The number of young Chinese students infected with HIV continues to rise, and young students have become an important group in HIV infection and transmission. This study aims to explore HIV/AIDS knowledge, attitudes, high-risk sexual behaviour and HIV testing among university students in Henan Province, China, to provide a reference for more targeted health education in universities. We conducted a cross-sectional survey of university students in Henan Province using stratified sampling. A validated self-administered questionnaire was used as the research instrument. Logistic regression analysis was used in data analysis. A total of 897 valid questionnaires were collected. The awareness rate of HIV/AIDS knowledge was 71.35%, the positive attitude rate of HIV/AIDS was 57.19%, the incidence of sexual behaviour was 16.16%, the incidence of high-risk sexual behaviour was 3.90%, and the HIV testing rate after high-risk sexual behaviour was 11.43%. Medical students (AOR = 1.67) and students who had attended AIDS health education (AOR = 1.41) were protective factors for knowledge of HIV/AIDS. Female students (AOR = 1.66) and knowledge of HIV/AIDS (AOR = 1.58) were protective factors for attitudes towards HIV/AIDS, and higher grades students (AOR = 0.74) was a risk factor for attitudes towards HIV/AIDS. Higher grades students (AOR = 2.21) and bisexual and homosexual students (AOR = 4.02) were risk factors for high-risk sexual behaviour, students who had attended AIDS health education (AOR = 0.36) and positive attitudes towards HIV/AIDS (AOR = 0.34) were protective factors for high-risk sexual behaviour. Homosexuality and bisexuality (AOR = 3.06) and sexual orientation uncertainty (AOR = 2.98) were protective factors for HIV testing. University students do not have a comprehensive understanding of HIV/AIDS, so it is necessary to strengthen AIDS education, guide students to establish positive attitudes towards HIV/AIDS, and raise their awareness of self-protection and the rate of HIV testing after high-risk sexual behaviour. Focus on male students, higher grades students, non-medical students and homosexual and bisexual students.