{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:27:28Z","timestamp":1780367248800,"version":"3.54.1"},"reference-count":84,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>As college students emerge as a key HIV-vulnerable population in China, HIV self-testing (HIVST) presents a critical strategy for enhancing detection rates and enabling timely intervention. While observational studies have identified multifactorial influences on HIVST willingness, few investigations integrate behavioral theory with machine learning approaches among college students. This study aims to fill this gap by exploring the determinants of HIVST willingness among college students using the Health Belief Model (HBM) and random forest analytics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study employed stratified cluster sampling to recruit 1,015 undergraduates from Xiangnan College (July-August 2022), The Health Belief Model (HBM) was synthesized with random forest analytics to elucidate determinants of HIVST willingness. Data were collected through questionnaires, and logistic regression and random forest modeling were used for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among participants, 69.3% (<jats:italic>n<\/jats:italic>\u202f=\u202f703) expressed willingness to adopt HIVST within the next 6 months. 15.0% reported sexual activity (<jats:italic>n<\/jats:italic>\u202f=\u202f152), with 12.0% (<jats:italic>n<\/jats:italic>\u202f=\u202f122) of sexually active participants demonstrating concurrent engagement in unprotected intercourse and HIV testing willingness. HBM-based logistic regression revealed that self-efficacy (OR = 1.64, 95% CI: 1.21-2.21) and cues to action (OR = 1.34, 1.04-1.75) were significant facilitators, contrasting with the inhibitory effects of perceived barriers (OR = 0.69, 0.55-0.86). Random forest modeling prioritized these psychological constructs (mean decrease Gini &amp;gt;2.5), identifying male students and arts majors as critical subpopulations requiring targeted intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Our dual-method analysis establishes that campus HIV control necessitates: 1) Gender-specific prevention programs addressing male students\u2019 elevated risk exposure; 2) HBM-informed education strengthening self-efficacy and environmental cues; 3) Structural interventions reducing testing barriers through discreet service delivery. This theoretical-empirical integration advances predictive understanding of HIVST behaviors, providing actionable insights for developing precision public health strategies in academic settings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1596876","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T10:14:35Z","timestamp":1753956875000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Predicting HIV self-testing intentions among Chinese college students: a dual-model analysis integrating health belief constructs and machine learning prioritization"],"prefix":"10.3389","volume":"13","author":[{"given":"Yan","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingfen","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiazhen","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianli","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref1","volume-title":"Global HIV & AIDS statistics\u2014fact sheet","year":"2023"},{"key":"ref2","volume-title":"Core epidemiology slides","year":""},{"key":"ref3","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1126\/science.aay0799","article-title":"HIV upsurge in China's students","volume":"364","author":"Li","year":"2019","journal-title":"Science"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"913","DOI":"10.46234\/ccdcw2020.249","article-title":"Epidemiological characteristics of newly-reported HIV cases among youth aged 15-24 years - China, 2010-2019","volume":"2","author":"Zhao","year":"2020","journal-title":"China CDC Wkly"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1080\/09540121.2023.2280460","article-title":"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","volume":"36","author":"Yang","year":"2024","journal-title":"AIDS Care"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.46234\/ccdcw2022.210","article-title":"HIV-related knowledge, attitude, and practices research among college students - six Chinese cities, 2021","volume":"4","author":"Liu","year":"2022","journal-title":"China CDC Wkly"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e870","DOI":"10.52225\/narra.v4i2.870","article-title":"Meta-analysis of the effectiveness of educational programs about HIV prevention on knowledge, attitude, and behavior among adolescents","volume":"4","author":"Ratnawati","year":"2024","journal-title":"Narra J"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.jad.2021.03.067","article-title":"Mental health and risky sexual behaviors among Chinese college students: a large cross-sectional study","volume":"287","author":"Jin","year":"2021","journal-title":"J Affect Disord"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"142","DOI":"10.11847\/zgggws1113830","article-title":"Occurrence of sexual behavior among college students in mainland China: a meta-analysis","volume":"34","author":"Yang","year":"2018","journal-title":"Chin J Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s12978-017-0368-4","article-title":"The relationships of school-based