Influence of HIV/AIDS knowledge on HIV testing behavior among young students (14-27 years) with a history of sexual activity: chain mediation analysis of social discrimination, self-efficacy, and sexual behavior characteristics

ABSTRACT

This study used a self-administered questionnaire to investigate the relationship between HIV/AIDS knowledge, social discrimination, HIV self-efficacy, sexual behavioral characteristics and HIV testing behavior among young students with a history of sexual activity in Chongqing. Propensity score matching was used to construct a control group with similar demographic characteristics to the HIV testing group, only without HIV testing behaviors. Structural equation modeling was used to conduct chain-mediated effect analysis. The HIV testing rate among young students with a history of sexual behavior was 17.16%. Young students with HIV testing behavior had higher levels of HIV/AIDS knowledge, lower social discrimination, better self-efficacy, and no difference in sexual behavior characteristic scores between the two groups (P = 0.062). The mediated effect values of social discrimination and self-efficacy were 0.022 and 0.063, respectively, while their chain mediated effect value was 0.007. There was no mediated effect of sexual behavior characteristics. The level of young students’ HIV/AIDS knowledge does not directly influence their HIV testing behavior but plays a complete chain mediating effect on HIV testing behavior through social discrimination and self-efficacy. HIV testing behavior should be promoted through the perspectives of enhancing HIV/AIDS knowledge level, reducing social discrimination, and improving self-efficacy.

KEYWORDS:

• Young students
• HIV/AIDS knowledge
• social discrimination
• HIV testing behavior
• chain mediation analysis

Acknowledgments

The authors would like to thank the experts at the Chongqing Health Education Institute and all the volunteers and students who participated in the survey.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval and consent to participate

The studies involving human participants were reviewed and approved by the Ethics Committee of Chongqing Medical University (No: 2019006).

Additional information

Funding

This study was supported by the project of Chongqing Science and Technology Bureau [grant no cstc2022ycjh-bgzxm0015] and the project of Chongqing Science and Technology Bureau [grant no CSTB2022NSCQ-MSX0804].