Qi Li, Guo Ronghuang, Qu Yi, Li Xiaomei
School of Nursing, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
School of Nursing, Qiqihar Medical University, Qiqihar, China.
Front Public Health. 2025 May 23;13:1544564. doi: 10.3389/fpubh.2025.1544564. eCollection 2025.
Although the global human immunodeficiency virus (HIV) infection rate has decreased in recent years, the proportion and number of HIV-infected individuals aged 18-24 years has increased. The main mode of HIV transmission is sexual, a large proportion of the infected population are college students, and numerous health education activities have been implemented to prevent HIV infection, where mastery of relevant knowledge greatly improves. Nevertheless, the effectiveness of necessary protective measures is not ideal during actual behavior, indicating insufficient conversion of prevention knowledge to behavioral. To understand the factors and interactions that influence preventive behavior, we conducted a cross-sectional exploratory study.
Participants ( = 1,111) were students from Heilongjiang Province. A survey questionnaire was distributed through online social platforms. The questionnaire collected data on sociodemographic variables, perception of infection risk (PIR), perceived benefits of preventive behavior (PBPB), perceived disorders of preventive behavior (PDPB), attitudes of preventive behavior (APB), and behavior of wearing condoms (BWC).
BWC did not differ significantly according to gender, academic qualification pursued, or subject major ( ≥ 0.05), but did differ significantly based on sexual orientation, receiving HIV infection prevention education, and commercial and casual sexual behaviors. No significant correlation was detected between PIR and APB ( ≥ 0.05), while PBPB and APB were significantly positively and PDPB and APB significantly negatively correlated ( < 0.05). Further, there was no significant correlation between PBPB and BWC ( ≥ 0.05), while PIR and APB were positively correlated with BWC ( < 0.05), and there was a negative correlation between PDPB and BWC ( < 0.05). APB did not mediate between PDPB and BWC, but APB partially mediated between PDPB and BWC, accounting for approximately 9.96% of the total effect value, and played a fully mediating role (100%) between PBPB and BWC.
Our analysis indicates that PBPB acts on BWC through APB, PIR directly affects BWC, and PDPB can directly affect BWC, while also influencing BWC through APB. Future efforts to increase PBPB, PIR, and APB, reduce PDPB, and promote the use of condoms in sexual behavior among college students are warranted.
尽管近年来全球人类免疫缺陷病毒（HIV）感染率有所下降，但18至24岁HIV感染者的比例和数量却有所增加。HIV的主要传播方式为性传播，其中很大一部分感染人群是大学生，并且已经开展了许多预防HIV感染的健康教育活动，相关知识的掌握程度有了很大提高。然而，在实际行为中必要防护措施的有效性并不理想，这表明预防知识向行为的转化不足。为了解影响预防行为的因素及其相互作用，我们开展了一项横断面探索性研究。
研究对象（n = 1111）为来自黑龙江省的学生。通过在线社交平台发放调查问卷。该问卷收集了关于社会人口学变量、感染风险感知（PIR）、预防行为的感知益处（PBPB）、预防行为的感知障碍（PDPB）、预防行为态度（APB）以及使用避孕套行为（BWC）的数据。
BWC在性别、学历或专业方面无显著差异（P≥0.05），但在性取向、接受HIV感染预防教育以及商业性行为和随意性行为方面存在显著差异。未检测到PIR与APB之间存在显著相关性（P≥0.05），而PBPB与APB呈显著正相关，PDPB与APB呈显著负相关（P<0.05）。此外，PBPB与BWC之间无显著相关性（P≥0.05），而PIR和APB与BWC呈正相关（P<0.05），PDPB与BWC呈负相关（P<0.05）。APB在PDPB与BWC之间未起中介作用，但APB在PDPB与BWC之间部分起中介作用，占总效应值的约9.96%，在PBPB与BWC之间起完全中介作用（100%）。
我们的分析表明，PBPB通过APB作用于BWC，PIR直接影响BWC，PDPB既可以直接影响BWC，也可以通过APB影响BWC。未来有必要努力提高PBPB、PIR和APB，降低PDPB，并促进大学生在性行为中使用避孕套。