sexuality education, sexual knowledge and sexual behaviors-a study of 18,000 Chinese college students","volume":"14","author":"Li","year":"2017","journal-title":"Reprod Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1037\/0003-066X.55.5.469","article-title":"Emerging adulthood. A theory of development from the late teens through the twenties","volume":"55","author":"Arnett","year":"2000","journal-title":"Am Psychol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1186\/s12889-025-21809-1","article-title":"Study on HIV knowledge and cultural attitudes about sexuality among Chinese college students","volume":"25","author":"Liu","year":"2025","journal-title":"BMC Public Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"104701","DOI":"10.1016\/j.actpsy.2025.104701","article-title":"Academic burnout among Chinese college students: a study based on FSQCA method","volume":"253","author":"Chen","year":"2025","journal-title":"Acta Psychol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.childyouth.2018.09.042","article-title":"\u201cMy youth, I call the shots\u201d: a qualitative examination of university students' perspectives on life transition and identity development in China","volume":"94","author":"Yuan","year":"2018","journal-title":"Child Youth Serv Rev"},{"key":"ref15","volume-title":"HIV risk behaviors.","year":""},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.46234\/ccdcw2021.249","article-title":"Research progress in the epidemiology of HIV\/AIDS in China","volume":"3","author":"He","year":"2021","journal-title":"China CDC Wkly"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3390\/diseases8010001","article-title":"I actually Don't know what HIV is: a mixed methods analysis of college students' HIV literacy","volume":"8","author":"Avina","year":"2020","journal-title":"Diseases"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e277","DOI":"10.1016\/S2352-3018(18)30044-4","article-title":"Reliability of HIV rapid diagnostic tests for self-testing compared with testing by health-care workers: a systematic review and meta-analysis","volume":"5","author":"Figueroa","year":"2018","journal-title":"Lancet HIV"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"100991","DOI":"10.1016\/j.eclinm.2021.100991","article-title":"Examining the effects of HIV self-testing compared to standard HIV testing services in the general population: a systematic review and meta-analysis","volume":"38","author":"Jamil","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1186\/s12992-018-0374-5","article-title":"Quantification and factors associated with HIV-related stigma among persons living with HIV\/AIDS on antiretroviral therapy at the HIV-day care unit of the Bamenda regional hospital, north west region of Cameroon","volume":"14","author":"Ajong","year":"2018","journal-title":"Glob Health"},{"key":"ref21","volume-title":"HIV\/AIDS in China: Epidemiology, Prevention and treatment","author":"Yin","year":"2020"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1186\/s12889-019-7435-4","article-title":"Inequities in consistent condom use among sexually experienced undergraduates in mainland China: implications for planning interventions","volume":"19","author":"Ruan","year":"2019","journal-title":"BMC Public Health"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/1471-2458-9-111","article-title":"Early initiation of sexual activity: a risk factor for sexually transmitted diseases, HIV infection, and unwanted pregnancy among university students in China","volume":"9","author":"Ma","year":"2009","journal-title":"BMC Public Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"21S","DOI":"10.1177\/1010539514549186","article-title":"Early sex initiation and subsequent unsafe sexual behaviors and sex-related risks among female undergraduates in Wuhan, China","volume":"27","author":"Li","year":"2015","journal-title":"Asia Pac J Public Health"},{"key":"ref25","volume-title":"Estimated HIV incidence and prevalence in the United States, 2018\u20132022. HIV Surveillance supplemental report","year":""},{"key":"ref26","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1037\/a0020997","article-title":"Unrealistic optimism about future life events: a cautionary note","volume":"118","author":"Harris","year":"2011","journal-title":"Psychol Rev"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1186\/s12889-018-5654-8","article-title":"HIV-related stigma and discrimination amongst healthcare providers in Guangzhou, China","volume":"18","author":"Dong","year":"2018","journal-title":"BMC Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1111\/hiv.12623","article-title":"HIV incidence is rapidly increasing with age among young men who have sex with men in China: a multicentre cross-sectional survey","volume":"19","author":"Mao","year":"2018","journal-title":"HIV Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1097\/JNC.0000000000000218","article-title":"Facilitators and barriers of HIV self-testing among Chinese men who have sex with men: a qualitative study","volume":"32","author":"Zhang","year":"2021","journal-title":"J Assoc Nurses AIDS Care"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1097\/QAI.0000000000001709","article-title":"HIV self-testing increases HIV testing frequency in high-risk men who have sex with men: a randomized controlled trial","volume":"78","author":"Katz","year":"2018","journal-title":"J