Abstract: Objective　To analyze the epidemiological characteristics and the first follow⁃up detection of newly reported HIV cases among young students aged 15 to 24 years in Henan Province from 2010 to 2019. Methods　Data were collected from both Case Reporting Cards and Follow⁃up Database from China Information System for HIV/AIDS Control and Prevention between 1st January 2010 and 31st December 2019. Demographic characteristics, route of infection, source of samples, history of sexually transmitted diseases, history of high-risk sexual behavior and the first CD4+ T lymphocyte counts were collected. The patients were followed up for the first time within 30 days after diagnosis, mainly including sexual behavior and other high-risk behaviors, whether safety measures were taken, and CD4+ T lymphocyte counts and other tests in the past 3 months. Logistic regression model was used to analyze factors influencing the first CD4+ T cell counts (CD4) less than 200 cells/μL. Results　A total of 1 011 cases of HIV infection were reported in the past decade, with the number of new cases reported annually rising from 50 in 2010 to 198 in 2019. Most cases were male (92.8%), 18-22 years old (67.6%) and Han nationality (98.5%). The route of HIV infection was most frequently homosexual contact (68.2%). The majority of cases (52.1%) were diagnosed at HIV voluntary counseling and testing (VCT) location. About 188(18.8%) students had not unprotected intercourse using condoms every time at the end in the past 3 months, among them, 83 (46.6%) had sex with 1 person, 57 (32.0%) had sex with 2 persons, 25 (14.0%) had sex with 3 persons and 13(7.3%) had sex with 4 or more persons. The proportion of initial CD4+ T lymphocyte counts less than 200 cells/μL was 17.2% (167 cases). The composition showed a descend trend (χ2 trend=99.685, P＜0.01), and it decreased to 8.0% in 2019. Compared to the male and homosexual transmission, female (OR=2.98, 95%CI: 1.63-5.47), heterosexual transmission (OR=2.37, 95%CI: 1.48-3.81), other routes of transmission or unknown (OR=16.27, 95%CI: 9.69-27.32) had greater proportion of the first CD4+ T lymphocyte counts test result ＜ 200 cells/μL. Conclusion　The number of newly diagnosed HIV students is increased significantly in Henan Province from 2010 to 2019, and the proportion of late diagnosis was relatively high. Therefore, school warning education and HIV detection should be further strengthened, cases should be detected as early as possible and antiviral treatment should be carried out, so as to reduce the second-generation transmission of the virus.