A cross-sectional survey on the sexual health status of Chinese men in Guinea

Abstract

Background

Sexual health among Chinese men living and working in Guinea has not been adequately studied.

Aim

To assess sexual health issues and related factors among Chinese men in Guinea.

Methods

A cross-sectional study was conducted using an anonymous questionnaire, with 258 Chinese male respondents living and working in Guinea. The survey collected data on demographics, lifestyle habits, sexual activity, condom use, and knowledge of sexually transmitted diseases (STDs).

Outcomes

The primary outcomes included levels of sexual activity, condom use, and STD awareness.

Results

Of the respondents, 89.1% reported sexual needs, but only 11.6% were sexually active during their stay. Younger age, urban residence, and non-smoking were positively associated with sexual activity. Among those who were sexually active, 80% had multiple sexual partners, and 60% consistently used condoms, while 13.3% never used them. Condom use was found to be lower among older, married, and less educated individuals. Awareness of STDs was generally low, with an average score of 8.03 out of 12. Younger respondents, those with higher education, those who were sexually active and those who considered themselves familiar with STD knowledge had a relatively higher level of awareness. Most respondents (93%) believed that promoting sexual health education is necessary.

Clinical Implications

Findings suggest a need for targeted sexual health education and intervention programs, especially among high-risk groups.

Strengths & Limitations

The study provides valuable data on a previously unexamined population; however, its cross-sectional design and reliance on self-reported data may limit the ability to establish causal relationships.

Conclusion

The study highlights unmet sexual health needs and knowledge gaps among Chinese men in Guinea, suggesting the importance of health education and preventive measures in this population.

Introduction

As the pace of economic globalization accelerates, an increasing number of Chinese citizens are moving abroad to live and work. Factors such as living and working environments, lifestyles, and access to medical resources can all impact sexual health. As a urologist of the Chinese medical team in Guinea, the author has observed that the sexual health of Chinese men living and working in Guinea (hereinafter referred to as “Chinese men in Guinea”) has not received sufficient attention, and there also has been a lack of relevant research on Chinese men living and working overseas.

Sexual health is an important component of overall health, involving physiological, psychological, and social factors. Neglecting sexual health issues and lacking of relevant knowledge will not only affect an individual's physical health and quality of life, but also have negative impacts on their psychological state, family relationships, and work efficiency, and even lead to the transmission of certain diseases between domestic and international populations. In Guinea, a West African country with relatively scarce medical resources, there is an even greater need to focus on and study the sexual health of Chinese men in order to develop effective health intervention measures and improve their health status.

Previous studies have primarily focused on domestic migrant populations, leaving a knowledge gap in the context of Chinese overseas workers. Given the increased global mobility and the unique socio-cultural contexts of these workers, understanding their sexual health behaviors and knowledge is crucial for developing targeted health interventions. This study aims to investigate the sexual health status of Chinese men in Guinea by addressing the following research questions: What demographic and lifestyle factors are significantly associated with the likelihood of engaging in sexual activity? Does condom use vary based on age, marital status, and education level? Is awareness of sexually transmitted diseases (STDs) significantly related to sexual activity, self-assessed knowledge, and educational attainment? We hope not only to provide health analysis and propose corresponding health promotion strategies for Chinese men in Guinea, but also to offer valuable reference data and experience for the health management of Chinese overseas workers.

Methods

Research design

In this cross-sectional study, we obtained data through anonymous questionnaire surveys, and evaluated the sexual health status of Chinese men in Guinea. The study was approved by the Institutional Review Board of the primary author’s academic institution, and informed consent was obtained from all participants.

Research subject

The study participants were Chinese men aged 18 and above who live and work in Guinea (not permanent residents). Their occupations included workers, technicians, managers, commercial service personnel, etc., covering various entities such as government agencies, enterprises, institutions and individual owners. The survey was conducted by directly sending mobile questionnaires to the individuals mentioned above, or by asking unit leaders to send the questionnaires through the mobile app WeChat version 8.0 (Tencent, Shenzhen, China) work groups, inviting voluntary participants. Participants were provided with a download link to access electronic health education materials.

Data collection

Referring to other previously published domestic and international cross-sectional studies,^1–4 and considering local conditions, a structured questionnaire was designed, including fill-in-the-blank and multiple-choice questions (single-choice and multiple-choice), all of which were mandatory and required truthful and independent responses. The questionnaire covered the following areas:

• 1) Basic demographic information: age, marital status, education level, the location of work and residence, total duration in Guinea, etc.

