Health literacy as a determinant of HIV/AIDS preventive behavior
A cross-sectional study among university students in Yogyakarta, Indonesia
DOI:
https://doi.org/10.24252/corejournal.v5i2.57773Keywords:
acquired immunodeficiency syndrome, health behavior, health literacy, universities, studentsAbstract
Previous studies have shown a general association between health literacy and HIV/AIDS prevention behaviors; however, few have focused specifically on university students in educational hubs such as Yogyakarta, Indonesia. Moreover, the role of digital access and socio-cultural context in shaping student health literacy remains underexplored. This study aimed to analyze the relationship between health literacy levels and HIV/AIDS prevention behavior among university students in Yogyakarta. A cross-sectional analytical design was used involving 133 students recruited through consecutive sampling between May 5–23, 2025. Data were collected via a structured online questionnaire measuring both health literacy and HIV/AIDS prevention behavior. Bivariate analysis was conducted using the Chi-Square test. The findings revealed a statistically significant association between health literacy and HIV/AIDS prevention behavior (p = 0.000). Students with higher health literacy were substantially more likely to engage in preventive behaviors, including safe sex practices and HIV testing, than those with low health literacy. This study reinforces the critical role of health literacy in influencing HIV/AIDS prevention among university students. The findings support the integration of health literacy education into academic programs as a public health strategy. Health professionals and policymakers should prioritize targeted literacy interventions to enhance health behaviors among youth populations.
References
Akakpo, M., & Neuerer, M. (2024). The relationship between health literacy and health seeking behavior amongst university students in Ghana: A cross sectional study. Health Science Reports, 7(5). https://doi.org/10.1002/hsr2.2153
Almanasef, M. (2021). Mental health literacy and help seeking behaviours among undergraduate pharmacy students in Abha, Saudi Arabia. Risk Management and Healthcare Policy, 14, 1281–1286. https://doi.org/10.2147/RMHP.S289211
Amanu, A., Birhanu, Z., & Godesso, A. (2023). Sexual and reproductive health literacy among young people in Sub-Saharan Africa: Evidence synthesis and implications. Global Health Action, 16(1), 2279841. https://doi.org/10.1080/16549716.2023.2279841
Amoah, P., Boateng, M., Koduah, A., & Acheampong, P. (2022). Interplay of health literacy, healthcare access and health behaviors with oral health status among older persons. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.997987
Bunman, S., Wannapaschaiyong, P., Dumavibhat, N., Virojskulchai, T., Nomsiri, A., Malarat, A., & Saiyasalee, S. (2023). Measuring health literacy among people living with HIV in a medical university hospital: A cross sectional study. The Bangkok Medical Journal, 19(2), 111–115. https://doi.org/10.31524/bkkmedj.2023.21.007
Colon Lopez, V., Perez Guzman, D., Torre, M., Centeno Alvarado, N., Agudelo Salas, I., Rolon, Y., & Lozada, G. (2022). Provider initiated HIV testing in Puerto Rico from data of the National HIV Behavioral Surveillance–Heterosexual cycle (NHBS het) 2016: National cross sectional survey. JMIR Public Health and Surveillance, 8(10), e29890. https://doi.org/10.2196/29890
Crowley, T., Bimerew, M., Noncungu, T., Akimanimpaye, F., Hoffman, J., Bimray, P., & Chipps, J. (2025). Health literacy of undergraduate students at a university in the Western Cape: A survey. Health SA Gesondheid. https://doi.org/10.4102/hsag.v30i0.2902
Dehghankar, L., Panahi, R., Khatooni, M., Fallah, S., Moafi, F., Anbari, M., & Siboni, F. (2022). The association between sexual health literacy and sexual function of women in Iran. Journal of Education and Health Promotion, 11(1), Article 11. https://doi.org/10.4103/jehp.jehp_414_21
Dehghankar, L., Panahi, R., Namdar, P., Siboni, F., Fallah, S., Anbari, M., & Shafaei, M. (2020). Association between health literacy and adopting preventive behaviors of breast cancer in Iran. Journal of Education and Health Promotion, 9(1), 241. https://doi.org/10.4103/jehp.jehp_313_20
Dewi, Y., Amir, Y., Fitriyani, F., & Arafah, A. (2021). Factors influencing the HIV prevention efforts among women in Pekanbaru. The Malaysian Journal of Nursing, 13(1). https://doi.org/10.31674/mjn.2021.v13i01.013
Doe, P., Hormenu, T., & Enyan, N. (2022). Integrating preconception health into routine reproductive health services of Ghana: A qualitative study among university students. Journal of Family & Reproductive Health. https://doi.org/10.18502/jfrh.v16i1.8593
Gedefaw, A., Yilma, T., & Endehabtu, B. (2020). Information-seeking behavior about cancer and associated factors among university students, Ethiopia: A cross sectional study. Cancer Management and Research, 12, 4829–4839. https://doi.org/10.2147/CMAR.S259849
