jbm Journal of Biosciences and Medicines 2327-509X 2327-5081 Scientific Research Publishing 10.4236/jbm.2024.1212011 jbm-137964 Article Biomedical Life Sciences Analysis of the Correlation between Awareness of HIV/AIDS and Willingness to Use Condom among 3128 Freshmen in a University in the Border Area Zhou Yun 1 2 Su Wei 3 Liang Xueyin 4 Huang Yixuan 1 Tang Xuexia 5 Cao Xuang 1 6 School of Health Science and Technology, West Yunnan University of Applied Sciences, Dali, China School of Public Health, Dali University, Dali, China College of Nursing and Rehabilitation, North China University of Science and Technology, Tangshan, China School of Medicine, Xi’an Siyuan College, Xi’an, China Library of West Yunnan University of Applied Sciences, Dali, China School of Clinical Medicine, Yunnan Pharmaceutical and Health Career College, Kunming, China

All authors declare that they have no conflicts of interest.

 02 12 2024 12 2024 12 12 137 146 05 11 2024 02 12 2024 05 12 2024 © 2024 by the authors and Scientific Research Publishing Inc. 2024 This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/ ). https://doi.org/10.4236/jbm.2024.1212011

Objective: A correlation study was conducted between AIDS awareness and condom use among 3128 freshmen in a border university to understand their knowledge of AIDS, their mastery of preventive measures, and their attitudes, and to explore the factors influencing their willingness to use condoms, with the aim of providing targeted and effective scientific recommendations for the prevention and treatment of AIDS and sexual health education in the region. Methods:A random whole-cluster sampling method was used, and a self-constructed questionnaire was administered to university freshmen via the Questionnaire Star platform to conduct a survey study, and SPSS 25.0 statistical software was used to analyze the relevant statistics. The c2 test and binary logistic regression were applied to analyze the influence factors. Results: The knowledge rate of freshmen about AIDS was 80.3%, and 5.7% of freshmen were not willing to use condoms when having sex. Multifactorial analysis showed that female students (OR = 3.96, 95% CI: 2.66 - 5.89), knowledge of AIDS (OR = 1.70, 95% CI: 1.19 - 2.42), unwillingness to have sex with others (OR = 2.12, 95% CI: 1.45 - 3.10), and having received AIDS education (OR = 0.34, 95% CI: 0.22 - 0.52) as facilitators influencing condom use.Conclusions:Freshmen in a border university have relatively good knowledge of AIDS and overall high willingness to use condoms, but still need to be improved. Schools should emphasize AIDS entrance education, focusing on health interventions for male students, establishing correct sexual concepts for new students, and improving AIDS knowledge to increase the rate of condom use among new students.

 Borderland Area College Freshmen AIDS Awareness Condom Influencing Factors 1. Introduction

Teenagers exhibit active sexual behaviors [1] and open-minded sexual attitudes [2]. College students are characterized by strong learning capabilities and great receptivity to new things. However, they often experience asynchronous psychological and physiological maturation and lack appropriate sexual attitudes and education [3]. Consequently, the incidence of high-risk sexual behaviors among college students is relatively high [4]. The HIV infection rate among adolescents is on the increase [5], with nearly 3000 new infection cases among students aged 15 - 24 each year [6]. Studies have demonstrated that only when the condom utilization rate exceeds 90% can HIV and other sexually transmitted diseases be effectively prevented [7]. Hence, condom use is of great significance. Nevertheless, domestic scholars usually concentrate on HIV education, prevention, and intervention [8], and there are few studies on the willingness of college freshmen to use condoms [9][10]. Consequently, this research examines the freshmen of a particular university in the border region to ascertain the current state of their awareness regarding AIDS knowledge and the factors influencing their inclination to use condoms. This, in turn, offers references and a foundation for formulating comprehensive intervention strategies for freshman entrance education in universities within the border area.

