Knowledge about biomedical HIV prevention among healthcare workers: A cross-sectional study in Europe and Central Asia.

Abstract

Background: Knowledge of HIV prevention among healthcare workers, such as undetectable equals untransmittable (U=U), post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) can hold implications for patient care and the HIV epidemic. Understanding the level of knowledge about HIV prevention among healthcare workers can provide information to enhance the effectiveness and equity of HIV prevention, treatment and care.

Methods: An online survey was conducted to collect data on HIV knowledge among clinical and non-clinical healthcare workers in 54 countries in Europe and Central Asia between September and December of 2023. Knowledge was measured using questions asking respondents to agree or disagree with correct statements about HIV transmission and prevention. Four main outcome variables assessed knowledge among healthcare workers about U=U, PrEP, PEP and a combined outcome measuring overall knowledge level. Fixed-effects logistic and Poisson regression models assessed whether sociodemographic factors, professional characteristics and experiences with people living with HIV were associated with knowledge about these topics. Additionally, we assessed the impact of having ever received training on infection control and training on HIV stigma and discrimination on healthcare workers' knowledge of U=U, PEP and PrEP.

Results: Among 18 348 healthcare workers, correct knowledge of U=U was reported by 61.25%, PEP by 55.70% and PrEP by 40.74%. A composite of correct knowledge across all topics was achieved by 31.29% of participants. Key sociodemographic and professional determinants influencing increased knowledge included being a man, of younger age and a medical doctor. Increased knowledge was also associated with having more experience caring for people with HIV, including working in an HIV care or infectious diseases department, and having cared for a higher number of people living with HIV in the past year. Having ever received training on infection control that included PEP and training on HIV stigma and discrimination was associated with increased knowledge in all areas. Across all determinants, respondents living in Western Europe reported higher knowledge about biomedical HIV prevention.

Interpretation: Substantial knowledge gaps in HIV prevention were found among healthcare workers in Europe and Central Asia. Suboptimal knowledge and sociodemographic and professional differences warrant targeted training initiatives and interventions for improving healthcare workers' knowledge of HIV. The non-representative nature of the sample limits the generalizability of the findings.