Human immunodeficiency virus knowledge and stigma among medical students in Egypt: a national cross-sectional study

Abstract

OBJECTIVES: To assess HIV knowledge, stigma and perceived adequacy of HIV curricular coverage among medical students in Egypt and to identify factors associated with HIV stigma. DESIGN: An online-based cross-sectional study. SETTING: Medical schools across Egypt. Data were collected in August 2025 using a bilingual (Arabic/English) online questionnaire using convenience sampling. PARTICIPANTS: First- through fifth-year students enrolled in Egyptian medical schools. PRIMARY AND SECONDARY OUTCOME MEASURES: HIV knowledge was assessed using the Brief HIV Knowledge Questionnaire (HIV-KQ-18); HIV-related stigma was assessed using the Healthcare Providers HIV/AIDS Stigma Scale (HPASS) and perceived adequacy of HIV curricular coverage. RESULTS: A total of 1503 students participated (mean age 20.6 years; 57.4% female), half of whom (48.9%) rated curricular coverage of stigma and psychosocial aspects of HIV as inadequate. The mean HIV-KQ-18 score was 8.96/18 (SD 4.26). Only 39.9% recognised that HIV cannot be transmitted through kissing, 47% believed washing after sex is protective and just 41.3% knew that not all infants born to mothers with HIV will have AIDS. The mean HPASS score was 60.1/108 (SD 17.6). Most students (76.8%) worried about contracting HIV from patients, 52% believed patients acquired HIV through risky behaviours and 43.6% endorsed a right to refuse providing care. Knowledge and stigma were inversely but weakly correlated (r = -0.17, p<0.001), and higher knowledge was independently associated with lower stigma on multivariable regression (B=-0.16, p<0.001). Despite higher knowledge, males reported significantly higher stigma (B=0.25, p<0.001) compared with their female counterparts. Similarly, participants who completed the Arabic form had significantly lower knowledge and higher stigma (B=0.24, p<0.001). CONCLUSIONS: HIV stigma is prevalent among medical students in Egypt, with significant variations observed across gender, survey language and levels of HIV knowledge. These findings call for multifaceted interventions and curriculum reform to reduce stigma among future clinicians.