Objective: Human immunodeficiency virus (HIV) is a notable public health problem among young adults. The present study examined college students' knowledge of HIV and pre-exposure prophylaxis (PrEP) in relation to their sexual health behaviors. Participants and Method: Participants included 1516 students who completed questionnaires on actual and perceived HIV knowledge, perceived PrEP knowledge, and sexual health behaviors. Results: While knowledge of HIV was high, knowledge of PrEP was low. Approximately 73% of the sample reported not using condoms at all times, and 41% reported never having been tested for HIV. Women, students at public schools, upper-year students, and students with higher HIV and PrEP knowledge were more likely to get tested for HIV than their counterparts. Knowledge of HIV and PrEP did not relate to condom use. Conclusion: These results suggest the need for increased education about PrEP and strategies to help students translate knowledge about HIV to recommended sexual health behaviors.