued users in Hainan Province Considering that the usage of captured online college students would be affected by working days and non-working days, this study selected Thursday, May 11, and Monday, May 15, as the days for collecting active participants in the first and second captures to include in the formula calculation. The study found that, over the ten consecutive days, the average number of Blued App online and registered by college students were 939 and 1579, with 2.34% (37/1, 579) for the secret users. The total number of registered students was 3128, with a mean age of 22 years (IQR: 20–23), and 82.99% (2596/3128) are active users. The estimated size of the MSM population in colleges in Hainan Province is 3,130 (95%CI: 3025–3235), with 1833 (95%CI: 1754–1911) being active online and 1,465 (95%CI: 1361–1570) being offline. The hidden population size is 59 (95%CI: 53–64) (Table 1 ). Table 1 The number of MSM using the Blued App in colleges on Hainan Island, China (n) Users status Dates in 2023 Average Population size (95%CI) 9 May 10 May 11 May 12 May 13 May 14 May 15 May 16 May 17 May 18 May Online 897 900 937 913 905 959 955 992 993 941 939 1833(1754 ~ 1911) Offline 540 525 613 583 601 595 608 624 665 683 604 1465(1361 ~ 1570) Secret 34 34 40 34 35 33 44 37 38 36 37 59(53 ~ 64) Registrants 1471 1459 1590 1530 1541 1587 1607 1653 1696 1660 1579 3130(3025 ~ 3235) The estimation of MSM population size in individual colleges and universities in Hainan Province Among the 25 campuses in Hainan Province, the top five population sizes of students using the Blued App were: A1 with 275 (95%CI: 243–307), A6 with 207 (95%CI: 185–229), B2 with 145 (95%CI:129–162), A3 with 130 (95%CI:108–152), and A7 with 126 (95%CI: 90–161). The campuses with the highest proportions of MSM students among male students were A2 (6.67%, 59/884), followed by A3 (6.16%, 130/2099), A15 (5.55%, 53/955), and B1 (3.92%, 113/2870). ( Table 2 ) Table 2 The estimated population size of MSM using the Blued App in colleges on Hainan Island, China Colleges Colleges category Search radius (km) Registrants (n) First capture (n) Secondary capture(n) Recapture (n) Population size (95%CI) Sorting N (%) A 1 Comprehensive college 0.85 440 127 150 69 275(243–307) 1 1.60(275/17149) A 2 Comprehensive college 0.47 85 28 26 12 59(42–76) 10 6.67(59/884) D 1 Comprehensive college 0.70 50 20 21 11 38(28–47) 15 1.18(38/3230) A 3 Normal college 0.66 242 60 70 32 130(108–152) 4 6.19(130/2099) A 4 Normal college 0.78 201 52 58 28 107(88–125) 8 2.33(107/4598) A 5 Medical college 0.51 192 54 55 27 109(89–129) 7 1.56(109/6983) B 1 Polytechnic college 0.72 178 65 75 43 113(101–125) 6 3.94(113/2870) F 1 Polytechnic college 0.45 42 11 4 2 19( 8 – 30 ) 22 0.67(19/2850) A 6 Finance and economics college 0.87 302 120 109 63 207(185–229) 2 1.41(207/14638) A 7 Normal college 0.50 219 52 42 17 126(90–161) 5 3.72(126/3383) B 2 Comprehensive college 0.90 254 90 81 50 145(129–162) 3 1.21(145/12030) A 8 Comprehensive college 0.45 130 48 63 32 94(81–107) 9 0.74(94/12745) A 9 Comprehensive college 0.44 76 23 14 10 32( 25 – 39 ) 18 0.45(32/7039) B 3 Finance and economics college 0.28 18 7 7 4 12( 8 – 16 ) 24 1.97(12/609) C 1 Polytechnic college 0.55 75 25 25 15 41(34–49) 13 0.71(41/5758) A 10 Political college 0.51 66 22 19 11 37(28–46) 16 0.94(37/3954) E 1 Chinese college 0.50 53 16 18 10 28( 22 – 35 ) 21 1.75(28/1600) A 11 Finance and economics college 0.34 58 18 23 13 32( 26 – 37 ) 17 0.48(32/6645) A 12 Finance and economics college 0.42 72 13 15 6 31( 19 – 43 ) 19 0.41(31/7515) B 4 Polytechnic college 0.54 112 25 22 12 45(34–56) 12 1.42(45/3174) B 5 Polytechnic college 0.30 60 13 11 3 41(16–66) 14 0.87(41/4704) A 13 Sports college 0.43 77 9 11 3 29(12–46) 20 3.89(29/746) B 6 Finance and economics college 0.20 27 9 12 7 15( 12 – 18 ) 23 0.84(15/1782) A 14 Medical college 0.32 12 4 5 2 9( 5 – 13 ) 25 1.82(9/494) A 15 Medical college 0.35 87 26 19 9 53(35–71) 11 5.55(53/955) The influencing factors of online activity of the MSM population at Hainan colleges and universities Our findings revealed that the active user size has statistically significant associations ( P < 0.05) between age, college level, and various colleges, indicating their pivotal roles in shaping the online activity patterns of MSM in Hainan colleges. Notably, E City and D City, relatively small urban areas with limited Blued registrants, exhibited a high proportion of active users (42.22% and 41.30%). The multivariate binary logistic regression analysis identified that users aged 18–19 years (OR = 1.56, 95%CI: 1.271–1.915) and 20–21 years (OR = 1.561, 95%CI: 1.294–1.885) exhibited a higher likelihood of being active users than individuals aged 22–24 years. Additionally, the proportion of active users among MSM from undergraduate colleges was 1.808 times (95%CI: 1.408–2.321) greater than that among those from junior colleges. In terms of the colleges' category, the finance and economics colleges (41.10%, OR = 1.412, 95%CI: 1.097–1.816) had a higher proportion of active users than comprehensive universities. This characteristic indicates a heightened potential risk for the transmission of STDs, warranting further investigation and public health attention. (Table 3 ) Table 3 The determinants on the Blued App usage days of the MSM in Hainan colleges, China N(%) Influencing factor Total caseload Active population, N*(%) Chi-square test Multivariate logistic regression χ 2 P P aOR (95%CI) Age, years < 0.001 18–19 637 36.58(233/637) 72.799 <0.001 < 0.001 1.56(1.271–1.915) 20–21 858 38.11(327/858) < 0.001 1.561(1.294–1.885) 22–24 1101 27.25(300/1101) reference BMI level 761.796 0.264 - - Thinnish 465 36.56(170/465) Normal 1879 32.57(612/1879) Overweight 187 28.34(53/187) Obesity 65 38.46(25/65) Colleges level 12.905 <0.001 Undergraduate Colleges 1947 34.98(681/1947) < 0.001 1.808(1.408–2.321) Junior Colleges 649 27.58(179/649) reference City–county 14.012 0.016 0.06 A City 1868 32.28(603/1868) 0.01 3.749(1.366–10.29) B City 532 37.03(197/532) 0.005 4.013(1.52–10.595) C City 67 25.37(17/67) 0.014 4.049(1.334–12.291) D City 45 42.22(19/45) 0.006 5.086(1.606–16.101) E City 46 41.30(19/46) - - F City 38 13.16(5/38) reference Colleges category 47.112 <0.001 < 0.001 Financial Colleges 399 41.10(164/399) 0.007 1.412(1.097–1.816) Science and Engineering Colleges 390 31.79(124/390) 0.433 1.15(0.811–1.633) Normal Colleges 527 26.94(142/527) 0.001 0.653(0.512–0.834) Sports Colleges 55 9.09(5/55) 0.021 0.325(0.125–0.842) Medical Colleges 237 31.22(74/237) 0.986 1.003(0.731–1.375) Language and Literature Colleges 46 41.30(19/46) 0.001 8.176(2.484–26.912) Political Science and Law Colleges 59 33.90(20/59) 0.06 1.779(0.976–3.243) Comprehensive Universities 883 35.33(312/883) reference Colleges 37.031 <0.001 - - A 1 377 31.56(119/377) A 6 253 47.04(119/253) B 2 208 38.46(80/208) A 3 191 28.80(55/191) A 7 176 22.16(39/176) Other Colleges 1391 32.21(448/1391) Total 2596 33.13(860/2596) N* represents the proportion of users who engaged with the Blued software online for at least five days within the total caseload. The - represents that these variables were excluded using a stepwise selection method. The usage of Blued App in the Hainan MSM population In the current study, we conducted a questionnaire survey involving 181 MSM residing in Hainan regarding the usage of the Blued App. Out of the 181 participants, 164 individuals had utilized the Blued App (90.61%), with college students comprising 15.47% (28/181) of the total sample. Among the 28 student MSM, 21 (75%) participants possess a bachelor's degree or higher. Notably, 89.28% (25/28) of these students reported engaging with the Blued App. Of those who have utilized the app, 67.85% (19/28) have been doing so for a duration exceeding two years. Additionally, our research reveals that 57.14% (16/28) of these student MSM primarily use Blued for seeking sexual partners., while 50% (14/28) utilize it for social interaction (Table 4 ). Table 4 A survey on the usage of social media in student MSM Variables Proportion, N(%) Education Senior high school 14.28(4/28) Junior college 10.71(3/28) Bachelor's degree or above 75(21/28) The using dating apps (Multiple choice) Blued 89.28(25/28) Finka 50(14/28) Tiktok private message 42.85(12/28) Little Red Book private message 28.57(8/28) The duration of suing Blued App ≤ 6 months 17.86(5/28) 7–12 months 10.71(3/28) 2 years and above 67.86(19/28) The main purposes for useing Blued (Multiple choice) social communication and friends 50(14/28) Find sexual partners 67.86(19/28) Understand circle culture 7.14(2/28) No specific use 3.57(1/28) Geographical distribution of MSM population in colleges and universities in Hainan Province The results showed that the MSM population in colleges and universities in Hainan Province was mainly concentrated in A City, accounting for 72.22% (2259/3128), while B City ranked second with 20.75% (649/3128). The distribution of other cities was relatively scattered, with no notable patterns of aggregation established (Fig. 1A). We also found that the highest online activity was in E City at 1.21% (19/1600), followed by B City at 0.82% (208/25169), and A City at 0.74% (663/89827) (Fig. 1B). Discussion The MSM population exhibits a higher risk for STDs than the general population, including HIV, syphilis, hepatitis B virus, and other infections. Student MSM has also become a high-risk population for STDs in China ( 2 ). Understanding the size and distribution of the MSM population is crucial for effectively preventing AIDS and achieving the UNAIDS 95-95-95 targets by 2030 ( 31 ). The significance of this study lies in providing data to support more effective prevention and control of the spread of STDs among MSM by accurately estimating the size and distribution of the MSM population among male college students in Hainan. The estimated size of the students MSM in Hainan colleges and universities was 3128, with 1833 active users. The number of online active users in this study is higher than that of MSM active users in universities in Chengdu (1084), and the number of registered users in Chengdu is as high as 8401 ( 32 ). This difference may reflect the deviation between online behavior and actual registered users. However, the estimated MSM size of students in this study is significantly lower than the estimated range of male homosexuals in Fuzhou city (8506) and Tianjin city (5968–11935) ( 33 , 34 ). At present, similar studies are few in China and only focus on individual cities. Notably, this disparity may be attributed to the combined effects of Tianjin and Fuzhou's elevated socioeconomic status, expansive population bases, and concentrated academic infrastructures as major metropolitan hubs in China. In Hainan, the A City and B City were identified as hotspots. The primary factor contributing to A and B cities emergence as geographical hotspots is the concentration of universities in Hainan Province within these two cities. A comprehensive analysis suggests that this phenomenon may be associated with the region's level of economic development. Furthermore, economically developed metropolitan exhibit more active MSM communities, attributable to their superior network infrastructure and high levels of Internet penetration. This