{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T06:34:03Z","timestamp":1764311643605,"version":"3.46.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"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":"\n Objective<\/jats:title>\n This study aimed to compare HIV-related knowledge, attitudes, sexual behaviors, and social networking between MSM college students with and without HIV infection, and to identify associated factors sustaining the high HIV prevalence in this population.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A cross-sectional survey was conducted among 686 HIV-positive and HIV-negative MSM college students recruited from Guangdong, Chongqing, and Shaanxi provinces (January 2019\u2013March 2021) via local Centers for Disease Control institutions and Non-Governmental Organizations. Data were collected through structured face-to-face interviews assessing sociodemographic, HIV knowledge sexual practices, and social behaviors. Comparative analyses utilized\n t<\/jats:italic>\n -tests and Barnard\/Fisher exact tests (significance:\n p<\/jats:italic>\n \u202f&lt;\u202f0.05), reporting effect sizes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n HIV-positive students were significantly older (median: 23 vs. 22\u202fyears;\n p<\/jats:italic>\n \u202f=\u202f0.007,\n \u03b4<\/jats:italic>\n \u202f=\u202f0.14) and more likely to engage in off-campus MSM networking (\n V<\/jats:italic>\n \u202f=\u202f0.20,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). Overall HIV knowledge awareness was 75.4%. However, it was significantly deficient in recognizing the interconnected epidemic risk between sexually transmitted infections and HIV. HIV-negative students reported higher rates of sexual activity with peers (\n V<\/jats:italic>\n \u202f=\u202f0.28,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), favorable attitudes toward one-night stands (\n V<\/jats:italic>\n \u202f=\u202f0.13,\n p<\/jats:italic>\n \u202f=\u202f0.019), and stronger protective practices including disclosing HIV status pre-intercourse (25.2% vs. 9.1%;\n V<\/jats:italic>\n \u202f=\u202f0.21,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), consistent condom use with casual partners (87.6% vs. 68.0%;\n V<\/jats:italic>\n \u202f=\u202f0.24,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001), and with partners met on-line (60.9% vs. 39.9%;\n V<\/jats:italic>\n \u202f=\u202f0.21,\n p<\/jats:italic>\n \u202f&lt;\u202f0.001). Only 50.6% of online partnerships involved condom consistency.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Persisting high HIV incidence among Chinese MSM students suggests deficits in translating HIV knowledge into protective behaviors, notably in on-line partner-seeking contexts. Tailored interventions must address structural vulnerabilities through integrated campus health services and technology-enabled risk-reduction strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1672161","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T06:29:59Z","timestamp":1764311399000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differences in HIV-related knowledge, attitudes, and behaviors among men who have sex with men (MSM): comparison between HIV-positive and HIV-negative college students"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhengwei","family":"Jing","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhui","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiyao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Therese","family":"Hesketh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Ning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhifeng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref1","first-page":"247","article-title":"Analysis 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