Knowledge, attitudes, and behavioural intention towards HIV pre-exposure prophylaxis among health science students in South Africa: cross-sectional study

Abstract

Background Advanced HIV disease remains a significant public health challenge in Sub-Saharan Africa, with inadequate uptake of biomedical prevention strategies such as HIV Pre-Exposure Prophylaxis (PrEP) contributing to persistent new infections and disease progression. Objective This study aimed to assess the knowledge, attitudes, and behavioural intention towards HIV PrEP among health science students at a selected Higher Education Institution (HEI) in Limpopo Province, South Africa. Methods A cross-sectional descriptive study was conducted among 350 health science students. Data were collected using a self-administered structured questionnaire and analysed using descriptive statistics and chi-square analyses in SPSS version 28.0, with statistical significance set at p < 0.05. Results Most health science students demonstrated good knowledge (88.6%) and positive attitudes (79.7%) towards PrEP, with high behavioural intention (80.3%). Social media was the most frequently cited source of PrEP awareness. Despite the overall high knowledge levels, important gaps were identified regarding PrEP eligibility and dosing frequency. In addition, nearly half of the participants expressed risk compensation concerns related to PrEP use. Notably, age ( p = 0.036) and year of study ( p = 0.026) were significantly associated with both knowledge and attitudes, with older and more academically advanced students demonstrating comparatively stronger performance across both domains, while gender, relationship status, and study programme were not significantly associated with any outcome measure. Conclusion Despite predominantly good knowledge and positive attitudes, persistent knowledge gaps and misconceptions about risk compensation concerns underscore the need for curriculum-integrated PrEP education and strengthened campus-based HIV prevention services, particularly in the context of the UNAIDS 95-95-95 targets, the Sustainable Development Goals, and the African Union Agenda 2063.