pattern is consistent with the geographic distribution characteristics of the MSM population in mainland China, where economically developed regions tend to have a more dispersed MSM population ( 35 ). Thus, the economic development level might be an important factor in the distribution of social networking MSM. There exists considerable heterogeneity across campuses in Hainan Province regarding the utilization of the Blued App. Notably, the estimated number of Blued App users, and the proportion of active users among student users, were notably high at the hotspot campuses of A1, A6, and B2. The significant proportion of Blued users at the A1, A6, and B2 campuses can be attributed primarily to a substantial enrollment of male students during the survey period. Long-term, comprehensive, and effective prevention interventions for STDs should be considered for these hot campuses. For example, lectures about HIV can be introduced in hot campuses, knowledge competitions related to STDs can be held, and benefits can be given to students to get more people involved. The current study revealed that the proportion of Blued App users among male college students ranged from 0.44–6.67%, which is lower than the 3.7–8.5% reported in a previous study ( 36 ). Our results indicated that a significant proportion of MSM students in Hainan colleges actively utilize the Blued App, predominantly for social interaction and seeking sexual partners. These results aligned with previous studies conducted in China ( 12 ). In modern society, digital communication technologies, encompassing social media platforms and the Internet, have emerged as the predominant channels for MSM to facilitate social interactions and seek partners. These platforms expedite the establishment of social connections and the identification of sexual partners, potentially increasing the risk of HIV transmission ( 37 , 38 ). Furthermore, these tools offer significant potential for identifying high-risk populations and improving risk surveillance. Prior studies have demonstrated that the strategic use of social media can substantially increase the detection rate of HIV infections among MSM in Chinese colleges, thereby reducing sexual risk behaviors ( 39 ). Moreover, a comprehensive management framework delivered via the Internet, which integrates HIV prevention, treatment, and associated technologies, has proven effective in reducing HIV incidence among MSM populations ( 40 – 42 ). Previous research has highlighted the importance of software such as Blued in conjunction with Internet data sources to provide and deliver health knowledge. For example, this model could be used to push information about the correct use of condoms to people with suspicious high-risk behavior labels ( 43 ). Additionally, considering that MSM frequently encounters discrimination and marginalization within social networks—obstacles that impede access to HIV and syphilis testing and treatment—leveraging the influence of key individuals within these networks may serve as an effective strategy to mitigate stigma and prejudice ( 44 ). Limitations : This study employed the capture-recapture method to estimate the size of the college student MSM population, which inherently assumes a closed population. However, the inherent mobility of MSM individuals during the data collection period may violate this assumption, representing a limitation. To address this, we implemented three key strategies: ( 1 ) the college student population is relatively stable, ( 2 ) the surveys exclusively wre conducted on weekdays to minimize transient population effects, and ( 3 ) the data collection was completed within a condensed timeframe to reduce exposure to migration influences. Additionally, while Blued App is a widely used platform among MSM in Chinese colleges, not all MSM individuals use this platform, potentially leading to an underestimation of the MSM population size. Lastly, some MSM individuals maintain multiple Blued App accounts simultaneously, which could result in double counting and consequently overestimate the size of the MSM population. Conclusion Our findings indicate that a substantial proportion of the MSM population in Hainan colleges are users of the Blued App, exhibiting significant online engagement. The primary motivation for utilizing the Blued App is to engage in social interactions and seek sexual partners. Notably, the MSM population is particularly large on campuses such as A1, A6, and B2. Conversely, campuses like A2, A13, and A15 demonstrate elevated levels of online activity. This research highlights the critical role of leveraging network platforms to accurately identify high-risk areas, which is essential for optimizing resource allocation and developing targeted intervention strategies. Abbreviations App: Geosocial networking smartphone application; MSM: Men who have sex with men; N (%): Represents the percentage of male students enrolled at the Hainan college campus; χ 2 : represents the results of the chi-square test, reflecting the relevance of the categorical variables; P: Significance; aOR: The strength of the association between the studied independent variable and the dependent variable after controlling for other potentially confounding variables. Declarations Authors' Contributions Dee Yu was the lead designer and overseer of the project, securing funding, providing supervision, and validating the research. Donghui Zhao was conceptualizing the study and the design. Shi Chen gathered data, drafted the initial manuscript, and conducted the statistical analysis. Xin Chen revised and reviewed the manuscript. All authors assisted with both the research and manuscript preparation. Fundings This study was supported by the Hainan Provincial Natural Science Foundation of China (824RC519), the Joint Program on Health Science and Technology Innovation of Hainan Province [WSJK2024MS155], and the Student Innovation and Entrepreneurship project of Hainan Medical University [X202411810113]. Competing interests The authors declare that they have no competing interests. Ethics approval and consent to participate This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and received approval from the Ethical Committee of Hainan Medical University, Hainan, China (HYLL-2024-838). All participants provided informed consent prior to their inclusion in the study, and their privacy and data security were strictly maintained throughout the research process. Clinical trial number Not applicable. Availability of data and materials As personal information is involved, it is not convenient to disclose the entire data. The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. References Dong MJ, Peng B, Liu ZF, Ye QN, Liu H, Lu XL, et al. The prevalence of HIV among MSM in China: a large-scale systematic analysis. BMC Infect Dis. 2019;19(1):1000. Li Y, Xu J, Reilly KH, Zhang J, Wei H, Jiang Y, et al. Prevalence of HIV and syphilis infection among high school and college student MSM in China: a systematic review and meta-analysis. PLoS ONE. 2013;8(7):e69137. Li M, Wu H, Yan H, Zunong J, Hui H, Li H, et al. HIV-Positive Men Are More Likely to Be Hyper Linked Within College Student Social Network - Northeast China, 2017–2018. China CDC Wkly. 2022;4(43):951–5. Yang Z, Huang Z, Dong Z, Zhang S, Han J, Jin M. Prevalence of high-risky behaviors in transmission of HIV among high school and college student MSM in China: a meta-analysis. BMC Public Health. 2015;15:1272. Zhao H, Li X, Wang J, Wang W, Yang C, Li J, et al. A systematic and meta-analysis of heterosexual behaviors and HIV prevalence among Chinese men who have sex with men. AIDS Res Ther. 2021;18(1):68. Rosenberg ES, Grey JA, Sanchez TH, Sullivan PS. Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012–2013. JMIR Public Health Surveill. 2016;2(1):e22. Grey JA, Bernstein KT, Sullivan PS, Purcell DW, Chesson HW, Gift TL, et al. Estimating the Population Sizes of Men Who Have Sex With Men in US States and Counties Using Data From the American Community Survey. JMIR Public Health Surveill. 2016;2(1):e14. Assi A, Abu Zaki S, Ghosn J, Kinge N, Naous J, Ghanem A, et al. Prevalence of HIV and other sexually transmitted infections and their association with sexual practices and substance use among 2238 MSM in Lebanon. Sci Rep. 2019;9(1):15142. Beyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367–77. Sullivan PS, Carballo-Diéguez A, Coates T, Goodreau SM, McGowan I, Sanders EJ, et al. Successes and challenges of HIV prevention in men who have sex with men. Lancet. 2012;380(9839):388–99. Wang L, Podson D, Chen Z, Lu H, Wang V, Shepard C, Williams JK, Mi G. Using Social Media To Increase HIV Testing Among Men Who Have Sex with Men - Beijing, China, 2013–2017. MMWR Morb Mortal Wkly Rep. 2019;68(21):478–82. Fan S, Li P, Hu Y, Gong H, Yu M, Ding Y, et al. Geosocial Networking Smartphone App Use and High-Risk Sexual Behaviors Among Men Who Have Sex With Men Attending University in China: Cross-sectional Study. JMIR Public Health Surveill. 2022;8(3):e31033. Zhao T, Chen G, Sun C, Gong X, Li H, Fu G. The epidemic of HIV and syphilis and the correlation with substance abuse among men who have sex with men in China: A systematic review and meta-analysis. Front Public Health. 2023;11:1082637. Scholz SM, Damm O, Elkenkamp S, Marcus U, Greiner W, Schmidt AJ. Population size and self-reported characteristics and sexual preferences of men-who-have-sex-with-men (MSM) in Germany based on social network data. PLoS ONE. 2019;14(2):e0212175. Rosenbaum JE, Jennings J, Ellen JM, Borkovic LM, Scott JA, Wylie C, et al. Giving syphilis and gonorrhea to friends: using in-person friendship networks to find additional cases of gonorrhea and syphilis. BMC Public Health. 2020;20(1):1526. Guo Z, Feng A, Zhou Y, Gao Y, Sun Y, Chen Y, et al. Geosocial networking mobile applications use and HIV and other sexually transmitted infections among men who have sex with men in Southern China: A cross-sectional study. Front Public Health. 2023;11:1063993. Hong H, Xu J, McGoogan J, Dong H, Xu G, Wu Z. Relationship between the use of gay mobile phone applications and HIV infection among men who have sex with men in Ningbo, China: a cross-sectional study. Int J STD AIDS. 2018;29(5):491–7. Kirby T, Thornber-Dunwell M. Phone apps could help promote sexual health in MSM. Lancet. 2014;384(9952):1415. Wang S. Chinese affective platform economies: dating, live streaming, and performative labor on Blued. Media Cult Soc. 2020;42(4):502–20. Zheng ZW, Yang QL, Liu ZQ, Qiu JL, Gu J, Hao YT, et al. Associations Between Affective States and Sexual and Health Status Among Men Who Have Sex With Men in China: Exploratory Study Using Social Media Data. J Med Internet Res. 2020;22(1):e13201. Yang G, Long J, Luo D, Xiao S, Kaminga AC. The Characteristics and Quality of Mobile Phone Apps Targeted at Men Who Have Sex With Men in China: A Window of Opportunity for Health Information Dissemination? JMIR Mhealth Uhealth. 2019;7(3):e12573. Cao B, Liu C, Stein G, Tang W, Best J, Zhang Y, et al. Faster and Riskier? Online Context of Sex Seeking Among Men Who Have Sex With Men in China. Sex Transm Dis. 2017;44(4):239–44. Jing L, Cui Y, Lu Q, Yu H. Multiplier method estimates of the population of men who have sex with men: the effect of privacy protection. J Public Health (Oxf). 