 2. Objects and Methods 2.1. Research Subjects

A total of 3128 freshmen from different prefectures of a university in Yunnan Province (a border area) were selected as the research subjects.

 2.2. Method

2.2.1. Research Methodology/Content

The whole cluster sampling method was used to conduct the on-site survey using the Questionnaire Star platform; Respondents were informed of the strict confidentiality of information and anonymity of responses before the survey. Reviewing a large number of literature [11][12], the questionnaire was designed based on the Core Information on AIDS Prevention and Control Publicity and Education (2019 Edition) [13] and the Operation Manual of National AIDS Sentinel Surveillance Implementation Program (Young Students) [14] and in combination with the characteristics of college students themselves. The questionnaire includes the general situation of the respondents, AIDS knowledge, attitude, behavior and so on. Among them, there were 20 questions on AIDS-related knowledge, and ≥15 correct answers were regarded as knowledge of AIDS.

2.2.2. Statistical Methods

Data were collected by questionnaire star, and statistical analysis was performed by SPSS 25.0 statistical software. The quantitative data were represented by ( x ¯ ± s ), and the two groups were compared by t-test. The count data were represented by %, and statistical analysis was performed by c2-test. The factors with P < 0.05 in the univariate analysis results were included in the binary logistic regression analysis, and the test level α = 0.05.

2.2.3. Quality Control

Consistent pre-investigation training for investigators by CDC experts; On-site survey under the guidance of CDC professionals. the questionnaire must be completed by students independently and anonymously, and the same IP address can only be answered once. After the questionnaires were collected, unqualified questionnaires such as those with logical problems and short response times were eliminated; two-person parallel data entry was used and inconsistent data were further verified.

 3. Results 3.1. General Information

A total of 3128 questionnaires were collected in this survey, with 3121 valid questionnaires and an effective rate of 99.77%. Among them, there were 1355 males (43.4%) and 1766 females (56.6%); 2358 Han Chinese (75.6%), 299 Yi (9.6%); 56 Bai (1.8%); 37 Hui (1.2%); 61 Dai (2%); 310 other nationalities (9.9%); 670 in towns and cities (21.5%), and 2451 in rural areas (78.5%), see Table 1.

Table 1. Knowledge of AIDS among freshmen in a college ( x ¯ ± s ).

projects n score F /t value P value unknown known
sex
male 1355 16.15 ± 2.24 1.871 0.061 248 1107
women 1766 15.99 ± 2.24 366 1400
ethnic group
han 2358 16.04 ± 2.25 1.117 0.349 466 1892
yi 299 15.93 ± 2.43 67 232
bai 56 16.41 ± 1.88 6 50
hui 37 16.05 ± 2.06 7 30
dai 61 16.48 ± 1.97 7 54
others 310 16.18 ± 2.10 61 249
residence 2.996 0.003
urban 670 16.29 ± 2.20 115 555
rural 2451 16.00 ± 2.25 499 1952
3.2. Knowledge of AIDS among Freshmen in Colleges

Freshmen in the region scored 16.06 ± 2.24 points for their knowledge of AIDS, with a maximum of 20 points and a minimum of 1 point. There was a statistically significant difference in the AIDS knowledge scores of freshmen from urban and rural origins (t = 2.986, P < 0.05), with urban scores higher than rural. The overall knowledge rate of AIDS was 80.3% (2507/3121), of which the three questions with the lowest knowledge rate were: it is not possible to be infected with AIDS by kissing an AIDS patient, with a knowledge rate of 49.2%; it is not possible to be infected with AIDS by being bitten by mosquitoes, with a knowledge rate of 34.2%; at present, the main mode of transmission of AIDS in China’s youthful students is transmission by men who have sex with men, with a knowledge rate of 19.0%, see Table 1 and Table2 for details.

Table 2. The awareness rate of AIDS-related knowledge among freshmen in a university.

