European students are more likely to provide incorrect HIV testing indications as compared to other international students

Abstract

<b>Introduction: </b> Expanding HIV testing is recognised as a major tool in halting the HIV epidemic. However, HIV testing is still advised inadequately by medical practitioners. Therefore we investigated medical students’ knowledge on HIV and indications for HIV testing. <br /> <b>Material and methods: </b>Fifth year students were pre-tested while entering the infectious diseases course. Questionnaires were anonymous and covered three areas: medical practice, transmission risk and indications for HIV testing. Logistic regression models were used to identify factors associated with incorrect responses to questions on HIV testing indications.<br /> <b>Results</b>: In total 224 students were included; 64% were female. The majority of students were from Europe (64.3%), followed by Asia (24.5%), North Africa (6.3%) and North America (4.9%); 72.8% were from high-income countries. Only 91 (41%) students provided correct indications for HIV testing, i.e. including sexual contacts, STDs or pregnancy in addition to medical condition. Over half (54%) listed only medical conditions related to immunodeficiency as an indication for HIV testing. In the multivariate logistic regression model the odds of incorrect indications for HIV testing were higher for European students (odds ratio (OR) = 2.56, 95% CI: 1.19–5.50; p < 0.016) and those overestimating the homosexual risk of HIV infection (OR = 1.03, 95% CI: 1.00–1.06; p = 0.026). The odds were lower for students overestimating the risk of mother-to-child transmission (OR = 0.97, 95% CI: 0.96–0.98; p < 0.001). <br /> <b>Conclusions</b>: Students tend to represent a condition-focused HIV testing approach, underscoring the importance of behaviour-related indications, as well as the asymptomatic character of HIV infection. This observation is especially relevant for students originating from Europe.