2020;42(2):429–34. Yan X, Lu Z, Zhang B, Li Y, Tang W, Zhang L, et al. Protecting Men Who Have Sex With Men From HIV Infection With an mHealth App for Partner Notification: Observational Study. JMIR Mhealth Uhealth. 2020;8(2):e14457. Wei L, Chen L, Zhang H, Yang Z, Zou H, et al. Use of gay app and the associated HIV/syphilis risk among non-commercial men who have sex with men in Shenzhen, China: a serial cross-sectional study. Sex Transm Infect. 2019;95(7):496–504. Zeng XM, Wang ZQ, Zhang F, Zheng Y. Epidemiological characteristics and risk factors of HIV/AIDS among young students in Hainan province. Chin J Health Educ. 2021;37(06):06–0492. Tuyishime E, Kayitesi C, Musengimana G, Malamba S, Moges H, Kankindi I, et al. Population Size Estimation of Men Who Have Sex With Men in Rwanda: Three-Source Capture-Recapture Method. JMIR Public Health Surveillance. 2023;9:e43114. Des Jarlais D, Khue PM, Feelemyer J, Arasteh K, Thi Huong D, Thi Hai Oanh K, et al. Using dual capture/recapture studies to estimate the population size of persons who inject drugs (PWID) in the city of Hai Phong, Vietnam. Drug Alcohol Depend. 2018;185:106–11. Braeye T, Verheagen J, Mignon A, Flipse W, Pierard D, Huygen K, et al. Capture-Recapture Estimators in Epidemiology with Applications to Pertussis and Pneumococcal Invasive Disease Surveillance. PLoS ONE. 2016;11(8):e0159832. Zhang Y, Ge L, Waller LA, Shah S, Lyles RH. A capture-recapture modeling framework emphasizing expert opinion in disease surveillance. Stat Methods Med Res. 2024;33(7):1197–210. UNAIDS. Fast track: ending the AIDS epidemic by 2030. Geneva: UNAIDS; 2014. Dai Z, He QY, Wang XD, et al. Estimating the size of the MSM population among college students in Chengdu using social networking applications. Chin J Health Stat. 2022;39(05):752–4. He DS, Zhang H, Xu SY, et al. Online estimation of the MSM population size among college students in Fuzhou based on capture-recapture method. Bull Disease Control Prev. 2024;39(01):1–4. Gong H, Yu MH, Zhou N, et al. Current status of MSM social networking application usage and population size estimation among college students in Tianjin. Chin J AIDS STD. 2017;23(02):129–31. Hu M, Xu C, Wang J. Spatiotemporal Analysis of Men Who Have Sex With Men in Mainland China: Social App Capture-Recapture Method. JMIR Mhealth Uhealth. 2020;8(1):e14800. Xie L, Mo PKH, Wang Z, Tian X, Lau JTF. Men who have sex with men were more depressed than their counterparts because of lower social support and higher loneliness: A comparative survey among Chinese university students. J Affect Disord. 2024;353:11–8. Cao B, Gupta S, Wang J, Hightow-Weidman LB, Muessig KE, Tang W, et al. Social Media Interventions to Promote HIV Testing, Linkage, Adherence, and Retention: Systematic Review and Meta-Analysis. J Med Internet Res. 2017;19(11):e394. Veronese V, Ryan KE, Hughes C, Lim MS, Pedrana A, Stoove M. Using Digital Communication Technology to Increase HIV Testing Among Men Who Have Sex With Men and Transgender Women: Systematic Review and Meta-Analysis. J Med Internet Res. 2020;22(7):e14230. Luo Q, Wu Z, Mi G, Xu J, Scott SR. Using HIV Risk Self-Assessment Tools to Increase HIV Testing in Men Who Have Sex With Men in Beijing, China: App-Based Randomized Controlled Trial. J Med Internet Res. 2023;25:e45262. Cao B, Liu C, Durvasula M, Tang W, Pan S, Saffer AJ, et al. Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey. J Med Internet Res. 2017;19(7):e251. Mi GD, Zhang BB, Yu F, Ren XL, Ong JJ, Fan YQ, et al. HIV incidence among men who have sex with men using geosocial networking smartphone application in Beijing, China: an open cohort study. Infect Dis Poverty. 2021;10(1):27. Yan X, Su H, Zhang B, Li Y, Zhang L, Jia Z. Adherence of HIV Self-Testing Among Men Who Have Sex With Men in China: Longitudinal Study. J Med Internet Res. 2020;22(9):e19627. Jia Z, Yan X, Li Y, Ma J. Internet Data for Improving Prevention and Control of Global Infectious Diseases. China CDC Wkly. 2020;2(52):1009–12. Wu D, Tang W, Lu H, Zhang TP, Cao B, Ong JJ, et al. Leading by Example: Web-Based Sexual Health Influencers Among Men Who Have Sex With Men Have Higher HIV and Syphilis Testing Rates in China. J Med Internet Res. 2019;21(1):e10171. Additional Declarations No competing interests reported. Supplementary Files Supplementaryfile1.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5940102","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":443892313,"identity":"783700b3-dc6c-4efe-b265-b7ba7abfb20c","order_by":0,"name":"Shi Chen","email":"","orcid":"","institution":"School of Public Health, Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University.","correspondingAuthor":false,"prefix":"","firstName":"Shi","middleName":"","lastName":"Chen","suffix":""},{"id":443892314,"identity":"4f117f66-e579-45d7-a061-873408ebea54","order_by":1,"name":"Xin 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06:08:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5940102/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5940102/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":80844864,"identity":"6a0e3dc9-935b-4ec2-b61e-a3fd91c78f8b","added_by":"auto","created_at":"2025-04-17 16:56:00","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":506629,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5940102/v1/0a977f9c1c286d4cc7ad410f.png"},{"id":85950529,"identity":"f1793eac-e136-43e0-933a-c11536594b65","added_by":"auto","created_at":"2025-07-03 13:47:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2003466,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5940102/v1/b16ba5f1-eab9-4947-8293-4ab19354f877.pdf"},{"id":80845759,"identity":"06f8dc13-4564-4aea-9aec-e8601647268c","added_by":"auto","created_at":"2025-04-17 17:12:00","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":18545,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementaryfile1.docx","url":"https://assets-eu.researchsquare.com/files/rs-5940102/v1/773d823eefc60e948bf7ea0a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Population size estimation of men who have sex with men in Hainan colleges based on geosocial networking App, South China","fulltext":[{"header":"Background","content":"\u003cp\u003eThe role of men who have sex with men (MSM) in the sexually transmitted diseases (STDs) epidemic is considerable. In China, the national prevalence of HIV among MSM from 2001 to 2018 was estimated to be 5.7% (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The prevalences of HIV and syphilis among student MSM were 4.4% and 5.7%, respectively (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). A comprehensive study of male college students throughout Northeast China identified an HIV-positive prevalence of 3.8% and an incidence rate of 2.9 per 100 person-years among college MSM (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Additionally, a meta-analysis reported that the HIV prevalence among MSM in high schools and colleges across China was 3.8% (95%CI: 2.5%-5.1%) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Moreover, the prevalence of HIV among MSM who had heterosexual sex was significantly higher, at 9% (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). In the United States, MSM comprised 53% and 67% of new HIV cases in 2006 and 2014, respectively (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Additionally, France reported over 40% of HIV-positive MSM cases among those living with HIV from 2015 to 2018 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Globally, MSM are experiencing an escalating risk of HIV infection, with the number of cases rising (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Furthermore, the death rate among MSM is much higher (8%) (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). The HIV epidemic among Chinese college students has worsened due to technological advancements (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe utilization of online platforms and social media may elevate the risk of STDs by facilitating the search for sexual partners (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In Germany, MSM represented 45.6% of users on online dating and social networking platforms (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). In the USA, Rosenbaum et al. demonstrated that mobile social apps can facilitate the spread of syphilis and gonorrhea (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In South China, Guo reported that 63.8% of MSM utilized social software to seek sexual partners, emphasizing the geosocial app's significance in MSM communities (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Song's study showed that 53.7% of MSM reported having used gay apps to find sexual partners (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Additionally, those studies accurately estimated the number of HIV-infected MSM in China by aggregating multiple data sources, such as the Internet and social software. Hong et al. reported an HIV prevalence of 7.9% among gay app users and demonstrated that HIV infection was significantly associated with app users (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). A behavior associated with higher-risk sexual practices and potential HIV infections, attributed to the rapid growth of internet technology (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe Blued, a leading MSM mobile geosocial network App in China (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), facilitates healthy gay relationships and HIV prevention, such as \"Internet\u0026thinsp;+\u0026thinsp;HIV\" models (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Users create profiles with photos and details. Internet and mobile apps revolutionize MSM dating, introducing discreet platforms (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Online partner search is simplified, with real-time anonymity reducing stigma (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). According to a survey results, 98.2% of MSM in China have used gay apps at some point in their lives, with Blued being the most popular (97.5% penetration rate). This is far higher than the penetration rate of other platforms like Finka (18.4%), making Blued about 5.3 times more prevalent than other single platforms (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). However, the lack of comprehensive data in China presents significant challenges to the development and implementation of effective STDs prevention strategies. The utilization of big data derived from social media platforms may offer a solution to this challenge, as technological advancements transform the socialization and partner-seeking behaviors of MSM.