Applying the health belief model to identify predictors of self-perceived risk of HIV infection among undergraduates in mainland China

Abstract

Objective This cross-sectional study aimed to identify predictors of self- perceived risk of HIV infection among undergraduates in mainland China, based on the health belief model.Methods A self-administered questionnaire survey method was used to collect information from 10665 eligible undergraduates across the whole country (except for Tibet). Multivariate Logistic regression analysis was chosen to explore the predictors of self-perceived risk of HIV infection.Results Approximately half (48.2%) of the undergraduates perceived themselves to be at risk of contracting HIV, yet only 8.9% reported to engage in risky sexual behaviors. After controlling for potential confounders, males [adjusted odd ratio (AOR)=0.72, 95% confidence interval (CI)=0.66-0.77], those residing in urban areas (AOR=0.86, 95% CI= 0.79-0.93), having higher levels of condom use self-efficacy (AOR=0.64, 95% CI=0.58-0.69) and knowing the national AIDS policy (AOR=0.68, 95% CI=0.62-0.74) were less likely to perceive themselves to be at risk of acquiring HIV. Conversely, freshmen (AOR=1.27, 95% CI=1.16-1.38), non-heterosexuals (AOR=1.57, 95% CI=1.39-1.77), and those who had expressed less stigma towards people living with HIV (PLHIV) (AOR=1.25, 95% CI=1.15-1.35) and had the intention of utilizing voluntary counseling and testing (VCT) services (AOR=1.29, 95% CI=1.16-1.43) perceived themselves to be at increased risk for HIV infection.Conclusions Undergraduates tended to overestimate their own risk of acquiring HIV infection. In order to help undergraduates accurately assess their risk of being infected with HIV and effectively avoid risk, a comprehensive intervention measure should be taken to target females, non-heterosexuals, freshmen and those residing in rural areas, raise their awareness of the national AIDS policy, relieve their stigma against PLHIV, improve their condom use self-efficacy and provide VCT services in college campus.