HIV knowledge, sexual attitudes, and PrEP-Eligible behaviors among college students in Southwest China: a cross-sectional study

• Published in: BMC infectious diseases Vol. 24; no. 1; pp. 827 - 14
• Main Authors: Qin, Shiyu, Qin, Jiao, Su, Qiuqian, Huang, Ting, Zhan, Junyu, Yang, Xi, Yang, Yuanhong, He, Jinfeng, Lin, Zhifeng, Huang, Xinju, Ye, Li, Liang, Hao, Tang, Hongyang, Cen, Ping, Liang, Bingyu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.08.2024; BioMed Central; BMC
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Antiretroviral drugs; Attitude (Psychology); Attitudes; Behavior; China - epidemiology; College students; Colleges & universities; Cross-Sectional Studies; Data collection; Disease prevention; Drug abuse; Education; Female; Health aspects; Health Knowledge, Attitudes, Practice; Health literacy; HIV; HIV (Viruses); HIV Infections - epidemiology; HIV Infections - prevention & control; HIV/sex-related knowledge; Human immunodeficiency virus; Humans; Male; Medical research; Medicine, Experimental; Pre-Exposure Prophylaxis; PrEP-eligible behaviors; Prophylaxis; Regression analysis; Sex; Sex education; Sexual assault; Sexual attitudes; Sexual behavior; Sexual Behavior - statistics & numerical data; Sexual behaviors; Sexually transmitted diseases; Social aspects; STD; Students; Students - psychology; Students - statistics & numerical data; Surveys; Surveys and Questionnaires; Universities; Young Adult; China; United States > US; Sex education; College students; PrEP-eligible behaviors; HIV/sex-related knowledge; Sexual behaviors; Sexual attitudes
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-024-09657-7

There is an increasing number of human immunodeficiency virus (HIV) reported cases among students in Southwest China. However, the data on HIV/sex-related knowledge, attitude toward sex, sexual behaviors, and correlates of pre-exposure prophylaxis (PrEP)-eligible behaviors among college students in this area is still limited. This study aimed to assess the prevalence of HIV/sex-related knowledge, sexual attitudes, sexual behaviors, and factors associated with PrEP-eligible behaviors among college students. An online survey from 2020 to 2021 based on a multistage stratified and cluster sampling method was conducted among college students in Southwest China, and a well-designed questionnaire collected data. Propensity score matching (PSM), logistic, and log-binomial regression were used to identify the determinants of PrEP-eligible behaviors. A total of 108,987 students participated in the survey, and 92,946 provided valid responses. 91.6% (85,145/92,946) had good HIV-related knowledge, while only 26.0% (24,137/92,946) reported awareness of sex-related knowledge. Furthermore, more than half of the participants (64.5%) held negative stances towards engaging in "one-night stand", and 58.9% (617/1,047) reported PrEP-eligible behaviors. Log-binomial regression analysis indicated that unaware of HIV-related knowledge (aPR = 1.66, 95% CI:1.22-2.26, P = 0.001), not discussing about sex with their parent(s) (aPR = 1.16, 95% CI:1.01-1.33, P = 0.021), not receiving sex-related education in school(aPR = 1.24, 95% CI: 1.07-1.45, P = 0.005), not participating in HIV/AIDS prevention activities in the past year (aPR = 1.32, 95%CI:1.09-1.60, P = 0.004), experiencing forced sex (aPR = 2.08, 95% CI: 1.19-3.63, P = 0.010), and having the drug abuse (aPR = 22.21, 95% CI:5.59-88.31, P < 0.001) were significantly associated with increased odds of PrEP-eligible behaviors. College students in Southwest China exhibited suboptimal HIV/sex-related knowledge, received limited sex education, reported conservative attitudes towards casual sex, and significant PrEP-eligible behaviors. These findings suggest that sexually experienced college students who were unaware of HIV-related knowledge, lacked sex education, experienced forced sex, and reported drug abuse were the key individuals for evaluating eligibility for PrEP initiation, and interventions aimed at increasing awareness of HIV/sex-related knowledge, promoting participation in sex education, addressing issues related to forced sex and tackling drug abuse could contribute to reducing the incidence of PrEP-eligible behaviors among college students.