\u003c/p\u003e \u003cp\u003eHainan Province, located in the southernmost region of China, is a key tourism and population hub near Southeast Asia. Between 2011 and 2019, young students in Hainan Province accounted for 5.99% of the annual HIV/AIDS cases. Notably, 91.38% of HIV-positive male students in higher education institutions acquired HIV through homosexual contact (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). As a tourism province, Hainan has high population mobility and complex temporary social networks, which may exacerbate the anonymous sexual behavior of MSM groups. This trend indicated a potential uncontrolled transmission of HIV among college MSM students in Hainan. Accurately estimating the size of the MSM population within colleges is essential for calculating the incidence of STDs in this group. However, the scarcity of comprehensive studies focusing on MSM among college students in Hainan Province hinders our ability to thoroughly understand and effectively address the prevalence of STDs in this demographic. To address STDs transmission among MSM in Hainan colleges, we assessed the risks by analyzing MSM numbers, distribution, and behavior through Blued App to improve disease control.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy colleges and universities\u003c/h2\u003e \u003cp\u003eIn Hainan Province, a total of 21 colleges and universities with 25 campuses, are enrolling students in 2023. These higher education institutions include 8 undergraduate colleges and 13 junior colleges, with disciplines spanning financial colleges (five), science and engineering colleges (four), comprehensive universities (four), medicine colleges (three), normal colleges (two), language and literature colleges (one), political science and law colleges (one), and sports colleges (one). The geographical distribution of the 25 campuses is as follows: 15 are located in A City, six in B City, and one each in D, F, C, and E City.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eCapture-recapture methods\u003c/h3\u003e\n\u003cp\u003eRecently, the capture-recapture (CRC) method, including two-source CRC (2S-CRC) and three-source CRC (3S-CRC), has been used in many countries to estimate the sizes of hard-to-reach populations, such as MSM and people who inject drugs (PWID) (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). This method addresses the under-reporting of cases by utilizing recapture information, specifically the intersection or overlap of sources, to estimate the number of unreported cases under appropriate assumptions (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Briefly, the estimation process is predicated on the observation or \"capture\" of individuals within a population across two separate occasions. During the initial capture event, individuals are assigned a unique identifier or \"mark.\" In the subsequent capture, referred to as \"recapture,\" both marked and unmarked individuals are enumerated. The data collected, particularly the number of marks distributed during the first capture and the counts of marked and unmarked individuals during the recapture, are employed to estimate the total population size.\u003c/p\u003e\n\u003ch3\u003eData collection and management\u003c/h3\u003e\n\u003cp\u003eThis study employed Blued App to examine MSM students across all colleges and universities in Hainan Province. ArcGIS 10.8.1 was utilized to produce density distribution maps of MSM populations at colleges and universities across various institutions in Hainan. These maps were correlated with the active usage of the Blued App to examine the impact of MSM populations in colleges and universities across different regions.\u003c/p\u003e \u003cp\u003eIn 2023, we collected data on Blued online users across colleges and universities in Hainan over ten consecutive days from May 9 to May 18 between 10:30 to 11:30 every night. Briefly, the Blued App was employed to locate the central location of the target campus and identify the radius according to the size of the campus (ranging from 0.20 to 0.90 km). Then, detailed information on each software user, encompassing nickname, age, height, weight, gender role, and online status was recorded. Nicknames are unique in the Blued App. At the same time, we also gathered pertinent data regarding student numbers from the Hainan Statistical Yearbook 2022.\u003c/p\u003e \u003cp\u003eInitially, data were collected from individual colleges, followed by integration into a comprehensive dataset. Subsequently, the dataset was scrutinized for potential errors or discrepancies. For quality control, data from 3128 MSM aged 18\u0026ndash;24 were included, with significant outliers being excluded. Ultimately, 341 individuals were excluded due to anomalies such as prolonged inactivity, age discrepancies, being outside the capture range, and inaccurate personal information, to ensure the efficient processing of the survey data. To gain a deeper understanding of Blued App usage within the MSM population, a pertinent questionnaire survey was carried out to assess the reliability of utilizing Blued App in this study. Detailed information about the questionnaire survey is provided in the supplementary file. (\u003cb\u003eSupplementary File 1\u003c/b\u003e).\u003c/p\u003e\n\u003ch3\u003eThe estimation of college MSM population size\u003c/h3\u003e\n\u003cp\u003eIn this study, the capture-recapture method was employed to estimate the size of the college MSM population using two cross-sectional data sources. The first data source comprised information from individuals who logged into the Blued App on May 11, 2023 (Source 1), which included variables such as nickname, age, height, weight, gender role, and online status. The second data source was derived from individuals who logged into the Blued App on May 15, 2023 (Source 2). Utilizing the following formulas 1 and 2, the population size and the corresponding 95% confidence interval of college MSM were calculated (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eN =[(M\u0026thinsp;+\u0026thinsp;1) (n\u0026thinsp;+\u0026thinsp;1)/(m\u0026thinsp;+\u0026thinsp;1)]-1\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cem\u003eCI\u003c/em\u003e\u0026thinsp;=\u0026thinsp;N\u0026thinsp;\u0026plusmn;\u0026thinsp;1.96\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\sqrt{Var\\left(N\\right)}\\)\u003c/span\u003e\u003c/span\u003e (Var(N)=[(M\u0026thinsp;+\u0026thinsp;1) (n\u0026thinsp;+\u0026thinsp;1) (M-m) (n-m)]/[(m\u0026thinsp;+\u0026thinsp;1)\u003csup\u003e2\u003c/sup\u003e(m\u0026thinsp;+\u0026thinsp;2)]).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eNote\u003c/strong\u003e \u003cp\u003eN, crowd size; M, the number of online persons collected for the first time; n, the number of online persons collected for the second time; m, the number of first and second repeated marks; \u003cem\u003eCI\u003c/em\u003e, Confidence interval of population size.\u003c/p\u003e \u003c/p\u003e\n\u003ch3\u003eThe definition of the relevant indicators\u003c/h3\u003e\n\u003cp\u003eIn this study, the users who were online for five or more days were defined as active users. The total number of male students enrolled in colleges in the same city of Hainan is summed, and the number of active users in this city is then divided by this total, and the ratio obtained indicates the online activity within the city.\u003c/p\u003e \u003cp\u003eA secret user is someone whose online status is set to 'private' on Blued, making them unobservable for comparison. However, there were only 37 secret users in this study, so their impact on the results was minimal.\u003c/p\u003e \u003cp\u003eDue to the uneven distribution of age groups, the population was divided into three categories: 18\u0026ndash;19 years, 20\u0026ndash;21 years, and 22\u0026ndash;24 years. Furthermore, to examine the population characteristics, height and weight data were utilized to calculate Body Mass Index (BMI).\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eThe geographical characteristics and MSM population density analysis\u003c/h2\u003e \u003cp\u003eWe performed a comprehensive analysis of the geographical characteristics associated with the estimated population data of MSM across all colleges in Hainan Province. Initially, the total number of college users of the Blued App within the same City was calculated. Subsequently, the 2S-CRC model was employed to estimate the population of MSM in these colleges. The MSM population density across colleges in various regions of Hainan Province was determined by dividing the estimated total MSM population by the number of male students enrolled in all colleges within the region. The MSM population density in colleges across different cities in Hainan Province was accurately mapped using ArcMap 10.8.1 to identify geographical hotspots.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eThe dependent variable is a binary indicator of online activity status, where a value of 1 denotes online activity lasting five days or more, and a value of 0 signifies online activity lasting less than five days. The independent variables include age, BMI, college rank, university location, university classification, and university campus. Chi-square test was used in univariate analysis and binary logistic regression analysis was conducted in multivariate analysis using SPSS 27.0. The significance level is 0.05. A frequency analysis was carried out on the questionnaire survey to evaluate the usage of the Blued App among the MSM population in the specified context, thereby providing reliable scientific data. It also analyzed demographic information, sexual risk behaviors, and social media usage to explore an intervention mechanism for MSM at Hainan Colleges.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eThe number and behavior dynamics of college Blued users in Hainan Province\u003c/h2\u003e \u003cp\u003eConsidering that the usage of captured online college students would be affected by working days and non-working days, this study selected Thursday, May 11, and Monday, May 15, as the days for collecting active participants in the first and second captures to include in the formula calculation. The study found that, over the ten consecutive days, the average number of Blued App online and registered by college students were 939 and 1579, with 2.34% (37/1, 579) for the secret users. The total number of registered students was 3128, with a mean age of 22 years (IQR: 20\u0026ndash;23), and 82.99% (2596/3128) are active users. The estimated size of the MSM population in colleges in Hainan Province is 3,130 (95%CI: 3025\u0026ndash;3235), with 1833 (95%CI: 1754\u0026ndash;1911) being active online and 1,465 (95%CI: 1361\u0026ndash;1570) being offline. The hidden population size is 59 (95%CI: 53\u0026ndash;64) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe number of MSM using the Blued App in colleges on Hainan Island, China (n)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eUsers status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"10\" nameend=\"c11\" namest=\"c2\"\u003e \u003cp\u003eDates in 2023\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePopulation size (95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e16 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e17 May\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e18 