Acquir Immune Defic Syndr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e069574","DOI":"10.1136\/bmjopen-2022-069574","article-title":"Investigating the impact of stigma, accessibility and confidentiality on STI\/STD\/HIV self-testing among college students in the USA: protocol for a scoping review","volume":"13","author":"Reeves","year":"2023","journal-title":"BMJ Open"},{"key":"ref32","volume-title":"WHO recommends HIV self-testing \u2013 evidence update and considerations for success","year":""},{"key":"ref33","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1177\/109019818801500203","article-title":"Social learning theory and the health belief model","volume":"15","author":"Rosenstock","year":"1988","journal-title":"Health Educ Q"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e110","DOI":"10.1097\/ADM.0000000000000640","article-title":"Self-efficacy mediates perceived benefits and barriers of adherence of heroin-dependent patients to methadone for addiction treatment: a health belief model study","volume":"14","author":"Yu","year":"2020","journal-title":"J Addict Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1398","DOI":"10.1016\/j.jiph.2021.08.024","article-title":"The health belief model as an explanatory framework for COVID-19 prevention practices","volume":"14","author":"Alagili","year":"2021","journal-title":"J Infect Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00332747.2022.2114270","article-title":"The health belief model in the context of alcohol protective behavioral strategies","volume":"86","author":"De Leon","year":"2023","journal-title":"Psychiatry"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e0284865","DOI":"10.1371\/journal.pone.0284865","article-title":"Acceptance and associated factors of HIV testing among college students in China: a systematic review and meta-analysis","volume":"18","author":"Liao","year":"2023","journal-title":"PLoS One"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1177\/0956462420920136","article-title":"Acceptability and correlates of HIV self-testing among university students in northern Nigeria","volume":"31","author":"Iliyasu","year":"2020","journal-title":"Int J STD AIDS"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20065029","article-title":"Low behavioral intention to use any type of HIV testing and HIV self-testing among migrant male factory workers who are at high risk of HIV infection in China: a secondary data analysis","volume":"20","author":"Zhang","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1186\/s12889-020-08651-3","article-title":"Feasibility of an HIV self-testing intervention: a formative qualitative study among individuals, community leaders, and HIV testing experts in northern Tanzania","volume":"20","author":"Njau","year":"2020","journal-title":"BMC Public Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"102331","DOI":"10.1016\/j.eclinm.2023.102331","article-title":"A machine learning system to optimise triage in an adult ophthalmic emergency department: a model development and validation study","volume":"66","author":"Brandao-de-Resende","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jinf.2020.11.007","article-title":"Predicting the diagnosis of HIV and sexually transmitted infections among men who have sex with men using machine learning approaches","volume":"82","author":"Bao","year":"2021","journal-title":"J Infect"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"967681","DOI":"10.3389\/fpubh.2022.967681","article-title":"Application of machine learning algorithms in predicting HIV infection among men who have sex with men: model development and validation","volume":"10","author":"He","year":"2022","journal-title":"Front Public Health"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3969\/j.issn.1006-3110.2020.02.007","article-title":"Analysis of willingness to accept voluntary counseling and testing services for HIV and its influencing factors among young students in China in 2018","volume":"27","author":"Liang","year":"2020","journal-title":"Pract Prevent Med"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"158","DOI":"10.19971\/j.cnki.1006-4028.23072","article-title":"Survey on AIDS related knowledge and behavior of college students in Jilin Province in 2021","volume":"40","author":"Hu","year":"2024","journal-title":"J Prev Med Inf"},{"key":"ref46","first-page":"156","article-title":"Analysis of condom use and influencing factors among college students with sexual behavior in Shandong Province","volume":"32","author":"Chen","year":"2023","journal-title":"Chin J Hum Sex"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1111\/j.1532-7795.2011.00775.x","article-title":"Condom use trajectories in adolescence and the transition to adulthood: the role of mother and father support","volume":"22","author":"Pingel","year":"2012","journal-title":"J Res Adolesc"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1001\/jamainternmed.2019.5222","article-title":"Effect of internet-distributed HIV self-tests on HIV diagnosis and behavioral outcomes in men who have sex with men: a randomized clinical trial","volume":"180","author":"MacGowan","year":"2020","journal-title":"JAMA Intern Med"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"717","DOI":"10.13668\/j.issn.1006-9070.2023.06.021","article-title":"Investigation on the willingness and