• 2) Lifestyle habits: smoking and drinking habits, hobbies, and leisure activities.

• 3) Sexual health status: sexual needs, whether having sexual activities (with female) during the stay in Guinea, the status of sexual partners, condoms use (entire duration of sexual intercourse), other ways of relieving sexual needs, etc.

• 4) Cognitive status of sexually transmitted diseases (STDs): respondents' self-assessed level of knowledge about STDs (subjective assessment), STD knowledge test score (objective assessment), self-assessed necessity of promoting sexual health education. The STD knowledge questions included: Which of the following are STDs (multiple-choice: AIDS, gonorrhea, syphilis, genital warts, hepatitis B, malaria, typhoid, COVID-19, tuberculosis); What are the possible transmission routes for STDs (multiple-choice: sexual activity, blood, body fluids, mother-to-child transmission, drug abuse, kissing, dining at the same table, daily work contact); Whether the seemingly healthy people may have been infected with STDs (single-choice: yes, no, don’t know); The effectiveness of condoms in preventing STDs (single-choice: Can 100% prevent, Can prevent most, No effect). The full score for the STD knowledge test was 12 points. Single-choice questions scored points for correct answers. Multiple-choice questions scored 1 point for each correct answer, and deducted 1 point for each incorrect answer.

The questionnaire was sent via the WeChat mini-program “Tencent Documents” on June 1, 2024. Once the respondents completed the questionnaire and clicked anonymous submission, the researchers received the data directly. After collecting all the data, it was analyzed.

Data processing and analysis

Data entry

Data were entered and verified by two individuals to ensure accuracy. Missing data were handled using single imputation methods, and non-meaningful or outlier values (e.g., negative scores for STD knowledge) were excluded from the analysis. For duplicate submissions, only the answers from the most recent submission were accepted.

Statistical analysis

Descriptive statistics such as frequency, percentage, mean, and standard deviation were used to summarize the basic characteristics and sexual health status of the research subjects. For univariate analysis, Chi-square test, two-tailed t-test or non-parametric test were used to analyze the relationship between sexual health status and various influencing factors. For multivariate analysis, logistic regression or multiple linear regression were used to identify the independent risk factors and protective factors of sexual health status, stepwise regression was employed to identify variables for the final model, with entry criteria set at p < 0.05.

All statistical analyses were conducted using SPSS version 27 (IBM, Chicago, IL, USA), with p < 0.05 considered statistically significant.

Data description and statistical results

A total of 276 questionnaires were collected, and those with non-standard data were excluded, 258 valid questionnaires were finally obtained.

Basic characteristics of the respondents (Table 1)

The majority of the respondents were young and middle-aged adults (average age was 37.6 years); 73.6% were married; 63.6% had received higher education at or above college level; the median duration of living and working in Guinea was 24 months. Those living and working in urban areas accounted for 17.1%, with the majority residing in rural areas and field bases (50.4% and 32.6%, respectively). In terms of lifestyle habits, 58.9% of the respondents were smokers, 79.1% drank alcohol. 90.7% had one or more hobbies, while 9.3% had no hobbies at all.

Status of sexual partners and condom use of the respondents who had sexual activities during their stay in Guinea (Tables 1 and 2)

Among the 30 respondents who were sexually active, the situation regarding sexual partners was quite complex: only 20% of them had sexual relations exclusively with a fixed partner, while the remaining 80% had multiple sexual partners. Although most sexually active respondents (60%) reported using condoms every time during entire sexual intercourse, 13.3% never used condoms, all of whom had non-fixed sexual partners.

Factors related to sexual activity during the stay in Guinea

Univariate analysis showed that factors related to sexual activitiy were age, education level, the location of work and residence, and smoking status (Table 3, p values were 0.014, 0.047, 0.002, <0.001, respectively). Further pairwise comparisons between age groups revealed that the proportion of individuals with sexual activities was the highest in the “20–29” group, with a statistical difference compared to the “ ≥ 40” group, while no statistical differences were observed between the other groups. The proportion of individuals with sexual activity is significantly higher among those with a college education or above compared to those with less than a college education. Pairwise comparisons showed that the proportion of individuals with sexual activity was highest among those working and living in urban areas, with a significant difference compared to rural areas, while no statistical differences were found between the other groups. The proportion of individuals with sexual activity was significantly higher among non-smokers compared to smokers.