AIDS-related knowledge number of people who know awareness rate/%
You can’t tell if someone has AIDS by looking at them. 2798 89.7
AIDS is a serious and incurable epidemic 2390 76.6
You can’t get HIV from eating with someone who has it. 2636 84.5
Sharing toilets and baths with HIV-infected people does not spread AIDS 2020 64.7
It is not possible to be infected with HIV by studying in the same classroom for a long time with someone who has HIV. 2793 89.5
You can’t get HIV from a mosquito bite. 1066 34.2
You can’t get HIV from kissing an AIDS patient. 1534 49.2
HIV can still be transmitted even if a condom is used during sexual activity. 2709 86.8
At present, China has not succeeded in developing a cure for AIDS. 2720 87.2
Currently, among young students in China, the primary mode of HIV transmission is through sexual contact between males. 593 19.0
3.3. Condom Use among College Freshmen

5.7% (178/3121) of freshmen were unwilling to use condoms during sexual intercourse, and 1.6% (50/3121) were unwilling to accept HIV testing after having high-risk sex. 3.9% (121/3121) of the freshmen had had sexual intercourse without using condoms, and the three main reasons for their unwillingness to use condoms were: forgetting to use condoms, accounting for 83.7%; being too embarrassed to buy condoms, accounting for 6.6%; and being unwilling to use condoms, accounting for 3.7%.

 3.4. Univariate Analysis of Freshmen’s Willingness to Use Condoms

There were significant differences in the willingness to use condoms among freshmen of different genders, knowledge of AIDS, attitudes toward premarital sex, willingness to have sex with others, multiple sexual partners, and whether or not they had received AIDS-related education (P < 0.05). There was a statistically significant difference in the willingness to use condoms between different genders (c2 = 95.402, P < 0.001), and girls were more willing to use condoms. There was a statistically significant difference in the willingness to use condoms among freshmen with different levels of AIDS knowledge (c2 = 8.461, P = 0.003), and freshmen with higher levels of knowledge were more willing to use condoms. There was a statistically significant difference in the willingness to use condoms among freshmen with different attitudes towards premarital sex (c2 = 24.345, P < 0.001), and freshmen who opposed premarital sex were more inclined to use condoms. There was a statistically significant difference in the willingness to use condoms among freshmen with different views on having sex with others (c2 = 67.941, P < 0.001), and freshmen who did not want to have sex with others were more willing to use condoms. There was a statistically significant difference in condom use willingness between freshmen with different sexual partners (c2 = 9.469, P = 0.002), and freshmen without multiple sexual partners were more willing to use condoms; there was a statistically significant difference in condom use willingness between freshmen with and without AIDS education (c2 = 39.945, P < 0.001), and freshmen who had received AIDS-related education were more willing to use condoms. See Table 3.

Table 3. Univariate analysis of condom use willingness of college freshmen.

projects n willing unwilling c 2 value P value
gender 95.402 <0.001
man 1355 1215 140
woman 1766 1728 38
residence 0.002 0.968
urban 670 632 38
rural 2451 2311 140
HIV/AIDS Knowledge
unaware 614 564 50 8.461 0.003
aware 2507 2379 128
attitudes towards premarital sex 24.345 <0.001
it doesn’t matter. 231 207 24
as long as it’s not known to others or agreed upon by both parties. 330 300 30
just don’t spread diseases. 585 545 40
oppose 1975 1891 84
would you be willing to engage in sexual relations with others? 67.941 <0.001
willing 561 488 73
unwilling. 2560 2455 105
have you ever had multiple sexual partners? 9.469 0.002
yes 66 56 10
no 3055 2887 168
ever had same-sex intercourse? 1.817 0.178
yes 31 27 4
no 3090 2916 174
have you received education related to AIDS? 39.945 <0.001
yes 2906 2761 145
no 215 182 33
should people with HIV/AIDS be allowed to use public facilities? 5.038 0.078
in favor 1734 1648 86
oppose 1189 1113 76
it doesn’t matter. 198 182 16
3.5. Multifactorial Analysis of Freshmen’s Willingness to Use Condoms