influencing factors of HIV self-testing among college students in Lianyungang","volume":"34","author":"Jiang","year":"2023","journal-title":"Jiangsu J Prev Med"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"149","DOI":"10.3969\/j.issn.1006-3110.2020.02.007","article-title":"Willingness to accept HIV\/AIDS voluntary counseling and testing serviceand its influencing factors among young students in China, 2018","volume":"27","author":"Liang","year":"2020","journal-title":"Pract Prevent Med"},{"key":"ref51","first-page":"396","article-title":"Investigation on the willingness and influencing factors of HIV self-testing among junior college students in Chengdu","volume":"37","author":"Huang","year":"2021","journal-title":"J Prev Med Inform"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1097\/QAI.0000000000003003","article-title":"Targeted implementation of HIV self-testing increases testing uptake among partners of index persons known to have HIV in Kenya","volume":"90","author":"Zewdie","year":"2022","journal-title":"J Acquir Immune Defic Syndr"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"402","DOI":"10.2105\/AJPH.2015.302979","article-title":"Young people and HIV: a call to action","volume":"106","author":"Koenig","year":"2016","journal-title":"Am J Public Health"},{"key":"ref54","first-page":"1912","article-title":"Acceptance of HIV testing among African-American college students at a historically black university in the south","volume":"98","author":"Payne","year":"2006","journal-title":"J Natl Med Assoc"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00257-19","article-title":"Bringing HIV self-testing to scale in the United States: a review of challenges, potential solutions, and future opportunities","volume":"57","author":"Steehler","year":"2019","journal-title":"J Clin Microbiol"},{"key":"ref56","volume-title":"HIV self-testing strategic framework: a guide for planning, introducing and scaling up","year":""},{"key":"ref57","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1089\/apc.2019.0283","article-title":"Verification of HIV self-testing use and results: a global systematic review","volume":"34","author":"Tahlil","year":"2020","journal-title":"AIDS Patient Care STDs"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1186\/s12889-022-12917-3","article-title":"HIV self-testing implementation, distribution and use among female sex workers in Cotonou, Benin: a qualitative evaluation of acceptability and feasibility","volume":"22","author":"Boisvert Moreau","year":"2022","journal-title":"BMC Public Health"},{"key":"ref59","volume-title":"Human immunodeficiency virus (HIV) rapid diagnostic tests for professional use and\/or self-testing: annex 4: WHO expert committee on biological standardization: WHO technical report series, 1011: sixty-eighth report","year":"2021"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1111\/j.1746-1561.2003.tb06575.x","article-title":"Sexual knowledge, attitudes, and risk behaviors of students in Turkey","volume":"73","author":"G\u00f6kengin","year":"2003","journal-title":"J Sch Health"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"164","DOI":"10.3760\/cma.j.cn112338-20200120-00048","article-title":"HIV related risk factors among adolescents and young adults","volume":"42","author":"Ling","year":"2021","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1111\/hiv.12500","article-title":"Prevalence of and factors associated with unprotected anal intercourse with regular and nonregular male sexual partners among newly diagnosed HIV-positive men who have sex with men in China","volume":"18","author":"Wang","year":"2017","journal-title":"HIV Med"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"e0140555","DOI":"10.1371\/journal.pone.0140555","article-title":"Exploring unprotected anal intercourse among newly diagnosed HIV positive men who have sex with men in China: an ethnographic study","volume":"10","author":"Li","year":"2015","journal-title":"PLoS One"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1080\/08964289.2015.1034645","article-title":"Social network assessments and interventions for health behavior change: a critical review","volume":"41","author":"Latkin","year":"2015","journal-title":"Behav Med"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"82","DOI":"10.21091\/mppa.2024.2011","article-title":"Comparison of perfectionism between music and medical students and its association with anxiety","volume":"39","author":"Alpheis","year":"2024","journal-title":"Med Probl Perform Art"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/j.ajic.2015.03.018","article-title":"Effect of a multimodal training program and traditional lecture method on nurses' hand hygiene knowledge, belief, and practice: a brief report","volume":"43","author":"Najafi Ghezeljeh","year":"2015","journal-title":"Am J Infect Control"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1891\/1541-6577.33.3.275","article-title":"Facilitators, barriers, and outcomes of self-initiated HIV testing: an integrative literature review","volume":"33","author":"Adebayo","year":"2019","journal-title":"Res Theory Nurs Pract"},{"key":"ref68","first-page":"309","article-title":"Willingness and influencing factors of HIV self-testing in Chinese college students: a meta-analysis","volume-title":"Capital Journal of Public