HIV/AIDS Knowledge, Attitudes, and Behaviors among Students Men Who Have Sex with Men in Chongqing Universities: A Cross-Sectional Study and Health Education Model Development

Introduction : The rising HIV infection rate among Chinese college students, particularly men who have sex with men ( MSM ), is a critical public health concern. University MSM students, with their dual identities as both students and sexual minorities, may have unique cognitive, behavioral, and service needs inadequately addressed by general interventions. This study, conducted in 2025, investigated HIV/AIDS-related knowledge, attitudes, and behaviors ( KAB ) among this population in Chongqing, China, aiming to develop a targeted health education model for university settings. Methods : A cross-sectional survey was conducted with 1,400 MSM students recruited via snowball sampling through online platforms and community-based organizations. An anonymous online questionnaire assessed demographics, HIV/AIDS-related knowledge (13 items), attitudes (13 items), behaviors (3 items), and health education needs (6 items). Chi-square tests, logistic regression, and path analysis were performed. Results : The overall awareness rate of basic HIV knowledge was 78.50%, positive attitudes 49.93%, and high-risk sexual behaviors 64.79%. Misconceptions about non-transmission routes ( e.g., mosquito bites ) were common (~ 70% awareness ). Multivariate analysis identified lower education level, arts/sports majors, non-participation in health education, and reliance on traditional media as significant risk factors for poorer KAB outcomes ( P  < 0.05 ). Path analysis validated the knowledge-attitude-behavior model, demonstrating that knowledge reduces high-risk behavior both directly and indirectly through attitudes. Students expressed strong demand for practical prevention information and favored interactive, structured educational formats. Conclusions : High-risk behaviors are prevalent among university MSM students, driven by identifiable and potentially modifiable factors. The validated KAB model provides a theoretical foundation for intervention. We propose a structured, multi-component health education model targeting specific subgroups ( e.g., arts/sports majors ) and integrating digital and formal curricula. Policy Implications : These findings underscore the need for precision health education strategies in university settings. Policymakers should prioritize resource allocation toward high-risk subgroups, mandate structured HIV education within formal curricula, and leverage digital platforms to enhance reach and engagement. Such targeted approaches are essential for reducing HIV transmission among MSM students and achieving national prevention goals.