Multivariate analysis (Logistic regression) showed that the factors associated with sexual activitiy were age, the location of work and residence, and smoking status (p values were 0.007, 0.021, and < 0.001, respectively). Compared to the " ≥ 40" group, the ORs for sexual activitiy in the "20 ~ 29" group and the "30 ~ 39" group were 6.360 (95%CI: 1.947–20.776) and 4.436 (95%CI: 1.435–13.707), respectively. Compared with those working and living outside the urban areas, the OR for sexual activitiy in the urban group was 2.938 (95%CI: 1.176–7.338). Compared to smokers, the OR for sexual activitiy in non-smokers was 5.364 (95%CI: 2.187–13.159).

Factors related to condom use during sexual activity

Univariate analysis showed that factors related to condom use were age, marital status, and education level (Table 4, p values were 0.028, 0.014, and 0.013, respectively). Further pairwise comparisons between age groups revealed that the proportion of individuals who "never" use condoms was significantly higher in the " ≥ 40" group than in the "30-39" group, while no statistical differences were observed between the other groups. The proportion of condom use among married individuals was significantly lower than that of non-married individuals (including unmarried and divorced). The condom use rate among individuals with an education level below college was significantly lower than those with a college education or above.

Multivariate analysis (Logistic regression) did not identify any factors with a significant independent influence on condom use.

Scores on STD knowledge and related factors

The results of the respondents' STD knowledge tests revealed that the overall level of awareness was low, with an average score of only 8.03 out of 12 (score range: 1–12, standard deviation: 2.028). Some individuals scored as low as 1 point. Most respondents (93%) believed that promoting sexual health education is necessary (Table 1).

Univariate analysis showed that factors related to the scores were age, marital status, education level, whether the respondent had sexual activitiy during his stay in Guinea, and the self-assessed level of knowledge about STDs (Table 5, p values were 0.009, 0.021, <0.001, 0.049, <0.001, respectively). Further pairwise comparisons between age groups revealed that the scores of the "20-29" age group were significantly higher than those of the "30-39"group, while no statistical differences were observed between other age groups. The score of married individuals was significantly higher than that of non-married individuals. The score of respondents with a college education or above was significantly higher than that of those with an education level below college. The score of individuals who had sexual activity in Guinea was significantly higher than those who had not. Pairwise comparisons showed that the score of individuals who considered themselves “familiar” with STD knowledge was significantly higher than those who “know a little” or “unfamiliar,” with no statistical difference between the latter two groups. In summary, those who were younger (20-29), married, had a college education or above, had sexual activity during their stay in Guinea and considered themselves familiar with STD knowledge had relatively high scores, indicating a relatively higher awareness of STDs.

Multivariate analysis (linear regression) showed that the factors related to the scores were age, education level, whether the respondent had sexual activitiy during his stay in Guinea, and the self-assessed level of knowledge about STDs (p values were 0.047, <0.001, 0.029, <0.001, respectively). Individuals who were younger (20-29), had a college degree or above, had sexual activity in Guinea, and considered themselves familiar with STD knowledge had higher scores on the STD knowledge test.

Discussion

In recent years, with the continuous deepening of China's economic cooperation with the world, more and more Chinese companies and workers have gone overseas. According to statistics,⁵ China sent 322 700 workers of various types abroad in 2021, of which 43 700 were in Africa. Guinea, located in West Africa, currently has >20 000 Chinese people dedicated to infrastructure construction, mining development and other economic and trade activities, most of whom are men.

The health risk factors of overseas workers involve many aspects, including language and cultural barriers, social factors, workplace-related factors, natural factors, political and legal environment, and barriers to accessing medical services, etc. As a result, their risks of physical and mental illness are higher than those of the general population.^6,7 These problems may further cause or promote the occurrence of unhealthy behaviors such as smoking, alcoholism, drug abuse, and unsafe sexual behavior.⁸

The medical conditions in Guinea are relatively underdeveloped. However, with the continuous assistance of the Chinese government and the efforts of successive Chinese medical teams in Guinea, the diagnosis and treatment of common and frequently occurring diseases have been greatly improved. But as a urologist in the medical aid team to Guinea, the author has often encountered men visiting the clinic or calling for consultations about sexual health while there is a lack of relevant instruments, equipment or medications. The sexual health status of Chinese men in Guinea has not received enough attention, and there also has been a lack of relevant research on Chinese men living and working overseas. Through this study, we hope to fill this gap, raise more attention to the sexual health status of Chinese men overseas, and promote the implementation of relevant policies and measures to create a healthier and more harmonious working and living environment for them, and also provide important reference and guidance for future Chinese medical aid projects.