Health","author":"Liao","year":"2022"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"2263","DOI":"10.1016\/j.socscimed.2009.02.041","article-title":"Increasing the acceptability of HIV counseling and testing with three c's: convenience, confidentiality and credibility","volume":"68","author":"Angotti","year":"2009","journal-title":"Soc Sci Med"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph191610185","article-title":"The influencing factors of HIV-preventive behavior based on health belief model among HIV-negative MSMs in Western China: a structural equation modeling analysis","volume":"19","author":"Liu","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"1646","DOI":"10.1186\/s12889-022-14046-3","article-title":"Does the perception of HIV risk among female sex workers affect HIV prevention behavior? Application of the health belief model (HBM)","volume":"22","author":"Asefa","year":"2022","journal-title":"BMC Public Health"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1016\/j.jadohealth.2021.05.017","article-title":"Addressing HIV\/sexually transmitted diseases and pregnancy prevention through schools: an approach for strengthening education, health services, and school environments that promote adolescent sexual health and well-being","volume":"70","author":"Wilkins","year":"2022","journal-title":"J Adolesc Health"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1186\/s12889-023-16140-6","article-title":"Trends and influencing factors of HIV health education receive rate among 0.57 million migrants in China from 2009 to 2017: a national population-based study","volume":"23","author":"Che","year":"2023","journal-title":"BMC Public Health"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/j.pedhc.2021.04.008","article-title":"Perspectives on sexual health, sexual health education, and HIV prevention from adolescent (13-18 years) sexual minority males","volume":"35","author":"Cahill","year":"2021","journal-title":"J Pediatr Health Care"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1080\/09540121.2021.1938964","article-title":"Self-efficacy as a crucial psychological predictor of treatment adherence among elderly people living with HIV: analyses based on the health belief model","volume":"34","author":"Yu","year":"2022","journal-title":"AIDS Care"},{"key":"ref76","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1017\/S0021932018000330","article-title":"Concerns about contracting HIV, knowing partners' HIV sero-status and discussion of HIV\/STI with sexual partners as determinants of uptake of HIV testing","volume":"51","author":"Ajayi","year":"2019","journal-title":"J Biosoc Sci"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"18(9)","DOI":"10.3390\/ijerph18094850","article-title":"Condom-protected sex and minority stress: associations with condom negotiation self-efficacy, \u201cpassing\u201d concerns, and experiences with Misgendering among transgender men and women in Brazil","volume":"18","author":"Catelan","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref78","doi-asserted-by":"publisher","first-page":"e130","DOI":"10.1016\/S2352-3018(20)30307-6","article-title":"Effect of SMS reminders on PrEP adherence in young Kenyan women (MPYA study): a randomised controlled trial","volume":"8","author":"Haberer","year":"2021","journal-title":"Lancet HIV"},{"key":"ref79","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1037\/\/0033-295x.84.2.191","article-title":"Self-efficacy: toward a unifying theory of behavioral change","volume":"84","author":"Bandura","year":"1977","journal-title":"Psychol Rev"},{"key":"ref80","doi-asserted-by":"publisher","first-page":"e0245542","DOI":"10.1371\/journal.pone.0245542","article-title":"Exploring perceptions of low risk behaviour and drivers to test for HIV among south African youth","volume":"16","author":"Muravha","year":"2021","journal-title":"PLoS One"},{"key":"ref81","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1037\/0278-6133.21.2.177","article-title":"Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth","volume":"21","author":"Fisher","year":"2002","journal-title":"Health Psychol"},{"key":"ref82","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1136\/sextrans-2015-052469","article-title":"Gay mobile apps and the evolving virtual risk environment: a cross-sectional online survey among men who have sex with men in China","volume":"92","author":"Tang","year":"2016","journal-title":"Sex Transm Infect"},{"key":"ref83","doi-asserted-by":"publisher","first-page":"e80594","DOI":"10.1371\/journal.pone.0080594","article-title":"Factors associated with willingness to accept oral fluid HIV rapid testing among most-at-risk populations in China","volume":"8","author":"Xun","year":"2013","journal-title":"PLoS One"},{"key":"ref84","volume-title":"UNAIDS global AIDS update\u2014confronting inequalities\u2014lessons for pandemic responses from 40 years of AIDS","year":"2021"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1596876\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T10:14:42Z","timestamp":1753956882000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1596876\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,31]]},"references-count":84,"alternative-id":["10.3389\/fpubh.2025.1596876"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1596876","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,31]]},"article-number":"1596876"}}