Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)


Environmental and Occupational Health

First Committee Member

Melva Thompson-Robinson

Second Committee Member

Jennifer Pharr

Third Committee Member

Marya Shegog

Fourth Committee Member

Sandra Owens

Number of Pages



Background: Contemporary research findings affirm that young adults aged 18 to 24 years have high prevalence of new HIV infections. Pre-Exposure Prophylaxis (PrEP) medication is the latest strategy in HIV prevention. Rates of PrEP uptake or use have been negligible among university students aged 18 to 24 years, especially among racial and ethnic minority students.

Objective: The objective of this study is to investigate the attitudes and beliefs that influence the uptake of PrEP medications and the HIV risk behaviors associated with the willingness to take PrEP medications among university students aged 18 to 24 years attending the University of Nevada, Las Vegas.

Methods: This exploratory study used a cross-sectional design, and the Sexual Health Model as the theoretical foundation. Using questions from the Youth Risk Behavior Surveillance System and the American College Health Association National College Health Assessment in 2018, as well as other existing universe of questions, the researcher used these questions in Qualtrics Survey Research Suite for online data collection via a survey. All these questions were shown by public health experts to have enough face and content validity. The collected quantitative data were analyzed in IBM SPSS Statistics Version 26 using descriptive statistics and binary logistic regression models.

Results: The study was conducted among a representative sample size of 363 and majority of respondents were self-identified as racial and ethnic minority university students (N = 240, 66.1%). The mean age was 18 years old. The results of the study indicated that of the 363 student participants, almost 100 percent (99.1%) had never taken PrEP medications. The binary logistic regression models yielded an increased likelihood of taking PrEP if it were within one’s cultural beliefs or practices (OR = 0.804 (95% CI: 0.657 - 0.983), β = -0.219, p < 0.05, p = 0.034), if one was in a monogamous relationship with a partner that they did not know was HIV positive (OR = 0.744 (95% CI: 0.582- 0.951), β = -0.296, p < 0.05, p = 0.018), and because someone they love wants them to take PrEP (OR = 0.677 (95% CI: 0.511 - 0.896), β = -0.390, p < 0.05, p = 0.006). In addition, a decreased likelihood of taking PrEP based on sociodemographic factors such as religious affiliation or religion (OR = 1.107 (95% CI: 1.032 -1.187), β = 0.102, p < 0.05, p = 0.004) and sexual orientation (OR = 1.282 (95% CI: 1.068 - 1.538), β = 0.248, p < 0.05, p = 0.008) were confirmed. All these factors were related to attitudes and beliefs that significantly influence the decision to take PrEP medications among young university students.

Moreover, the binary logistic regression models revealed that alcohol consumption (OR = 4.471 (95% CI: 1.437 - 13.904), β = 1.498, p < 0.05, p = 0.010) was a significant HIV risk behavior associated with the willingness to not take PrEP medications among young university students. In addition, sexual pleasure by touching oneself or self-stimulation (OR = 0.797 (95% CI: 0.698 - 0.910), β = - 0.227, p < 0.05, p = 0.001) and watching or using pornography for sexual pleasure (OR = 0.373 (95% CI: 0.232 - 0.601), β = -0.507, p < 0.05, p = 0.000) were significant HIV risk behaviors associated with the willingness to take PrEP medications among young university students.

Conclusion: The study demonstrates that HIV risk behaviors of alcohol consumption, use of pornography, and masturbation influence the willingness to take PrEP medications. It also underscores the need to respect cultural beliefs and practices and highlight the influence of intimate-partner relationships, as well as sexual orientation during health communication as these factors influence the decision to take PrEP among the young university students. These factors also have greater potential for HIV prevention and must be prioritized when implementing health promotion, behavioral interventions, or HIV prevention strategies among these at-risk populations.

Study Significance: The study contributes to the literature on PrEP medication as a prevention approach for university students and young adults’ health. Particularly, the study explored ways that unswervingly strengthen the PrEP care-continuum through social, behavioral, and implementation science investigations (NIH, 2018).


HIV Prevention; Pre-Exposure Prophylaxis (PrEP) Medications; Pre-Exposure Prophylaxis (PrEP) Uptake; Pre-Exposure Prophylaxis (PrEP)-Related Attitudes and Beliefs; University Student’s Health; Young Adults’ Health


Epidemiology | Public Health | Social and Behavioral Sciences

File Format


File Size

1.9 MB

Degree Grantor

University of Nevada, Las Vegas




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