Hepatitis B carriers are at risk of spreading the virus and developing cirrhosis and hepatoma. The purpose of this study was to examine differences in knowledge, health beliefs, and self-efficacy related to hepatitis B prevention among university students. Using a comparative descriptive design, the study population, defined to include second- through fourth-year students, enrolled at a university in southern Taiwan. Students were stratified by hepatitis B virus infectious status and then selected at random for participation. Survey data were obtained via an online SPSS data entry system. The response rate was 39.9%. A total of 109, 113, and 106 students were assigned, based on their status, to the immune group (having hepatitis B antibody), susceptible group (having neither hepatitis B antigen nor antibody), and carrier group (having hepatitis B antigen without antibody), respectively. Most participants in this study attached a social stigma to hepatitis B carriers. Approximately 24% of carriers and 19% of susceptible students were unaware of their hepatitis B infectious status. Compared with the other two groups, carriers were less likely to change their lifestyle to promote health. Although more than two thirds of susceptible students agreed that their current behavior is risky, only half were worried about becoming hepatitis B carriers. The findings revealed the pressing need for hepatitis B prevention education among university students. School nurses should work closely with school administrators to establish a health promotion program to increase carriers' self-efficacy to promote their personal health, curtail risky behavior among susceptible students, and remove the stigma attached to hepatitis B carriers among university students.
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