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Background: Liangshan is one of the areas severely affected by both HIV and poverty in China. We investigated associations between perceptions of social norms related to casual sex and the occurrence of casual sex in lifetime among Yi minority people. Participants were Yi minority people aged 15–49 years old living in Liangshan. Of the participants, 11.8% were confirmed to be HIV-positive. About half of the participants (46.6%) had engaged in casual sex in their lifetime. All six perceptions of social norms were significantly associated with the presence of casual sex in lifetime. They were acceptable of belife: (1) casual sex in general (OR: 15.03), (2) not to use condom during casual sex (OR: 1.58), (3) a Yi woman to have more than one sex partner(OR: 4.54), (4) a Yi man to have more than one sex partner(OR: 4.51), (5) premarital sex with casual sex partner (OR: 4.29), and (6) extra-marital sex with casual sex partner (OR: 3.23). Casual sex may play an important role in facilitating HIV transmission among Yi minority people. Future interventions should consider making use of the Yi clan system to change perceptions of social norms related to casual sex.

Perceptions of social norms played an important role in the occurrence of casual sex among Yi minority residents in China: a population-based study