Variables with P < 0.05 in the results of univariate analysis were included in the analysis of binary logistic regression model, which showed that female students (OR = 3.96, 95% CI: 2.66 to 5.89), knowledge of AIDS (OR = 1.70, 95% CI: 1.19 to 2.42), reluctance to have to have sex (OR = 2.12, 95% CI: 1.45 to 3.10), and having received AIDS-related education (OR = 0.34, 95% CI: 0.22 to 0.52) were the facilitators influencing condom use, as shown in Table 4.

 4. Discussion

This survey found that the AIDS knowledge rate among freshmen in the region was 80.3%, which was higher than the AIDS knowledge rate among college students in some provinces and cities in China in 2017 (77.4%) [15], but there was still a certain gap with the national requirement (90%) [16]. Low AIDS awareness can lead to high-risk sexual behavior [17], increasing the risk of AIDS. Studies have shown that health education is an important way to improve AIDS knowledge awareness [18]-[20], so incorporating AIDS health education into freshman admission education is of great significance to improving freshmen’s AIDS awareness. In addition, the AIDS knowledge score in urban areas was significantly higher than that in rural areas in this study, which is similar to the results of Zhang Wen et al. [21], which may be related to the fact that urban areas have more AIDS prevention and control publicity channels.

Table 4. Binary logistic regression analyses influencing the willingness of college freshmen to use condoms.

Projects β SE c 2 value P value OR value 95% CI
Gender
Man 1.00
Woman 1.377 0.203 45.9 <0.001 3.96 2.66 - 5.89
HIV/AIDS Knowledge
Unaware 1.00
Aware 0.533 0.181 8.716 0.003 1.70 1.19 - 2.42
Would you be willing to engage in sexual relations with others?
Willing 1.00
Unwilling. 0.754 0.193 15.282 <0.001 2.12 1.45 - 3.10
Have you received education related to AIDS?
Yes 1.00
No −1.067 0.217 24.239 <0.001 0.34 0.22 - 0.52

The use of condoms can effectively prevent the occurrence of AIDS and other sexually transmitted disease. This survey found that as many as 83.7% of freshmen forgot to use condoms when having sex, highlighting the lack of education on AIDS and STDs among college freshmen. Multivariate analysis found that gender, AIDS knowledge, willingness to have sex with others, whether there are too many sexual partners, and whether AIDS education has been received are important factors affecting condom use. This result is similar to the research results of Yan Yizhe [22]. In terms of gender: some studies have shown [10] that boys have more open sexual attitudes and weaker risk awareness, and low risk awareness leads to low willingness to use condoms. Some studies have also shown [23] that boys think it is normal to refuse to use condoms with their partners and think that this behavior is “part of the game” in interacting with female partners. Some individuals believe that using condoms can affect their sexual experience. The above are all the reasons why girls are more willing to use condoms than boys in this study. In terms of knowledge of AIDS: people who know AIDS knowledge are more willing to use condoms than those who do not know. People who know have a higher risk awareness and are more willing to use condoms for self-protection. Factors related to willingness to have sex with others: People who are unwilling to have sex with others are more willing to use condoms. Studies have shown that [24] premarital sex may reduce the awareness of high-risk sexual behavior and make it more likely to engage in high-risk sexual behavior. College students have an open attitude towards sex and are a high-risk group for high-risk sexual behavior; in terms of AIDS health education: health education is the best “vaccine” to prevent AIDS. People who have received AIDS-related education have good AIDS-related know-ledge, a higher awareness of self-protection, and are more willing to use condoms. A review of the literature found that most domestic and foreign researchers focus on AIDS treatment, education, prevention, and intervention, and there are fewer studies on the willingness of college freshmen to use condoms, especially in border areas, applied undergraduate colleges, and freshmen. There are fewer analyses of condom use and influencing factors. Therefore, this study “Correlation analysis between AIDS awareness and condom use willingness of 3128 freshmen in a border college” provides a new idea and method for the targeted AIDS prevention and control work of relevant departments in the future.

