IntroductionUptake of HIV testing services is sub-optimal among young adults. HIV self-testing offers opportunities to improve uptake of HIV testing services among young adults. The study was conducted to determine preferences of HIV testing, uptake of HIV self-testing and the factors associated with HIV-self testing among young adults.MethodsThe study was a descriptive cross-sectional design. A self-administered questionnaire for data collection. We interviewed 384 university students to collect information about HIV testing and their preferences. Logistic regression analysis was used to determine the factors associated with HIV self-testing. The study obtained ethical clearance from the Mbale Regional Referral Hospital Research and Ethics Committee.ResultsThe median age of the participants was 24 (interquartile range: 22-28). Uptake of HIV self-testing was 55% among young adults. Similarly, 56% of the young adults preferred HIV self-testing over facility-based HIV testing in the future. Privacy (46%), confidentiality (7%) and convenience (32%) were the most common reasons given for preferring HIV self-testing. Participants who preferred to test in the healthcare facility cited preference for counselling services (21%) and the perception that the HIV test results from the healthcare facility were more accurate (37%), credible and trustworthy (21%). HIV self-testing was significantly associated with several factors: increasing age (95% CI: 0.89 (0.80-0.98)), fourth year of study (95%CI: 2.90 (1.01-8.31), students of anaesthesia program (95% CI: 0.40 (0.17-0.95), Muslim religion (95% CI: 0. 07 (0.01-0.41), consistent use of condoms (95% CI: 0.36 (0.15-0.88), and having multiple sexual partners (95% CI: 3.22 (1.49-7.00).ConclusionYoung adults preferred HIV self-testing over provider-based testing in the health facility. This preference was related to privacy, confidentiality and convenience. Addressing concerns about accuracy of test results in HIV self-testing and need for counselling services may improve uptake of HIV self-testing among young adults.