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Background There are very few studies from the Middle East on HIV knowledge, attitudes, and other sexual health issues among university students. This is particularly true for Lebanon. The present study focuses on factors that predict sexual risk behaviors and sexual health screening behaviors in a sample of university students in Lebanon. Methods A diverse sample of 250 undergraduate students at a university in Beirut, Lebanon participated in a survey study. They completed measures of religiosity, ethnic identification, identity threat, psychological distress, self-harm, contraceptives usage, HIV/STI screening, and sexual risk behaviors. Results Religion is negatively associated with a range of risky sexual behaviors. Psychological distress is associated with having sex under the influence of alcohol and drugs, engaging in a sexual activity later regretted, and feeling forced to engage in a sexual activity that they did not want to engage in. Sex under the influence of alcohol and drugs/substances, discussing methods of contraception, and willingly engaging in sexual activities later regretted had significant effects on the variance of having had condomless vaginal sex in the past month. Gender and sex under the influence of alcohol had significant effects on screening for STIs. Conclusion Religiosity appears to be protective against identity threat and psychological distress and negatively associated with a variety of sexual risk behaviors. Perceived stigma associated with female sexuality can limit STIs screening. Interventions that focus on managing different variables (drug and alcohol use in students, unwanted pregnancy, religion, stigma related to screening, and sexual health education) are recommended.

Background Unlike native gay and bisexual male (GBM), immigrants/refugees GBM have an added vulnerability to poor sexual health due to their stigmatized sexual minority status. The objective of this cross-sectional study was to compare sexual health variables in a sample of native-born and immigrants/refugees GBM in Lebanon. This study also aimed to identify the correlates of sexually transmitted infections (STIs) knowledge. Methods This study was conducted in November 2019 following modified time-location sampling. Instruments included rapid tests for HIV and Hepatitis B and C and a behavioral questionnaire. Results Our results can be grouped into three main levels: education, stigma and risky behavior. Compared with native-born GBM, immigrants/refugees GBM were more likely to report non-university level of education, and lower STIs knowledge. Moreover, they showed more healthcare and employment respective stigma. Hence, more heterosexual marriage, more commercial sex work, more history of syphilis in the last 12 months and a higher mean number of male sex partners in the last 6 months were noted among these communities. Positive correlations were found between STIs knowledge and socioeconomic status; feeling sufficiently informed about STIs. Being immigrants/refugees and feeling sufficiently informed about STIs were strong indicators of STIs knowledge. Conclusion This study highlights the respective roles of education and immigrant/refugee status in STIs knowledge in Lebanon. Efforts to increase general educational opportunities for immigrants/refugees and specifically sexual education would be helpful inherently, and might also support higher STIs knowledge. Moreover, our participants most probably had to conform to cultural and religious norms and get married. This entails a degree of hiding their true identity and causing distress. Both hiding identity and experiencing stigma may push people of sexual minorities to cope in a wide range of ways and one possible strategy might be sexual risk-taking.