To sum up, the knowledge rate of AIDS among freshmen in border areas is relatively good, but gender, living environment, knowledge of AIDS, willingness to use condoms and so on have a certain impact on high-risk sexual behavior. Schools, as an important place for students to study and live, should play their role in increasing the strength of AIDS health education, especially focusing on the risk of male students, unwilling to use condoms and other key groups. Education, so that students have a correct understanding of “sex”, set up a correct concept of sex, improve their own awareness of prevention, and face up to the important role of condoms, and learn to be responsible for their own health and the health of others.

 Funding

The Scientific Research Fund Project of the Education Department of Yunnan Province in 2023 (No. 2023J1284).

 Authors’ Contributions

Yun Zhou: Writing—original draft, Design questionnaire, Funding. Wei Su: Writing—original draft. Xueyin Liang: Writing—review & editing. Yixuan Huang and Xuexia Tang: Completing the on-site questionnaire. Xuang Cao: Methodology, Investigation, Data curation.

 References Whiting, W., Pharr, J.R., Buttner, M.P. and Lough, N.L. (2019) Behavioral Interventions to Increase Condom Use among College Students in the United States: A Systematic Review. Health Education & Behavior, 46, 877-888. https://doi.org/10.1177/1090198119853008 10.1177/109019811985300831165629https://doi.org/10.1177/1090198119853008 Whiting, W. Pharr, J.R. Buttner, M.P. Lough, N.L. 2019 Behavioral Interventions to Increase Condom Use among College Students in the United States: A Systematic Review Health Education & Behavior 46 10.1177/1090198119853008 31165629 Huang, M.X., Xiao, Y. and Wang, S.F. (2020) Investigation on the Status of Sexual Conception and Behavior of College Students in 6 Universities in Guangzhou under the Background of Internet. Chinese Sexuality Science, 29, 157-160. https://doi.org/10.3969/j.issn.1672-1993.2020.10.044 10.3969/j.issn.1672-1993.2020.10.044https://doi.org/10.3969/j.issn.1672-1993.2020.10.044 Huang, M.X. Xiao, Y. Wang, S.F. 2020 Investigation on the Status of Sexual Conception and Behavior of College Students in 6 Universities in Guangzhou under the Background of Internet Chinese Sexuality Science 29 10.3969/j.issn.1672-1993.2020.10.044 Liu, Y. (2010) Investigation on the Status of Sexual Conception and Behavior of College Students in 6 Universities in Guangzhou under the Background of Internet. Qingdao University of Science and Technology. Liu, Y. 2010 Investigation on the Status of Sexual Conception and Behavior of College Students in 6 Universities in Guangzhou under the Background of Internet Li, J., Yu, Y.F., Yu, J.L., et al. (2022) Meta-Analysis of the Incidence of High-Risk Sexual Behavior among College Students in China. Contemporary Nurses ( Upper Ten Journal), 29, 4-9. https://doi.org/10.19791/j.cnki.1006-6411.2022.07.002 10.19791/j.cnki.1006-6411.2022.07.002https://doi.org/10.19791/j.cnki.1006-6411.2022.07.002 Li, J. Yu, Y.F. Yu, J.L. 2022 Meta-Analysis of the Incidence of High-Risk Sexual Behavior among College Students in China Contemporary Nurses (Upper Ten Journal) 