| ObjectiveThis study aims to investigate the current situation of AIDS knowledge,attitudes,high-risk sexual behaviours and HIV testing among students in a university in Henan Province,using logistic regression and decision trees to analyse the influencing factors.Based on structural equation modeling to explore the specific influence paths among knowledge,attitudes and high-risk sexual behaviours,as well as the influence of the three on active HIV testing,in order to provide a reference for developing more effective HIV prevention intervention programmes,saving health resources and curbing the trend of HIV epidemic.Methods1.The questionnaire used in this study was revised after reviewing relevant literature,expert interviews and a pre-survey.A comprehensive university in a part of Henan Province was selected to draw respondents from June 2021 to December 2021,using convenience sampling and whole group sampling methods.Sample size calculation: according to the estimation of the sample size of questionnaire-type studies,Tabchnick and Fidell suggested that the sample should be 5 to 20 times the number of scale entries,and in this study,there were 40 scale entries and the sample size was 200 to 800 cases.2.SPSS 26.0 statistical software was used to analyse the data.Statistical methods such as means,standard deviations and percentages were used to describe the general demographic characteristics and the current status of AIDS knowledge,attitudes,sexual behaviours and active HIV testing.The t-test,one-way ANOVA,chi-square test and Fisher’s exact probability method were used to analyse the differences between the knowledge,attitudes,high-risk sexual behaviours and active HIV testing of the study participants according to the type of data.Logistic regression and decision trees were used to analyse the factors affecting the knowledge,attitudes,high-risk sexual behaviours and HIV testing status of the study participants.With the help of AMOS 26.0 software,a structural equation model of AIDS knowledge,attitudes and high-risk sexual behaviors among university students in Henan Province was constructed,and the specific influence paths of the three were explored.Results1.909 questionnaires were distributed,12 invalid questionnaires with response time less than100 seconds were excluded,and finally 897 valid questionnaires were collected,with a valid questionnaire recovery rate of 98.68%.Among the 897 students surveyed,the knowledge rate of AIDS was 71.35%,the positive attitude rate of AIDS was 57.19%,the incidence rate of sexual behavior was 16.16%,the incidence rate of high-risk sexual behavior was 3.90%,and the active testing rate of HIV was 4.12%.2.In the knowledge section,logistic regression analysis showed that junior students(OR=1.783,95% CI: 1.140 ～ 2.789)had a higher level of AIDS knowledge than first-year students,and medical students(OR=1.763,95% CI: 1.209～2.572)had a higher level of knowledge than non-medical students.The decision tree model analysis revealed that major,grade,and whether or not they had attended a school course on HIV health education were influential factors for AIDS knowledge,with major having the most significant effect.3.In the attitude section,logistic regression analysis showed that female students(OR=1.652,95% CI: 1.242～2.196)had higher levels of positive AIDS attitudes than male students.The decision tree model analysis showed that gender,whether or not they had attended a school health education course on AIDS,and major were factors influencing attitudes towards AIDS,with gender having the most significant effect.4.In the high-risk sexual behaviours section,logistic regression analysis showed that homosexual and bisexual students(OR=3.892,95% CI:1.395～10.857)had a higher risk of having highrisk sexual behaviours than heterosexual students.Students who did not attend an AIDS health education programme(OR=2.711,95% CI:1.321～5.64)were at higher risk of having high-risk sexual behaviours than those who attended an AIDS health education programme.The decision tree model analysis revealed that grade,sexual orientation,participation in an AIDS course,and monthly living expenses were factors influencing high-risk sexual behaviours,with grade having the most significant effect.5.In the active HIV testing section,logistic regression analysis showed that students with homosexual and bisexual sexual orientation(OR=2.852,95% CI: 1.022～7.959)had higher levels of active HIV testing than heterosexual students.Decision tree model analysis revealed that sexual orientation,grade,monthly disposable expenses,and knowledge of AIDS were influential factors in active HIV testing.Sexual orientation had the most significant effect.6.Structural equation model of knowledge,attitudes,and high-risk sexual behaviours showed that the model fitted the data well,with a standardised path coefficient of 0.077 for knowledge acting directly on high-risk sexual behaviours and-0.185 for acting through attitudes;the path coefficient for attitudes acting directly on high-risk sexual behaviours was-0.435 and was stronger.ConclusionStudents at a university in Henan have some knowledge of AIDS,but not enough knowledge of non-transmission of AIDS and HIV testing,with particular attention to lower level students and nonmedical students.Some students do not have a correct sexual concept,view AIDS correctly and treat HIVinfected and AIDS patients fairly,especially male students.Some students are not sufficiently aware of the risks of HIV,high-risk sexual behaviours occur,and the level of active HIV testing needs to be improved,with a particular focus on homosexual and bisexual students.In addition,this study found that changing students’ AIDS-related attitudes is the key to improving students’ AIDS knowledge and attitudes and reducing high-risk sexual behaviors.Comprehensive,multiform and targeted AIDS health education in university should not only be provided,but should also be sustained in the long term in order to control the spread of HIV among students in university. |
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