Abstract
BACKGROUND: Despite high level of acceptance, human immunodeficiency virus (HIV) testing rate among Chinese college students remained low. Few studies examined the extent of the relationship between HIV testing behavior and its influencing factors among college students. This study aimed to investigate HIV testing rates among college students and examine key factors associated with HIV testing behavior. METHODS: The convenience sampling method was used for college students from four colleges in Shanxi from October to December 2023. A network questionnaire survey was designed to collect information on general demographics, sexual encounters, and HIV testing behavior. Logistic regression and the decision tree model were combined to identify key factors influencing HIV testing behavior among college students. RESULTS: Among 3,115 college students, the rate of HIV testing was 2.5% (n = 77) in the past year. The binary logistic regression analysis indicated that students who had received school sex education (aOR = 2.78, 95%CI:1.51-5.09), homosexual orientation (aOR = 3.12, 95%CI:1.09-8.93), and had engaged in a sexual encounter in the past year (aOR = 5.13, 95%CI:2.50-10.53) were positively associated with HIV testing behavior. In addition, compared with freshmen, only sophomores were more likely to undergo HIV testing (aOR = 1.87, 95%CI:1.01-3.43). Further, the decision tree model revealed that the most significant factor influencing HIV testing behavior was having had a sexual encounter in the past year, followed by being in love and having received school sex education. The accuracy rate of the decision tree model was 97.53%, the precision rate was 97.53%, and the F1 value was 0.99. CONCLUSION: HIV testing rate among the college students was relatively low. Sexual experience, being in love and school sex education were significant predictors of HIV testing behavior. Being offered HIV self-testing services and implemented sex education programs at an early age may promote HIV testing behavior among college students.