29 10.19791/j.cnki.1006-6411.2022.07.002 He, S., Gan, Q.Y., Fan, S.F., et al. (2018) Meta-Analysis of the Incidence of High-Risk Sexual Behaviors among College Students in China. China AIDS STD, 24, 208-210. https://doi.org/10.13419/j.cnki.aids.2018.02.28 10.13419/j.cnki.aids.2018.02.28https://doi.org/10.13419/j.cnki.aids.2018.02.28 He, S. Gan, Q.Y. Fan, S.F. 2018 Meta-Analysis of the Incidence of High-Risk Sexual Behaviors among College Students in China China AIDS STD 24 10.13419/j.cnki.aids.2018.02.28 Chen, T.Q., Huang, Y.Y., Bu, K., et al. (2021) Willingness and Behavior of HIV Testing among College Students in Beijing City: A Multi-Dimensional Analysis. Chinese Journal of Public Health, 37, 244-250. https://doi.org/10.11847/zgggws1125765 10.11847/zgggws1125765https://doi.org/10.11847/zgggws1125765 Chen, T.Q. Huang, Y.Y. Bu, K. 2021 Willingness and Behavior of HIV Testing among College Students in Beijing City: A Multi-Dimensional Analysis Chinese Journal of Public Health 37 10.11847/zgggws1125765 Yu, B., Han, J.Y., Huang, Y.L., et al. (2022) Research Progress on the Influencing Factors of Condom Use Behavior among Young MSM Students in China. China AIDS STD, 28, 1107-1110. https://doi.org/10.13419/j.cnki.aids.2022.09.26 10.13419/j.cnki.aids.2022.09.26https://doi.org/10.13419/j.cnki.aids.2022.09.26 Yu, B. Han, J.Y. Huang, Y.L. 2022 Research Progress on the Influencing Factors of Condom Use Behavior among Young MSM Students in China China AIDS STD 28 10.13419/j.cnki.aids.2022.09.26 Zheng, Q.Y., Duan, D., Zhu, Q.S., et al. (2022) Hotspots and Frontier Trends of AIDS Research among Chinese and Foreign College Students. Modern Preventive Medicine, 49, 1506-1513. Zheng, Q.Y. Duan, D. Zhu, Q.S. 2022 Hotspots and Frontier Trends of AIDS Research among Chinese and Foreign College Students Modern Preventive Medicine 49 Zhan, C.L., Zhou, H.W., Li, H.B., et al. (2022) Analysis of Willingness and Influencing Factors of On-Campus Free Condom Using among College Students in Shanghai. Chinese Journal of Disease Control & Prevention, 26, 1395-1401. https://doi.org/10.16462/j.cnki.zhjbkz.2022.12.006 10.16462/j.cnki.zhjbkz.2022.12.006https://doi.org/10.16462/j.cnki.zhjbkz.2022.12.006 Zhan, C.L. Zhou, H.W. Li, H.B. 2022 Analysis of Willingness and Influencing Factors of On-Campus Free Condom Using among College Students in Shanghai Chinese Journal of Disease Control & Prevention 26 10.16462/j.cnki.zhjbkz.2022.12.006 Tang, R., Wei, P.M. and Liu, Y.Y. (2022) Investigation of Knowledge of AIDS and Attitude about Condom Use in Freshmen from Higher Vocational Colleges. Chinese Journal of Dermatovenereology, 36, 193-198+215. https://doi.org/10.13735/j.cjdv.1001-7089.202107078 10.13735/j.cjdv.1001-7089.202107078https://doi.org/10.13735/j.cjdv.1001-7089.202107078 Tang, R. Wei, P.M. Liu, Y.Y. 2022 Investigation of Knowledge of AIDS and Attitude about Condom Use in Freshmen from Higher Vocational Colleges Chinese Journal of Dermatovenereology 36 10.13735/j.cjdv.1001-7089.202107078 Pourzan, G. and Laird-Fick, H.S. (2019) A Vexing Vulvitis: A Case Report and Review of Plasma Cell Vulvitis. Journal of Obstetrics and Gynaecology, 39, 