May\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e897\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e900\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e937\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e913\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e905\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e959\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e955\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e992\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e993\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e941\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e939\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1833(1754\u0026thinsp;~\u0026thinsp;1911)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOffline\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e540\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e525\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e583\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e601\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e595\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e624\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e665\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e604\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1465(1361\u0026thinsp;~\u0026thinsp;1570)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecret\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e59(53\u0026thinsp;~\u0026thinsp;64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRegistrants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1471\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1459\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1590\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1530\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1541\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1587\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1607\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1653\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1696\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1660\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e1579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e3130(3025\u0026thinsp;~\u0026thinsp;3235)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eThe estimation of MSM population size in individual colleges and universities in Hainan Province\u003c/h2\u003e \u003cp\u003eAmong the 25 campuses in Hainan Province, the top five population sizes of students using the Blued App were: A1 with 275 (95%CI: 243\u0026ndash;307), A6 with 207 (95%CI: 185\u0026ndash;229), B2 with 145 (95%CI:129\u0026ndash;162), A3 with 130 (95%CI:108\u0026ndash;152), and A7 with 126 (95%CI: 90\u0026ndash;161). The campuses with the highest proportions of MSM students among male students were A2 (6.67%, 59/884), followed by A3 (6.16%, 130/2099), A15 (5.55%, 53/955), and B1 (3.92%, 113/2870). \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe estimated population size of MSM using the Blued App in colleges on Hainan Island, China\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eColleges\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eColleges category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSearch radius (km)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRegistrants (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFirst capture (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSecondary capture(n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eRecapture (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePopulation size (95%CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSorting\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e440\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e275(243\u0026ndash;307)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.60(275/17149)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e59(42\u0026ndash;76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.67(59/884)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eD 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e38(28\u0026ndash;47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.18(38/3230)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e130(108\u0026ndash;152)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.19(130/2099)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e107(88\u0026ndash;125)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e2.33(107/4598)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e109(89\u0026ndash;129)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.56(109/6983)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolytechnic college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e113(101\u0026ndash;125)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.94(113/2870)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolytechnic college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e19(\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13 CR14 CR15 CR16 CR17 CR18 CR19 CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.67(19/2850)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinance and economics college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e302\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e207(185\u0026ndash;229)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.41(207/14638)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e126(90\u0026ndash;161)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.72(126/3383)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e254\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e145(129\u0026ndash;162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.21(145/12030)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e94(81\u0026ndash;107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.74(94/12745)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e32(\u003cspan additionalcitationids=\"CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.45(32/7039)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinance and economics college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e12(\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12 CR13 CR14 CR15\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.97(12/609)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolytechnic college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e41(34\u0026ndash;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.71(41/5758)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolitical college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e37(28\u0026ndash;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.94(37/3954)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eE 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eChinese college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e28(\u003cspan additionalcitationids=\"CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.75(28/1600)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinance and economics college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e32(\u003cspan additionalcitationids=\"CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.48(32/6645)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinance and economics college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e31(\u003cspan additionalcitationids=\"CR20 CR21 CR22 CR23 CR24 CR25 CR26 CR27 CR28 CR29 CR30 CR31 CR32 CR33 CR34 CR35 CR36 CR37 CR38 CR39 CR40 CR41 CR42\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.41(31/7515)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolytechnic college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e45(34\u0026ndash;56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.42(45/3174)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB 5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolytechnic college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e41(16\u0026ndash;66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.87(41/4704)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSports college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e29(12\u0026ndash;46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.89(29/746)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eB 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinance and economics college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e15(\u003cspan additionalcitationids=\"CR13 CR14 CR15 CR16 CR17\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.84(15/1782)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e9(\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9 CR10 CR11 CR12\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.82(9/494)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA 15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e53(35\u0026ndash;71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e5.55(53/955)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eThe influencing factors of online activity of the MSM population at Hainan colleges and universities\u003c/h2\u003e \u003cp\u003eOur findings revealed that the active user size has statistically significant associations (\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05) between age, college level, and various colleges, indicating their pivotal roles in shaping the online activity patterns of MSM in Hainan colleges. Notably, E City and D City, relatively small urban areas with limited Blued registrants, exhibited a high proportion of active users (42.22% and 41.30%). The multivariate binary logistic regression analysis identified that users aged 18\u0026ndash;19 years (OR\u0026thinsp;=\u0026thinsp;1.56, 95%CI: 1.271\u0026ndash;1.915) and 20\u0026ndash;21 years (OR\u0026thinsp;=\u0026thinsp;1.561, 95%CI: 1.294\u0026ndash;1.885) exhibited a higher likelihood of being active users than individuals aged 22\u0026ndash;24 years. Additionally, the proportion of active users among MSM from undergraduate colleges was 1.808 times (95%CI: 1.408\u0026ndash;2.321) greater than that among those from junior colleges. In terms of the colleges' category, the finance and economics colleges (41.10%, OR\u0026thinsp;=\u0026thinsp;1.412, 95%CI: 1.097\u0026ndash;1.816) had a higher proportion of active users than comprehensive universities. This characteristic indicates a heightened potential risk for the transmission of STDs, warranting further investigation and public health attention. