ArticleBMC public health2026
Changes of HIV related knowledge, attitudes and practices in newly enrolled students in universities: evidence from Zhejiang, China.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHIV has been reported a disproportionately increase among young students worldwide including China. Considering newly enrolled university students experienced living away from home, the absence of family control and the changes from a relatively closed environment to an open environment, HIV related knowledge, attitudes and practices (KAP) for this group may change after enrollment in universities. Thus, we aim to explore the changes of HIV related knowledge, attitudes and practices in newly enrolled students in universities.
methodThis prospective-based investigations were carried out among students when they enrolled in the university and 3 months after enrollment. All the newly enrolled students in the university were invited to participate in the investigation. HIV related knowledge was measured using the 8-item HIV Knowledge Questionnaire. Changes regarding HIV related knowledge, attitudes, sexual behaviors and social network self-efficacy were analyzed, and statistical differences were examined using Mcnemar and Wilcoxon signed-rank test.
resultsAmong the participants, 56.2% (431) were male students with 43.8% (336) were female students. The average HIV related knowledge score was 7.55 ± 0.73 at the enrolment and it increased to 7.64 ± 0.65 after 3 months of enrollment (p < 0.001). Regarding the HIV related attitudes, most items showed no significant difference between enrolment and after 3 months of enrolment (p > 0.05). However, more students thought they had traditional sexual beliefs after 3 months of enrollment compared with that at the enrollment (42.5% vs. 32.8%). Regarding the HIV related practice, the romantic love experiences increased from 23.2%(178/767) at enrollment to 30.0%(230/767) after 3 months of enrollment(p < 0.001), and the percentage of having sexual intercourse increased from 1.2%(9/767) to 2.0%(15/767) although it did not show significant difference with the P value of 0.07. In addition, condom using, sexual partner and internet dating did not show statistical difference between enrollment and after 3 months of enrollment (p > 0.05). The total score of social networking self-efficacy decreased from 80.31 to 79.25 from enrollment to 3 months after enrolment(p = 0.002) with decreased dimension of self-disclosure (p = 0.002) and self-control (p < 0.001).
conclusionThis prospective study highlights that newly enrolled university students experienced an increase in HIV-related knowledge and a rise in romantic relationship within the first three months. However, this was not accompanied by a positive shift in attitudes or safer practices. This knowledge-behavior gap, coupled with declining social self-efficacy, highlights the urgent need for early, skills-based HIV interventions that go beyond mere knowledge dissemination to effectively address behavioral risks during this transitional period.
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