Abstract
Men who have sex with men college students in China face a high risk of HIV infection, yet evidence comparing uptake of different HIV testing modalities remains limited. Using data from three national cross-sectional surveys conducted between 2021 and 2023 among college students from 151 universities in 14 provinces, we examined HIV testing behaviors and associated factors among this population. Among 1,567 participants, 62.0% had ever tested for HIV, with self-testing more commonly reported than facility-based testing. Across testing modalities, recreational drug use during sexual activity, lack of awareness of post-exposure prophylaxis, and absence of a regular sexual partner were associated with lower odds of HIV testing. Self-testing was more common among students engaged in commercial sex, whereas facility-based testing was more likely among older students and those unwilling to use post-exposure prophylaxis. These findings highlight key behavioral gaps and underscore the need for targeted HIV prevention to improve testing uptake.