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe determinants on the Blued App usage days of the MSM in Hainan colleges, China N(%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eInfluencing factor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal caseload\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eActive population, N*(%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eChi-square test\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eMultivariate logistic regression\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eaOR (95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge, years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.58(233/637)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e72.799\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.56(1.271\u0026ndash;1.915)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38.11(327/858)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.561(1.294\u0026ndash;1.885)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22\u0026ndash;24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.25(300/1101)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ereference\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBMI level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e761.796\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.264\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThinnish\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e465\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.56(170/465)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1879\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.57(612/1879)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.34(53/187)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eObesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38.46(25/65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eColleges level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.905\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndergraduate Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1947\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.98(681/1947)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.808(1.408\u0026ndash;2.321)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJunior Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e649\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.58(179/649)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ereference\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCity\u0026ndash;county\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA City\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1868\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.28(603/1868)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.749(1.366\u0026ndash;10.29)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB City\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e532\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.03(197/532)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4.013(1.52\u0026ndash;10.595)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eC City\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.37(17/67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4.049(1.334\u0026ndash;12.291)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eD City\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.22(19/45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.086(1.606\u0026ndash;16.101)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eE City\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.30(19/46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF City\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.16(5/38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ereference\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eColleges category\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinancial Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e399\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.10(164/399)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.412(1.097\u0026ndash;1.816)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eScience and Engineering Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.79(124/390)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.15(0.811\u0026ndash;1.633)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e527\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.94(142/527)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.653(0.512\u0026ndash;0.834)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSports Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.09(5/55)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.325(0.125\u0026ndash;0.842)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e237\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.22(74/237)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.986\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.003(0.731\u0026ndash;1.375)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLanguage and Literature Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.30(19/46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8.176(2.484\u0026ndash;26.912)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePolitical Science and Law Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.90(20/59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.779(0.976\u0026ndash;3.243)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eComprehensive Universities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e883\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.33(312/883)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003ereference\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eColleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA 1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.56(119/377)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e47.04(119/253)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB 2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38.46(80/208)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA 3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.80(55/191)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA 7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.16(39/176)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther Colleges\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1391\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.21(448/1391)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2596\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.13(860/2596)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eN* represents the proportion of users who engaged with the Blued software online for at least five days within the total caseload.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eThe - represents that these variables were excluded using a stepwise selection method.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eThe usage of Blued App in the Hainan MSM population\u003c/h2\u003e \u003cp\u003eIn the current study, we conducted a questionnaire survey involving 181 MSM residing in Hainan regarding the usage of the Blued App. Out of the 181 participants, 164 individuals had utilized the Blued App (90.61%), with college students comprising 15.47% (28/181) of the total sample. Among the 28 student MSM, 21 (75%) participants possess a bachelor's degree or higher. Notably, 89.28% (25/28) of these students reported engaging with the Blued App. Of those who have utilized the app, 67.85% (19/28) have been doing so for a duration exceeding two years. Additionally, our research reveals that 57.14% (16/28) of these student MSM primarily use Blued for seeking sexual partners., while 50% (14/28) utilize it for social interaction (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eA survey on the usage of social media in student MSM\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProportion, N(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSenior high school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.28(4/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJunior college\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.71(3/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor's degree or above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75(21/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe using dating apps (Multiple choice)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBlued\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89.28(25/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFinka\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50(14/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTiktok private message\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.85(12/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLittle Red Book private message\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.57(8/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe duration of suing Blued App\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.86(5/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7\u0026ndash;12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.71(3/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 years and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.86(19/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe main purposes for useing Blued (Multiple choice)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esocial communication and friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50(14/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFind sexual partners\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.86(19/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnderstand circle culture\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.14(2/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo specific use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.57(1/28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eGeographical distribution of MSM population in colleges and universities in Hainan Province\u003c/h2\u003e \u003cp\u003eThe results showed that the MSM population in colleges and universities in Hainan Province was mainly concentrated in A City, accounting for 72.22% (2259/3128), while B City ranked second with 20.75% (649/3128). The distribution of other cities was relatively scattered, with no notable patterns of aggregation established (Fig.\u0026nbsp;1A). We also found that the highest online activity was in E City at 1.21% (19/1600), followed by B City at 0.82% (208/25169), and A City at 0.74% (663/89827) (Fig.\u0026nbsp;1B).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe MSM population exhibits a higher risk for STDs than the general population, including HIV, syphilis, hepatitis B virus, and other infections. Student MSM has also become a high-risk population for STDs in China (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Understanding the size and distribution of the MSM population is crucial for effectively preventing AIDS and achieving the UNAIDS 95-95-95 targets by 2030 (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). The significance of this study lies in providing data to support more effective prevention and control of the spread of STDs among MSM by accurately estimating the size and distribution of the MSM population among male college students in Hainan.