722-723. https://doi.org/10.1080/01443615.2019.1572076 10.1080/01443615.2019.157207631006288https://doi.org/10.1080/01443615.2019.1572076 Pourzan, G. Laird-Fick, H.S. 2019 A Vexing Vulvitis: A Case Report and Review of Plasma Cell Vulvitis Journal of Obstetrics and Gynaecology 39 10.1080/01443615.2019.1572076 31006288 Meng, Y., Yan, C.S., Wang, D.F., et al. (2015) Knowledge and Influence Factors towards AIDS among Undergraduates in Private Colleges in Zhengzhou. Chinese Journal of School Health, 36, 1482-1484. https://doi.org/10.16835/j.cnki.1000-9817.2015.10.016 10.16835/j.cnki.1000-9817.2015.10.016https://doi.org/10.16835/j.cnki.1000-9817.2015.10.016 Meng, Y. Yan, C.S. Wang, D.F. 2015 Knowledge and Influence Factors towards AIDS among Undergraduates in Private Colleges in Zhengzhou Chinese Journal of School Health 36 10.16835/j.cnki.1000-9817.2015.10.016 Chinese Center for Disease Control and Prevention (2016). Questionnaire on Core Knowledge of AIDS Publicity and Education and Knowledge of AIDS. https://wenku.baidu.com/view/3060d2db70fe910ef12d2af90242a8956becaa33.html 2016 Center for STD/AIDS Prevention and Control and Chinese Center for Disease Control and Prevention (n.d.) Operational Manual for the National AIDS Sentinel Surveillance Implementation Program. Wang, Y.X., Ma, Y.H., Zhang, B., et al. (2017) AIDS Knowledge and Source of Knowledge among College Students in 15 Provinces in China. Chinese Journal ofSchool Health, 38, 657-659+662. https://doi.org/10.16835/j.cnki.1000-9817.2017.05.005 10.16835/j.cnki.1000-9817.2017.05.005https://doi.org/10.16835/j.cnki.1000-9817.2017.05.005 Wang, Y.X. Ma, Y.H. Zhang, B. 2017 AIDS Knowledge and Source of Knowledge among College Students in 15 Provinces in China Chinese Journal of School Health 38 10.16835/j.cnki.1000-9817.2017.05.005 State Council of the People’s Republic of China (2017) Circular of the General Office of the State Council on the issuance of the 13th Five-Year Plan of Action for the Containment and Prevention of AIDS in China. Bulletin of the State Council of the People’s Republic of China. 2017 Circular of the General Office of the State Council on the issuance of the 13th Five-Year Plan of Action for the Containment and Prevention of AIDS in China Li, Y., Luo, H.Y., Li, H.L., et al. (2019) Survey on College Students’ Attitudes toward AIDS Awareness and Analysis of Blind Spots in Health Education. China AIDS STD, 25, 966-967. https://doi.org/10.13419/j.cnki.aids.2019.09.25 10.13419/j.cnki.aids.2019.09.25https://doi.org/10.13419/j.cnki.aids.2019.09.25 Li, Y. Luo, H.Y. Li, H.L. 2019 Survey on College Students’ Attitudes toward AIDS Awareness and Analysis of Blind Spots in Health Education China AIDS STD 25 10.13419/j.cnki.aids.2019.09.25 Ebersole, A.M., Boch, S.J., Bonny, A.E., Chisolm, D.J. and Berlan, E.D. (2021) Disparities in HIV Education and Testing between Metropolitan and Nonmetropolitan Adolescents and Young Adults in the U.S. Journal of Adolescent Health, 68, 819-822. https://doi.org/10.1016/j.jadohealth.2020.11.009 10.1016/j.jadohealth.2020.11.00933288461https://doi.org/10.1016/j.jadohealth.2020.11.009 Ebersole, A.M. Boch, S.J. Bonny, A.E. Chisolm, D.J. Berlan, E.D. 2021 Disparities in