Comparative characteristics of HIV/AIDS knowledge belief and behavior among self-reported sexually active female college students in Zhejiang Province in 2018 and 2020

Objective: To analyze differences on characteristics of HIV/AIDS knowledge, beliefs and behavior among female college students who reported having sex in Zhejiang Province between 2018 and 2020, and provide reference for HIV/AIDS prevention and control among female college students.

Methods: Cross-sectional surveys were conducted in October-November 2018 and November-December 2020 among female college students in 13 universities in 11 cities in Zhejiang Province, and female college students who self-reported having sexual intercourse in the past year were included as study subjects, with sample size estimates of 5 265 and 9 466 for the two surveys, respectively. The factors related to the change of relevant characteristics of the two survey subjects were analyzed. The χ2 test was used for univariate analysis and logistic regression model was used for multivariate analysis.Statistical analyses were performed with SPSS 23.0 software.

Results: Of the 17 354 and 20 675 female college students surveyed in 2018 and 2020, respectively, the proportion who self-reported having had sex in the past year was 6.56% (1 139/17 354) and 4.19% (866/20 675). Multivariate logistic regression analysis showed that compared with female college students in 2018, the students who have sexual behaviour, receiving health education class by their university in the past year (aOR=1.57, 95%CI:1.29-1.91), receiving HIV testing promotion by the university in the past year (aOR=2.59,95%CI:2.13-3.14), receiving self-assessment of HIV risk by the university in the past year (aOR=2.97,95%CI:2.43-3.65), high self-efficacyfor condom use (aOR=2.00, 95%CI:1.66-2.41), receiving voluntary counseling and HIV testing (VCT) (aOR=1.81,95%CI: 1.41-2.87), perceived risk of HIV infection (aOR=2.44, 95%CI:1.32-4.54), using condoms whenever having casual sexual behaviour in the past year (aOR=3.35,95%CI:1.66-6.77) were significantly higher in 2020.

Conclusions: Compared with female college students in 2018, the proportion of female college students who self-reported sexual activity decreased slightly in 2020, and the proportion of receiving HIV/AIDS lectures or health education classes, the proportion of self-rated at risk of HIV infection, the proportion of receiving VCT, the proportion of using condoms with very high confidence in self-efficacy and condom use had an increased.