\u003c/p\u003e \u003cp\u003eThe estimated size of the students MSM in Hainan colleges and universities was 3128, with 1833 active users. The number of online active users in this study is higher than that of MSM active users in universities in Chengdu (1084), and the number of registered users in Chengdu is as high as 8401 (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). This difference may reflect the deviation between online behavior and actual registered users. However, the estimated MSM size of students in this study is significantly lower than the estimated range of male homosexuals in Fuzhou city (8506) and Tianjin city (5968\u0026ndash;11935) (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). At present, similar studies are few in China and only focus on individual cities. Notably, this disparity may be attributed to the combined effects of Tianjin and Fuzhou's elevated socioeconomic status, expansive population bases, and concentrated academic infrastructures as major metropolitan hubs in China. In Hainan, the A City and B City were identified as hotspots. The primary factor contributing to A and B cities emergence as geographical hotspots is the concentration of universities in Hainan Province within these two cities. A comprehensive analysis suggests that this phenomenon may be associated with the region's level of economic development. Furthermore, economically developed metropolitan exhibit more active MSM communities, attributable to their superior network infrastructure and high levels of Internet penetration. This pattern is consistent with the geographic distribution characteristics of the MSM population in mainland China, where economically developed regions tend to have a more dispersed MSM population (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Thus, the economic development level might be an important factor in the distribution of social networking MSM.\u003c/p\u003e \u003cp\u003eThere exists considerable heterogeneity across campuses in Hainan Province regarding the utilization of the Blued App. Notably, the estimated number of Blued App users, and the proportion of active users among student users, were notably high at the hotspot campuses of A1, A6, and B2. The significant proportion of Blued users at the A1, A6, and B2 campuses can be attributed primarily to a substantial enrollment of male students during the survey period. Long-term, comprehensive, and effective prevention interventions for STDs should be considered for these hot campuses. For example, lectures about HIV can be introduced in hot campuses, knowledge competitions related to STDs can be held, and benefits can be given to students to get more people involved.\u003c/p\u003e \u003cp\u003eThe current study revealed that the proportion of Blued App users among male college students ranged from 0.44\u0026ndash;6.67%, which is lower than the 3.7\u0026ndash;8.5% reported in a previous study (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Our results indicated that a significant proportion of MSM students in Hainan colleges actively utilize the Blued App, predominantly for social interaction and seeking sexual partners. These results aligned with previous studies conducted in China (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In modern society, digital communication technologies, encompassing social media platforms and the Internet, have emerged as the predominant channels for MSM to facilitate social interactions and seek partners. These platforms expedite the establishment of social connections and the identification of sexual partners, potentially increasing the risk of HIV transmission (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Furthermore, these tools offer significant potential for identifying high-risk populations and improving risk surveillance. Prior studies have demonstrated that the strategic use of social media can substantially increase the detection rate of HIV infections among MSM in Chinese colleges, thereby reducing sexual risk behaviors (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). Moreover, a comprehensive management framework delivered via the Internet, which integrates HIV prevention, treatment, and associated technologies, has proven effective in reducing HIV incidence among MSM populations (\u003cspan additionalcitationids=\"CR41\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). Previous research has highlighted the importance of software such as Blued in conjunction with Internet data sources to provide and deliver health knowledge. For example, this model could be used to push information about the correct use of condoms to people with suspicious high-risk behavior labels (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). Additionally, considering that MSM frequently encounters discrimination and marginalization within social networks\u0026mdash;obstacles that impede access to HIV and syphilis testing and treatment\u0026mdash;leveraging the influence of key individuals within these networks may serve as an effective strategy to mitigate stigma and prejudice (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eLimitations\u003c/b\u003e: This study employed the capture-recapture method to estimate the size of the college student MSM population, which inherently assumes a closed population. However, the inherent mobility of MSM individuals during the data collection period may violate this assumption, representing a limitation. To address this, we implemented three key strategies: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) the college student population is relatively stable, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) the surveys exclusively wre conducted on weekdays to minimize transient population effects, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) the data collection was completed within a condensed timeframe to reduce exposure to migration influences. Additionally, while Blued App is a widely used platform among MSM in Chinese colleges, not all MSM individuals use this platform, potentially leading to an underestimation of the MSM population size. Lastly, some MSM individuals maintain multiple Blued App accounts simultaneously, which could result in double counting and consequently overestimate the size of the MSM population.\u003c/p\u003e "},{"header":"Conclusion","content":"\u003cp\u003eOur findings indicate that a substantial proportion of the MSM population in Hainan colleges are users of the Blued App, exhibiting significant online engagement. The primary motivation for utilizing the Blued App is to engage in social interactions and seek sexual partners. Notably, the MSM population is particularly large on campuses such as A1, A6, and B2. Conversely, campuses like A2, A13, and A15 demonstrate elevated levels of online activity. This research highlights the critical role of leveraging network platforms to accurately identify high-risk areas, which is essential for optimizing resource allocation and developing targeted intervention strategies.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eApp: Geosocial networking smartphone application; MSM: Men who have sex with men; N (%): Represents the percentage of male students enrolled at the Hainan college campus; \u0026chi;\u003csup\u003e2\u003c/sup\u003e: \u0026nbsp; represents the results of the chi-square test, reflecting the relevance of the categorical variables; P: Significance; aOR: The strength of the association between the studied independent variable and the dependent variable after controlling for other potentially confounding variables.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDee Yu was the lead designer and overseer of the project, securing funding, providing supervision, and validating the research. Donghui Zhao was conceptualizing the study and the design. Shi Chen gathered data, drafted the initial manuscript, and conducted the statistical analysis. Xin Chen revised and reviewed the manuscript. All authors assisted with both the research and manuscript preparation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFundings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was supported by the Hainan Provincial Natural Science Foundation of China (824RC519), the Joint Program on Health Science and Technology Innovation of Hainan Province [WSJK2024MS155], and the Student Innovation and Entrepreneurship project of Hainan Medical University [X202411810113].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the ethical principles of the Declaration of Helsinki and received approval from the Ethical Committee of Hainan Medical University, Hainan, China (HYLL-2024-838). All participants provided informed consent prior to their inclusion in the study, and their privacy and data security were strictly maintained throughout the research process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs personal information is involved, it is not convenient to disclose the entire data. The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eDong MJ, Peng B, Liu ZF, Ye QN, Liu H, Lu XL, et al. The prevalence of HIV among MSM in China: a large-scale systematic analysis. BMC Infect Dis. 2019;19(1):1000.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi Y, Xu J, Reilly KH, Zhang J, Wei H, Jiang Y, et al. Prevalence of HIV and syphilis infection among high school and college student MSM in China: a systematic review and meta-analysis. PLoS ONE. 2013;8(7):e69137.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi M, Wu H, Yan H, Zunong J, Hui H, Li H, et al. HIV-Positive Men Are More Likely to Be Hyper Linked Within College Student Social Network - Northeast China, 2017\u0026ndash;2018. China CDC Wkly. 2022;4(43):951\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang Z, Huang Z, Dong Z, Zhang S, Han J, Jin M. Prevalence of high-risky behaviors in transmission of HIV among high school and college student MSM in China: a meta-analysis. BMC Public Health. 2015;15:1272.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao H, Li X, Wang J, Wang W, Yang C, Li J, et al. A systematic and meta-analysis of heterosexual behaviors and HIV prevalence among Chinese men who have sex with men. AIDS Res Ther. 2021;18(1):68.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosenberg ES, Grey JA, Sanchez TH, Sullivan PS. Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012\u0026ndash;2013. JMIR Public Health Surveill. 2016;2(1):e22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGrey JA, Bernstein KT, Sullivan PS, Purcell DW, Chesson HW, Gift TL, et al. Estimating the Population Sizes of Men Who Have Sex With Men in US States and Counties Using Data From the American Community Survey. JMIR Public Health Surveill. 2016;2(1):e14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAssi A, Abu Zaki S, Ghosn J, Kinge N, Naous J, Ghanem A, et al. Prevalence of HIV and other sexually transmitted infections and their association with sexual practices and substance use among 2238 MSM in Lebanon. Sci Rep. 2019;9(1):15142.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeyrer C, Baral SD, van Griensven F, Goodreau SM, Chariyalertsak S, Wirtz AL, et al. Global epidemiology of HIV infection in men who have sex with men. Lancet. 2012;380(9839):367\u0026ndash;77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSullivan PS, Carballo-Di\u0026eacute;guez A, Coates T, Goodreau SM, McGowan I, Sanders EJ, et al. Successes and challenges of HIV prevention in men who have sex with men. Lancet. 2012;380(9839):388\u0026ndash;99.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang L, Podson D, Chen Z, Lu H, Wang V, Shepard C, Williams JK, Mi G. Using Social Media To Increase HIV Testing Among Men Who Have Sex with Men - Beijing, China, 2013\u0026ndash;2017. MMWR Morb Mortal Wkly Rep. 2019;68(21):478\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFan S, Li P, Hu Y, Gong H, Yu M, Ding Y, et al. Geosocial Networking Smartphone App Use and High-Risk Sexual Behaviors Among Men Who Have Sex With Men Attending University in China: Cross-sectional Study. JMIR Public Health Surveill. 2022;8(3):e31033.