Unhealthy lifestyle

A total of 258 respondents participated in this study. The smoking and drinking rates of men living and working in Guinea are higher than those of men in China (50.5%, 48%),^9,10 possibly due to the reasons mentioned above. Studies have shown that heavy smoking and drinking are harmful to health, including sexual health.^11,12 The issue of unhealthy lifestyles among overseas workers should be given attention.

Sexual needs

This study shows that although 89.1% of the respondents reported having sexual needs, only 11.6% of them had sexual activity during their stay in Guinea. This is the first report on the sexual needs and the proportion of individuals having sexual activity among Chinese workers abroad, and this percentage is significantly lower than the reported proportion of domestic migrant workers engaging in sexual activity (82.3%, 65.3%).^1,2 It is evident that men in Guinea are facing the issue of unmet sexual needs. The low proportion of sexual activity among overseas workers may be caused by a combination of factors,^4,8 for example: traditional Chinese values and cultural differences in Guinea discourage casual sexual activities, limiting social interactions and sexual opportunities; language difficulties and limited integration reduce the chances of forming relationships; rural or field-based living arrangements offer little privacy or social opportunities, limiting sexual activities; some companies have strict discipline, prohibiting workers from going out alone, which limits their personal space; concerns about financial costs and health risks, such as AIDs, lead to cautious behavior regarding sexual activity; workers may avoid sexual activities due to fears of legal repercussions or social stigma, etc. Although some respondents use masturbation as a way to relieve their sexual desire, most people still need to divert their attention or suppress their sexual needs through other activities. As young and middle-aged men in their sexually active period, long-term unmet sexual needs may lead to a series of physiological, psychological and even social problems, such as prostate diseases, sexual dysfunction, anxiety, depression, and even sexual crimes.^13–16

Factors related to sexual activity during the stay in Guinea

Univariate analysis of the data showed that younger respondents, those with higher education levels, those working and living in urban areas, and non-smokers were more likely to have sexual activity during their stay in Guinea. Multivariate analysis indicated that the factors related to having sexual activity were younger age, working and living in urban areas, and being a non-smoker.

The positive correlation between youth and sexual frequency can be explained by multiple physiological and psychological factors. Younger individuals generally have higher sexual desire, energy and fewer health issues, leading to a higher frequency of sexual activity. As age increases, physiological functions may be affected by natural aging. In addition, life stress, illness, and medication use may also negatively impact sexual activity in older populations, resulting in decreased sexual activity.^1,17 People with higher education levels tend to have more knowledge about sexual health, better understand its importance, and take measures to maintain sexual health. Additionally, higher education levels are often associated with higher incomes, which improves the quality of life and physical and mental health, thereby promoting more frequent sexual activity.^1,2 Further data analysis revealed a correlation between age and education level. Younger migrant workers generally have higher education levels, which may explain why education level is not an independent factor in the multivariate analysis. Urban lifestyles offer more social opportunities, cultural activities, and an open attitude toward sex. Moreover, better working conditions, living environments, and healthcare in urban areas may further contribute to increased sexual activity frequency.^1,2 Smoking is associated with various health problems. Studies have shown¹¹ that smokers have a higher risk of erectile dysfunction and decreased libido; on the contrary, non-smokers tend to be in better overall health, leading to higher frequency and quality of sexual activity.

Status of sexual partners and condom use

Due to being away from their families, overseas workers almost never have their spouse as their sexual partner. Studies on migrant worker populations show varying results in this regard: Dai et al.¹ reported that 15.2% of the respondents had multiple sexual partners in the past 12 months, of which 76.2% had never or rarely used condoms, and 58% of all sexually active respondents never used condoms during sexual intercourse; Wu et al.¹⁸ found that 27.8% of male migrant workers in Shanghai had multiple sexual partners, 19.7% had engaged in paid sexual services, and 29.6%–41.5% of the respondents did not use condoms during risky sexual behaviors; Narushima et al.⁴ reported that among foreign workers in Canada, over 50% of the men had multiple sexual partners while working abroad, only 18.9% of the respondents always used condoms during sexual activity, while 12.6% never used them. Compared to these domestic and international studies, the proportion of multiple sexual partners in our study is higher. Although the proportion of those not using condoms is lower, all of their sexual partners were non-fixed, including Guinean natives. According to the data released by UNAIDS in 2022, the HIV infection rate in Guinea is more than ten times that in China (1.4% vs 0.09%). Having multiple sexual partners and low condom usage both increase the risk of STDs, which may further lead to the possibility of cross-border transmission of such diseases.^3,19

