{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:11:38Z","timestamp":1787019098012,"version":"build-2736575974"},"reference-count":37,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Patient Care and STDs"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Limited research exists on HIV pre-exposure prophylaxis (PrEP) interest among female university students in high-HIV-prevalence African settings. This study sought to establish the relationship between epidemiological and perceived HIV risk and PrEP intention among young women in higher education in Zambia. We recruited female students at an urban university to complete an online survey on intention to use PrEP in the next year (primary outcome); PrEP knowledge, attitudes, and behaviors; demographics; epidemiological HIV risk; and risk perception. Descriptive statistics, regression, and mediation analyses were used. Of the 454 sexually active participants, 118 (26%) reported PrEP intention. Actual PrEP use was rare (&lt;5%). The odds of PrEP intention increased for those with perceived high HIV risk [adjusted odds ratio (aOR) = 3.08; 95% confidence interval (CI): 1.71\u20135.55] and with each year at university (aOR = 1.47; 95% CI: 1.21\u20131.80) but decreased with higher PrEP stigma (aOR = 0.91; 95% CI: 0.86\u20130.96) and more negative PrEP perceptions (aOR = 0.91; 95% CI: 0.85\u20130.97). More epidemiological risk factors were originally associated with PrEP intention (aOR = 1.24; 95% CI: 1.01\u20131.53 for each risk factor), though this relationship weakened after adjustment for perceived HIV risk, which mediated 69% of the relationship between epidemiological HIV risk and PrEP intention. Only 23% of high-risk participants recognized their high epidemiological HIV risk (3+ risk factors). Along with PrEP education and stigma reduction, there is a need for approaches that help female university students in Zambia accurately identify their HIV risk to make informed decisions about PrEP use.<\/jats:p>","DOI":"10.1177\/10872914251382524","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:27:17Z","timestamp":1759480037000},"page":"418-426","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["HIV Risk and Intention to Use HIV Pre-exposure Prophylaxis Among Sexually Active Female University Students in Zambia: A Cross-Sectional Survey to Understand Influential Factors"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7577-5500","authenticated-orcid":false,"given":"Karen","family":"Hampanda","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Bolt","sequence":"additional","affiliation":[{"name":"Department of Center for Innovative Design &amp; Analysis, Colorado School of Public Health, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lillian","family":"Nayame","sequence":"additional","affiliation":[{"name":"School of Public Health Department of Health Promotion, University of Zambia, Lusaka, Zambia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7907-0899","authenticated-orcid":false,"given":"Madeleine","family":"Sehrt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Thorne","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Twaambo E.","family":"Hamoonga","sequence":"additional","affiliation":[{"name":"School of Public Health Department of Population Studies and Global Health, University of Zambia, Lusaka, Zambia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margo S.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1255-7191","authenticated-orcid":false,"given":"Jillian","family":"Pintye","sequence":"additional","affiliation":[{"name":"Department of Biobehavioral Nursing &amp; Health Informatics, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Amstutz","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland."},{"name":"Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway."},{"name":"Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, England."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa L.","family":"Abuogi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Mweemba","sequence":"additional","affiliation":[{"name":"Department of Center for Innovative Design &amp; Analysis, Colorado School of Public Health, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Zambia Population-Based HIV Impact Assessment (ZAMPHIA) 2015\u20132016","author":"PHIA Project","year":"2016","unstructured":"PHIA Project. 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