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao T, Chen G, Sun C, Gong X, Li H, Fu G. The epidemic of HIV and syphilis and the correlation with substance abuse among men who have sex with men in China: A systematic review and meta-analysis. Front Public Health. 2023;11:1082637.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eScholz SM, Damm O, Elkenkamp S, Marcus U, Greiner W, Schmidt AJ. Population size and self-reported characteristics and sexual preferences of men-who-have-sex-with-men (MSM) in Germany based on social network data. PLoS ONE. 2019;14(2):e0212175.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosenbaum JE, Jennings J, Ellen JM, Borkovic LM, Scott JA, Wylie C, et al. Giving syphilis and gonorrhea to friends: using in-person friendship networks to find additional cases of gonorrhea and syphilis. BMC Public Health. 2020;20(1):1526.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuo Z, Feng A, Zhou Y, Gao Y, Sun Y, Chen Y, et al. Geosocial networking mobile applications use and HIV and other sexually transmitted infections among men who have sex with men in Southern China: A cross-sectional study. Front Public Health. 2023;11:1063993.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHong H, Xu J, McGoogan J, Dong H, Xu G, Wu Z. Relationship between the use of gay mobile phone applications and HIV infection among men who have sex with men in Ningbo, China: a cross-sectional study. Int J STD AIDS. 2018;29(5):491\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKirby T, Thornber-Dunwell M. Phone apps could help promote sexual health in MSM. Lancet. 2014;384(9952):1415.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang S. Chinese affective platform economies: dating, live streaming, and performative labor on Blued. Media Cult Soc. 2020;42(4):502\u0026ndash;20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZheng ZW, Yang QL, Liu ZQ, Qiu JL, Gu J, Hao YT, et al. Associations Between Affective States and Sexual and Health Status Among Men Who Have Sex With Men in China: Exploratory Study Using Social Media Data. J Med Internet Res. 2020;22(1):e13201.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYang G, Long J, Luo D, Xiao S, Kaminga AC. The Characteristics and Quality of Mobile Phone Apps Targeted at Men Who Have Sex With Men in China: A Window of Opportunity for Health Information Dissemination? JMIR Mhealth Uhealth. 2019;7(3):e12573.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCao B, Liu C, Stein G, Tang W, Best J, Zhang Y, et al. Faster and Riskier? Online Context of Sex Seeking Among Men Who Have Sex With Men in China. Sex Transm Dis. 2017;44(4):239\u0026ndash;44.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJing L, Cui Y, Lu Q, Yu H. Multiplier method estimates of the population of men who have sex with men: the effect of privacy protection. J Public Health (Oxf). 2020;42(2):429\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan X, Lu Z, Zhang B, Li Y, Tang W, Zhang L, et al. Protecting Men Who Have Sex With Men From HIV Infection With an mHealth App for Partner Notification: Observational Study. JMIR Mhealth Uhealth. 2020;8(2):e14457.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWei L, Chen L, Zhang H, Yang Z, Zou H, et al. Use of gay app and the associated HIV/syphilis risk among non-commercial men who have sex with men in Shenzhen, China: a serial cross-sectional study. Sex Transm Infect. 2019;95(7):496\u0026ndash;504.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeng XM, Wang ZQ, Zhang F, Zheng Y. Epidemiological characteristics and risk factors of HIV/AIDS among young students in Hainan province. Chin J Health Educ. 2021;37(06):06\u0026ndash;0492.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTuyishime E, Kayitesi C, Musengimana G, Malamba S, Moges H, Kankindi I, et al. Population Size Estimation of Men Who Have Sex With Men in Rwanda: Three-Source Capture-Recapture Method. JMIR Public Health Surveillance. 2023;9:e43114.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDes Jarlais D, Khue PM, Feelemyer J, Arasteh K, Thi Huong D, Thi Hai Oanh K, et al. Using dual capture/recapture studies to estimate the population size of persons who inject drugs (PWID) in the city of Hai Phong, Vietnam. Drug Alcohol Depend. 2018;185:106\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBraeye T, Verheagen J, Mignon A, Flipse W, Pierard D, Huygen K, et al. Capture-Recapture Estimators in Epidemiology with Applications to Pertussis and Pneumococcal Invasive Disease Surveillance. PLoS ONE. 2016;11(8):e0159832.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang Y, Ge L, Waller LA, Shah S, Lyles RH. A capture-recapture modeling framework emphasizing expert opinion in disease surveillance. Stat Methods Med Res. 2024;33(7):1197\u0026ndash;210.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNAIDS. Fast track: ending the AIDS epidemic by 2030. Geneva: UNAIDS; 2014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDai Z, He QY, Wang XD, et al. Estimating the size of the MSM population among college students in Chengdu using social networking applications. Chin J Health Stat. 2022;39(05):752\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHe DS, Zhang H, Xu SY, et al. Online estimation of the MSM population size among college students in Fuzhou based on capture-recapture method. Bull Disease Control Prev. 2024;39(01):1\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGong H, Yu MH, Zhou N, et al. Current status of MSM social networking application usage and population size estimation among college students in Tianjin. Chin J AIDS STD. 2017;23(02):129\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHu M, Xu C, Wang J. Spatiotemporal Analysis of Men Who Have Sex With Men in Mainland China: Social App Capture-Recapture Method. JMIR Mhealth Uhealth. 2020;8(1):e14800.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXie L, Mo PKH, Wang Z, Tian X, Lau JTF. Men who have sex with men were more depressed than their counterparts because of lower social support and higher loneliness: A comparative survey among Chinese university students. J Affect Disord. 2024;353:11\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCao B, Gupta S, Wang J, Hightow-Weidman LB, Muessig KE, Tang W, et al. Social Media Interventions to Promote HIV Testing, Linkage, Adherence, and Retention: Systematic Review and Meta-Analysis. J Med Internet Res. 2017;19(11):e394.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVeronese V, Ryan KE, Hughes C, Lim MS, Pedrana A, Stoove M. Using Digital Communication Technology to Increase HIV Testing Among Men Who Have Sex With Men and Transgender Women: Systematic Review and Meta-Analysis. J Med Internet Res. 2020;22(7):e14230.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo Q, Wu Z, Mi G, Xu J, Scott SR. Using HIV Risk Self-Assessment Tools to Increase HIV Testing in Men Who Have Sex With Men in Beijing, China: App-Based Randomized Controlled Trial. J Med Internet Res. 2023;25:e45262.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCao B, Liu C, Durvasula M, Tang W, Pan S, Saffer AJ, et al. Social Media Engagement and HIV Testing Among Men Who Have Sex With Men in China: A Nationwide Cross-Sectional Survey. J Med Internet Res. 2017;19(7):e251.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMi GD, Zhang BB, Yu F, Ren XL, Ong JJ, Fan YQ, et al. HIV incidence among men who have sex with men using geosocial networking smartphone application in Beijing, China: an open cohort study. Infect Dis Poverty. 2021;10(1):27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYan X, Su H, Zhang B, Li Y, Zhang L, Jia Z. Adherence of HIV Self-Testing Among Men Who Have Sex With Men in China: Longitudinal Study. J Med Internet Res. 2020;22(9):e19627.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJia Z, Yan X, Li Y, Ma J. Internet Data for Improving Prevention and Control of Global Infectious Diseases. China CDC Wkly. 2020;2(52):1009\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu D, Tang W, Lu H, Zhang TP, Cao B, Ong JJ, et al. Leading by Example: Web-Based Sexual Health Influencers Among Men Who Have Sex With Men Have Higher HIV and Syphilis Testing Rates in China. J Med Internet Res. 2019;21(1):e10171.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"student MSM, capture-recapture model, Blued App, geosocial network, Hainan","lastPublishedDoi":"10.21203/rs.3.rs-5940102/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5940102/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMen who have sex with men (MSM) have historically been a high-risk group for sexually transmitted diseases. In Hainan, the incidence of HIV and syphilis among MSM has increased rapidly. Additionally, there is a growing number of young students being diagnosed with HIV, with MSM identified as the primary demographic affected. However, the size of the MSM population within colleges and universities in Hainan Province, as well as the distribution of active MSM users, remains unknown.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eIn this study, the Blued App was employed to collect data on online users within Hainan colleges and universities from May 9 to May 18, 2023. A capture-recapture model was utilized to estimate MSM numbers, and uni-variate and geographic density analyses integrating survey data were used to uncover regional disparities among the MSM community at colleges and universities in Hainan.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe findings indicated that the estimated MSM size in colleges across Hainan Province was 3130 (95%CI: 3025\u0026ndash;3235), with 1833 (95%CI: 1754\u0026ndash;1911) being active users. A questionnaire survey revealed that 89.28% of student MSM reported using the Blued App, and 57.14% of the individuals utilized it for seeking sexual partners. Among the 25 campuses in Hainan Province, A1 had the largest number of students using the Blued App, with a population size of 275 (95% CI:243\u0026ndash;307), followed by A6 (207, 95%CI: 185\u0026ndash;229). Among the male students, A2 (6.67%, 59/884) and A3 (6.16%, 130/2099) demonstrated a high proportion of MSM. A6 (47.04%, 119/253) and B2 (38.46%, 80/208) displayed a significant proportion of active users.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe proportion of MSM in male students of colleges across Hainan is moderate, with A City and B City identified as significant hotspots. Particular attention should be directed towards sexual health education, and sexually transmitted disease surveillance in specific colleges.\u003c/p\u003e","manuscriptTitle":"Population size estimation of men who have sex with men in Hainan colleges based on geosocial networking App, South China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-17 16:55:55","doi":"10.21203/rs.3.rs-5940102/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"88509ea1-d6c3-4b8b-83ab-0ae0764e9158","owner":[],"postedDate":"April 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-03T13:38:56+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-17 16:55:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5940102","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5940102","identity":"rs-5940102","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}