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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.