HIV Education and Testing between Metropolitan and Nonmetropolitan Adolescents and Young Adults in the U S. Journal of Adolescent Health 68 10.1016/j.jadohealth.2020.11.009 33288461 Du, M.M., Jin, Y.Y., Li, Y.P., et al. (2020) Effectiveness Evaluation of AIDS Health Education in a College in Chengdu Based on Paired Design. Modern Preventive Medicine, 47, 1075-1078. Du, M.M. Jin, Y.Y. Li, Y.P. 2020 Effectiveness Evaluation of AIDS Health Education in a College in Chengdu Based on Paired Design Modern Preventive Medicine 47 Cahill, S.R., Wang, T.M., Fontenot, H.B., Geffen, S.R., Conron, K.J., Mayer, K.H., et al. (2021) Perspectives on Sexual Health, Sexual Health Education, and HIV Prevention from Adolescent (13-18 Years) Sexual Minority Males. Journal of PediatricHealth Care, 35, 500-508. https://doi.org/10.1016/j.pedhc.2021.04.008 10.1016/j.pedhc.2021.04.00834154868https://doi.org/10.1016/j.pedhc.2021.04.008 Cahill, S.R. Wang, T.M. Fontenot, H.B. Geffen, S.R. Conron, K.J. Mayer, K.H. Health, S 2021 Perspectives on Sexual Health, Sexual Health Education, and HIV Prevention from Adolescent (13-18 Years) Sexual Minority Males Journal of Pediatric Health Care 35 10.1016/j.pedhc.2021.04.008 34154868 Zhang, W., Liu, J.L., Ren, J.X., et al. (2023) Investigation on Status Quo of AIDS Knowledge Awareness and Health Education Needs among College Students in Weifang City. Chinese Journal of Preventive Medicine, 24, 1322-1327. https://doi.org/10.16506/j.1009-6639.2023.12.009 10.16506/j.1009-6639.2023.12.009https://doi.org/10.16506/j.1009-6639.2023.12.009 Zhang, W. Liu, J.L. Ren, J.X. 2023 Investigation on Status Quo of AIDS Knowledge Awareness and Health Education Needs among College Students in Weifang City Chinese Journal of Preventive Medicine 24 10.16506/j.1009-6639.2023.12.009 Yan, Y.Z. (2021) Study on Strategies and Influencing Factors of College Students’ Condom Use Resistance. Southwest University. Yan, Y.Z. 2021 Study on Strategies and Influencing Factors of College Students’ Condom Use Resistance Davis, K.C., Schraufnagel, T.J., Kajumulo, K.F., Gilmore, A.K., Norris, J. and George, W.H. (2013) A Qualitative Examination of Men’s Condom Use Attitudes and Resistance: “It’s Just Part of the Game”. Archives of Sexual Behavior, 43, 631-643. https://doi.org/10.1007/s10508-013-0150-9 10.1007/s10508-013-0150-923912776https://doi.org/10.1007/s10508-013-0150-9 Davis, K.C. Schraufnagel, T.J. Kajumulo, K.F. Gilmore, A.K. Norris, J. George, W.H. 2013 A Qualitative Examination of Men’s Condom Use Attitudes and Resistance: “It’s Just Part of the Game” Archives of Sexual Behavior 43 10.1007/s10508-013-0150-9 23912776 Yang, X., Yuan, S., Zhang, R., Yu, J., Nzala, S.H., Wang, P., et al. (2019) Risky Sexual Behaviors and Associated Factors among College Students in Lusaka, Zambia. Archives of Sexual Behavior, 48, 2117-2123. https://doi.org/10.1007/s10508-019-1442-5 10.1007/s10508-019-1442-531309429https://doi.org/10.1007/s10508-019-1442-5 Yang, X. Yuan, S. Zhang, R. Yu, J. Nzala, S.H. Wang, P. Lusaka, Z 2019 Risky Sexual Behaviors and Associated Factors among College Students in Lusaka, Zambia Archives of Sexual Behavior 48 10.1007/s10508-019-1442-5 31309429