HIV Knowledge and Attitudes in Healthcare in Slovakia

HIV related stigma in healthcare remains one of the biggest obstacles to ending HIV/AIDS epidemy. The aim of the study was to investigate knowledge in HIV prevention/control, behaviours, and discrimination towards people living with HIV (PLWH) among health-care providers in Slovakia.

Slovakia adapted the 2023 ECDC/EACS survey - originally implemented in 54 countries- between 15 September and 5 December 2023. Data were collected via an online anonymous questionnaire and analysed by Chi-square for homogeneity and by Fisher-Freeman-Halton Exact Test.

Out of 177 respondents 83.1% were females and 16.9% males. The average age was 43.2 years. The majority were physicians (55.9%) followed by other clinicians (23.7%). A substantial proportion of participants were not aware of having treated any people living with HIV (PLWH) within the past 12 months (72.3%). Most respondents had received training in patients' informed consent, privacy, and confidentiality (63.3%). Significantly fewer had been trained in equity, diversity, and inclusion (10.2%), infection control (19.8%), HIV stigma and discrimination (9.6%), or post-exposure prophylaxis (PEP) (9.6%). Only 9.6% of respondents had correct knowledge about all three topics: undetectable equals untransmittable (U=U), pre-exposure prophylaxis (PrEP) and PEP; 18.1% had correct knowledge about two of them, 36.7% about one, and 35.6% were not familiar with any. Knowledge about U=U, PrEP, and PEP was significantly associated with the number of PLWH respondents who had interacted with at work in the past 12 months, but showed no significant association with years of healthcare experience or participation in relevant trainings. Fear of occupational transmission did not differ between clinical and non-clinical staff. A notable proportion of respondents (25.4%) expressed a preference to avoid providing care to people who inject drugs, followed by sex workers (12.4%), transgender individuals (7.3%), and men who have sex with men (5.7%). Completing training in all topics did not have a significant impact on concerns about the care and treatment of PLWH.

The findings provide an important insight into the scope and forms of HIV-related stigma in healthcare facilities in Slovakia, which should be gradually overcome by raising the visibility of PLWH, a deeper understanding of their problems and their acceptance. Therefore, close cooperation between healthcare workers, lay public, media and non-governmental and for shaping targeted organizations is necessary for reducing fear and prejudice against to PLWH measures and policies to reduce stigma and improve care for PLWH.