Objective  To evaluate current status of AIDS-related knowledge and influencing factors of human immunodeficiency virus (HIV) infection among young male students who have sex with men (MSM) in four large cities in China and to provide evidences for developing interventions on HIV/AIDS.

  Methods  Using snow balling sampling combined with participants′ referral, we conducted a questionnaire survey among 548 MSM in young students in Harbin, Tianjin, Xi′an, and Chongqing city from April 2017 to March 2018.

  Results  Among all the respondents, the overall awareness rate was 89.4% for the eight main items of knowledge about HIV/AIDS prevention and control for Chinese adolescents and 92.6% for the eight main items of knowledge about HIV/AIDS prevention and control for Chinese citizens. Multivariate logistic regression analysis revealed that homosexual orientation (odds ratio OR = 9.050), bisexual orientation (OR = 18.225), and having multiple sexual partners before college admission (OR = 2.318) were risk factors of HIV infection; while, studying for undergraduate (OR = 0.070) or master (OR = 0.049), having received education program on AIDS prevention in primary school (OR = 0.089), junior high school (OR = 0.128), senior high school (OR = 0.106), or university (OR = 0.178), having multiple temporary partners in the last 3 months (OR = 0.447), using condoms every time when having sex with fixed partners (OR = 0.383) and temporary partners (OR = 0.245) in the last 3 months were protective factors against HIV infection among the respondents.

  Conclusion  The awareness of knowledge about HIV/AIDS is at a good level generally among young student MSM but health education on HIV/AIDS still need to be promoted among some of the MSM to reduce their high-risk behaviors.