Univariate analysis of this data showed that older, married individuals, and those without higher education had lower rates of condom use or did not use condoms at all. A study on migrant population in Shanghai¹ found that age significantly impacts condom use: young migrant workers are more likely to use condoms during sexual intercourse than older individuals, with condom use significantly decreasing among those over 35. A study on unmarried male migrant population² also found that as age increases, awareness and frequency of condom use among unmarried males decrease. Herbenick et al.²⁰ reported that condom use is highest among young people in the United States, but it gradually decreases with age. These studies suggest that younger individuals have a stronger awareness of preventing STDs and unwanted pregnancies, but as they age, older individuals are more likely to be in long-term stable relationships, reducing the need for condoms. Additionally, older individuals may have a lower awareness of sexual health prevention.

Herbenick et al.²⁰ believe that the low condom use rate among married men is because they are typically in long-term, stable sexual relationships, therefore have a low risk of contracting STDs. Meanwhile, they may use other forms of contraception (such as oral contraceptives, intrauterine devices.) or have plans to have children. However, other studies on migrant workers, both domestically and internationally,^1,3,18,21 reported that married men who have been separated from their spouses for a long time use condoms less often than unmarried men even during extramarital sex, which is consistent with the data from this group of respondents. These studies suggested that this phenomenon is closely related to cultural barriers, misunderstandings about condoms, difficulties in accessing condoms, and insufficient awareness of STD prevention.

Education level is an important factor affecting condom use among migrant populations during sexual intercourse.^1,2,4,18 Higher education levels enable individuals to have more sexual health knowledge and understand the importance of condoms in preventing STDs and unintended pregnancies, and therefore more likely to use condoms. In contrast, individuals with lower education levels tend to use condoms less frequently due to a lack of knowledge.

Although the above influencing factors were identified in the univariate analysis, this study did not screen out any factors that have a significant impact on whether condoms are used during sexual activity in the multivariate analysis. On one hand, this could be due to the limited sample size in the statistical analysis; on the other hand, factors such as age, marital status, and education level may influence condom use, but their effects may not be independent or decisive. The complexity of these factors and multi-factor interactions need to be considered.

Awareness of STDs

In this study, the respondents' scores by age group, ranked from highest to lowest, were: 20-29 group, ≥40 group, and 30-39 group. Wu et al.¹⁸ found that migrant workers aged 35 and above had relatively poor awareness of STDs, especially in terms of prevention measures and transmission routes. Dai et al.¹ also reported that older migrant workers generally had weaker understanding of STDs. Both studies suggested that as people age, their exposure to sexual health education decreases, leading to lower awareness of protection against STDs. In our study, the significantly better awareness of STDs in the 20-29 group compared to the 30-39 group is likely due to similar reasons. The ≥40 group also scored higher than the 30-39 group, possibly because this age group has relatively richer life experience, and some of them are well-educated managers in Chinese companies. Wang et al.² found that younger unmarried men (especially those aged 18–29) had a lower awareness of STDs, while older individuals (over 30) showed a slight improvement in awareness. They suggested that younger men are more likely to ignore sexual health education, whereas older individuals may have more sexual health knowledge. This discrepancy may be due to the fact that Wang's study focused on unmarried men, which differs from the previous studies, leading to inconsistent results.

Univariate analysis showed that the scores of married respondents were higher than those of unmarried respondents, which is consistent with other studies. Zhao et al.²¹ and Luo et al.²² both investigated AIDS knowledge among rural migrant workers. Both studies found that, compared to unmarried individuals, married individuals had higher awareness of AIDS transmission knowledge. Marital status has some influence on the awareness and behavior related to STDs, possibly because married individuals, with more life experience, tend to pay more attention to sexual health and the prevention of STDs. In multivariate analysis, marital status was not an independent influencing factor, possibly because the proportion of unmarried individuals with sexual experience is not low at present, and their awareness of STDs has improved compared to the past, reducing the decisive impact of marital status.

