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Relationships between family functioning and HIV/AIDS-related preventive behaviors among young students with sexual

Xinmei Yang¹, Yang Chen², Xiaojing Xu³

¹School of Public Health and Health Management, Fujian Health College, Fuzhou, China.

Frontiers in Public Health

|February 20, 2026

Abstract

Objectives:

The prevalence of human immunodeficiency virus (HIV) remains a severe public health issue, especially among young people. To determine whether family functioning and self-monitoring influence HIV/acquired immunodeficiency syndrome (AIDS)-related preventive behaviors among young students with sexual experience, we conducted a cross-sectional exploratory study.

Methods:

This study, which used a convenience sampling method, was conducted in Fuzhou, China. The questionnaires used for this research included the Adaptation-Partnership-Growth-Affection-Resolve (APGAR) scale, the Self-Monitoring Scale, and questions concerning HIV/AIDS-related preventive behaviors. Binary logistic regression, multiple linear regression, and the Karlson-Holm-Breen method were employed to assess the relationship between family functioning and HIV/AIDS-related preventive behavior and to identify the mediating role of self-monitoring in this context.

Results:

A total of 29,038 students participated in the survey, of whom 2,510 had sexual experience. Family functioning had positive effects on students' attitudes toward HIV testing [odds ratio (OR): 1.763; p < 0.01], reading/hearing HIV/AIDS news (OR: 2.776; p < 0.001), seeking online information (OR: 2.815; p < 0.001), and engaging in discussions about HIV/AIDS with others (OR: 2.686; p < 0.001). Moreover, the results of the mediation analysis revealed that self-monitoring played a mediating role in the relationship between family functioning and HIV/AIDS-related preventive behaviors.

Conclusion:

Family functioning was mediated by self-monitoring and indirectly affected HIV/AIDS-related preventive behaviors. It is essential to promote family functioning education in public health programs and to develop family intervention tools. Practical activities pertaining to the prevention of HIV/AIDS should be added to the self-management content of sex education courses for young students.

Keywords:

HIV/AIDS family functioning preventive behaviors self-monitoring young students

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