Gilan, N., Ghasemi, S., Mohamadi, A., Khezeli, M., Heydarpour, F., & Bahrami, S. (2021). Association of social capital and AIDS health literacy with AIDS risk perception in adolescents. HIV & AIDS Review, 20(1), 52–58. https://doi.org/10.5114/HIVAR.2021.105112
Gona, P., Gona, C., Ballout, S., Rao, S., Kimokoti, R., Mapoma, C., & Mokdad, A. (2020). Burden and changes in HIV/AIDS morbidity and mortality in Southern Africa Development Community countries, 1990–2017. BMC Public Health, 20(1). https://doi.org/10.1186/S12889-020-08988-9
Gountas, I., Pantavou, K., Siakalis, G., Dimitriou, A., Demetriades, I., & Nikolopoulos, G. (2023). Modeling the HIV epidemic in MSM in Cyprus: Reaching only the 95 95 95 cascade of care targets fails to reduce HIV incidence by 90% in 2030. [Preprint]. https://doi.org/10.1101/2023.01.29.23285158
Harsch, S., Jawid, A., Jawid, E., Saboga Nunes, L., Sorensen, K., Sahrai, D., & Bittlingmayer, U. (2021). Health literacy and health behavior among women in Ghazni, Afghanistan. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.629334
Huang, Y., Qi, F., Wang, R., Jia, X., Wang, Y., Lin, P., & Li, S. (2021). The effect of health literacy on health status among residents in Qingdao, China: A path analysis. Environmental Health and Preventive Medicine, 26(1). https://doi.org/10.1186/S12199-021-01001-8
Iswanto, E., & Ayubi, D. (2023). The relationship of mental health literacy to help seeking behavior: Systematic review. Journal of Social Research, 2(3), 755–764. https://doi.org/10.55324/JOSR.V2I3.726
Jahangir, Y., Arora, A., Liamputtong, P., Nabi, M., & Meyer, S. (2020). Provider perspectives on sexual health services used by Bangladeshi women with mHealth digital approach: A qualitative study. International Journal of Environmental Research and Public Health, 17(17), 6195. https://doi.org/10.3390/IJERPH17176195
Jiang, S., Ng, J., Choi, S., & Ha, A. (2024). Relationships among eHealth literacy, physical literacy, and physical activity in Chinese university students: Cross-sectional study. Journal of Medical Internet Research, 26, e56386. https://doi.org/10.2196/56386
Kene, C., Deribe, L., Adugna, H., Tekalegn, Y., Seyoum, K., & Geta, G. (2021). HIV/AIDS related knowledge of university students in Southeast Ethiopia: A cross-sectional survey. HIV/AIDS – Research and Palliative Care, 13, 681–690. https://doi.org/10.2147/HIV.S300859
Khan, S. (2024). Community-based HIV awareness & prevention. [Preprint]. https://doi.org/10.20944/preprints202401.1748.v1
Kim, K., Shin, S., Kim, S., & Lee, E. (2023). The relation between eHealth literacy and health-related behaviors: Systematic review and meta-analysis. Journal of Medical Internet Research, 25, e40778. https://doi.org/10.2196/40778
Kim, S., Hwang, S., Lee, J., & Choi, M. (2025). Health literacy disparities in South Korea: Insights from a latent profile analysis. BMC Public Health, 25(1). https://doi.org/10.1186/S12889-025-23025-3
Kolifah, Y., Rohimah, Y., & Martono, M. (2024). Effect of e-health literacy support on the HIV/AIDS transmission preventive behavior of punk teenagers in Indonesia. GSC Advanced Research and Reviews, 18(2), 246–251. https://doi.org/10.30574/GSCARR.2024.18.2.0056
Liu, Y., Lu, L., Wang, Y., Wilkinson, M., Ren, Y., Wang, C., & Liu, S. (2020). Effects of health education on HIV/AIDS related knowledge among first-year university students in China. African Health Sciences, 20(4), 1582–1590. https://doi.org/10.4314/AHS.V20I4.10
Manwong, M., Thongnopakun, S., Rodjarkpai, Y., Wattanaburanon, A., & Visanuyothin, S. (2022). Sexual health literacy and preventive behaviors among middle-school students in a rural area during the COVID-19 situation: A mixed methods study. Health Promotion Perspectives, 12(2), 178. https://doi.org/10.34172/hpp.2022.22
Mariyani, M., Istiarsyah, I., Ardiansyah, A., & Sari, M. (2024). HIV/AIDS and drug prevention strategies for the higher education context. JPB, 4(1), 17–25. https://doi.org/10.61992/JPB.V4I1.200
Marshall, A., Mackson, G., Kaighobadi, F., Hoffman, N., Ciarleglio, A., & Sandfort, T. (2024). Health literacy among sexual and gender diverse adolescents in New York City. Health Education & Behavior, 52(3), 289–298. https://doi.org/10.1177/10901981241307616
McDaid, L., Flowers, P., Ferlatte, O., Young, I., Patterson, S., & Gilbert, M. (2020). Sexual health literacy among gay, bisexual and other men who have sex with men: A conceptual framework for future research. Culture, Health & Sexuality, 23(2), 207–223. https://doi.org/10.1080/13691058.2019.1700307
Mirkuzie, A., Ali, S., Abate, E., Worku, A., & Misganaw, A. (2021). Progress towards the 2020 fast track HIV/AIDS reduction targets across ages in Ethiopia as compared to neighboring countries using Global Burden of Disease 2017 data. BMC Public Health, 21(1). https://doi.org/10.1186/S12889-021-10269-Y
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Este Latifahanun, Safirina Aulia Rahmi, Sarif Febriandi, Mahardika Ratih Resti Andani, Riadinata Shinta P
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
