Level of comprehensive knowledge about HIV & AIDS among university students in Malawi

Malawi continues to face a substantial HIV burden. However, little empirical evidence from a multi-institutional, nationally representative point of view exists on the level of HIV/AIDS knowledge among university students, a population that is vulnerable and central to national HIV prevention goals. This study addressed the gap by assessing the levels of HIV/AIDS knowledge and associated factors among full-time undergraduate students across six public and private universities in Malawi. A cross-sectional survey involving 526 students was conducted using stratified random sampling and a self-administered questionnaire, with data analysed through descriptive statistics, chi-square tests, Analysis of Variance (ANOVA), and t-tests. Findings showed that students possessed a generally high level of HIV/AIDS knowledge (82.3 %), with significant differences observed by sex, programme of study, and year of study. Knowledge of behavioural prevention measures was strong, yet notable gaps remained, particularly regarding biomedical prevention methods such as pre-exposure prophylaxis (PrEP) and misconceptions about sterilised needle sharing and non-sexual transmission. These findings indicate that while progress has been made in HIV awareness, important knowledge deficits persist, especially in emerging HIV science. The study contributes new evidence that can inform the design of structured, standardised, and integrated HIV education within higher-learning institutions. Strengthening HIV knowledge among university students is essential for reducing vulnerability to new infections and directly contributes to national and global targets, including SDG 3.3 on ending AIDS by 2030 and Agenda 2063 aspirations for healthy and well-nourished citizens.