This study found that migrant workers with higher education levels had significantly better knowledge of basic information, transmission routes, and prevention measures for STDs compared to those without higher education. The latter group had a vague or even incorrect understanding of STDs. Some still believed that AIDS could be transmitted through daily contact, considered condoms solely as contraceptive tools without knowing they can prevent STDs, and mistakenly thought that diseases like malaria and typhoid were also STDs. The influence of education level on the awareness of STDs has been recognized by many studies.^1–4,21,22

Our analysis results suggested that respondents who were sexually active during their stay in Guinea had a relatively higher level of awareness about STDs. This may be because individuals who are sexually active pay more attention to sexual health issues and are more likely to receive or actively seek related knowledge, leading to a more comprehensive understanding of the risks and prevention of STDs. In contrast, those without sexual activity may have lower participation in sexual health education, which may lead them to ignore the basic knowledge about STD prevention.^1–4,21,22

We found that respondents who considered themselves familiar with STD knowledge scored higher on the test compared to those who believed they had no knowledge of STDs. In other words, in terms of awareness of STD knowledge, subjective self-assessment was generally consistent with the results of the objective theoretical test. Previous studies have not reported on the factor of self-assessment, but we believe that self-assessment can influence individual behavior, which is why we included it in the questionnaire. We believe that respondents who considered themselves familiar with STD knowledge often had higher education levels, paid more attention to sexual health knowledge, or had more actual sexual experience. These factors may have given them a certain level of confidence, which indeed led to higher scores compared to the other two groups in the questionnaire. However, in actual sexual activity, there was no significant difference in condom use rates between the groups, indicating that the respondents' theoretical knowledge did not translate well into practical protective measures, which is consistent with the findings of other studies.^23,24

This survey also found that 93% of the respondents believed that the popularization of sexual health knowledge is necessary, indicating that most respondents recognized the importance of sexual health-related knowledge and their own lack of it.

Limitations and prospects

Firstly, due to the cross-sectional design, non-random selection of participants, and limited sample size, the reliability of establishing causal relationships may be affected. Secondly, the self-reported data from respondents may be subject to recall bias or underreporting due to the privacy and sensitivity of sexual behavior. Thirdly, the survey questionnaire was designed with reference to many studies, however, some items had a high level of missing data and could not be included in the statistical analysis. For these reasons, when comparing our results with other domestic and international studies or generalizing them to other regions, these issues should be taken into account. In future research, we hope to collaborate with more organizations and communities, and provide more sexual health services.

Conclusions

To our knowledge, this cross-sectional survey conducted in Guinea is the first to reveal sexual health issues among Chinese men temporarily living and working overseas.

The smoking and drinking rates among Chinese men in Guinea are higher than in China. As young and middle-aged adults in their sexually active years, most of them have unmet sexual needs. Younger individuals, those working and living in urban areas, and non-smokers are more likely to be sexually active during their stay in Guinea. Among those who are sexually active, the majority (80%) have multiple sexual partners. Most sexually active individuals (60%) consistently use condoms, but 13.3% never use them, and all of those who do not use condoms have multiple sexual partners. Condom use is relatively lower among older individuals, married men, and those without higher education, though these influencing factors may not be independent or decisive. Overall, Chinese men in Guinea have a low level of awareness about STDs. However, younger individuals (20-29), those with a college education or above, those who are sexually active during their stay, and those who consider themselves familiar with STD knowledge tend to have a relatively higher level of awareness. Most respondents believe that promoting sexual health education is necessary.

In view of the above issues, we recommend promoting healthy lifestyles by reducing unhealthy habits such as smoking and drinking, and strengthening sexual health education to raise awareness about STD prevention, especially among individuals with non-fixed sexual partners and low condom usage. It is also suggested to incorporate sexual health interventions into medical aid programs, such as increasing screenings for sexual health and urogenital diseases, particularly prostate diseases and STDs. Additionally, providing mental health support to prevent anxiety and other psychological issues, as well as the resulting sexual dysfunction is recommended.

Our preliminary study provides valuable data and references for the sexual health management of Chinese overseas workers, and offers a scientific basis for future medical intervention strategies.

Acknowledgments

We would like to thank the Chinese Embassy in Guinea, the Economic and Commercial Office, the Chinese Business Association, and various Chinese enterprises in Guinea for their support and cooperation.

Author contributions

All authors contributed to the design of this research. Lin Yun-hua drafted the manuscript and involved in the interpretation of the data. Song Xian-tao played a major role in contacting the heads of each unit and organizing the completion of the questionnaires in the survey. Wang Jun-sheng and Zhang Ning performed statistical analyses. Zhang Ning revised the manuscript. All authors read and approved the final manuscript.

Lin Yun-hua and Song Xian-tao Equal contributors.

Funding

None declared.

Conflicts of interest

The authors declare that they have no competing interests.

References