HIV-related knowledge and stigma among healthcare workers in Greece: A secondary analysis of a European survey

HIV-related stigma in healthcare settings remains a barrier to equitable care for people living with HIV. Data on HIV-related knowledge and stigmatizing attitudes among healthcare workers (HCWs) in Greece are limited. This study aimed to describe HIV-related knowledge, stigmatizing attitudes and discriminatory practices among HCWs in Greece and to identify factors associated with higher knowledge and stigma.

We conducted a secondary analysis of the Greek subset of the 2023 ECDC/EACS survey on HIV-related knowledge and stigma among HCWs. HIV knowledge was assessed using three items on undetectable equals untransmittable ('U=U'), post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), combined into a four-level ordinal variable. Stigmatizing attitudes were assessed using an eight-item mean score. Associations with knowledge were examined using proportional-odds ordinal logistic regression, and associations with stigma were assessed using a multivariable linear model.

Among 826 respondents, correct knowledge was reported by 57.9% for 'U=U', 59.4% for PEP and 39.0% for PrEP. Nearly half answered no more than one item correctly. Higher knowledge was independently associated with younger age, male gender, doctor role, hospital-based practice and greater occupational contact with people living with HIV. The mean stigma score was 2.1 on a 1-5 scale. Higher stigma scores were independently associated with older age, lower HIV knowledge and absence of prior HIV stigma/discrimination training. Doctors had lower adjusted stigma scores than nurses in pairwise comparisons.

Important gaps in HIV prevention knowledge and persistent stigmatizing attitudes were observed among HCWs in Greece. Findings support structured, decentralized educational and stigma-reduction interventions across healthcare settings.