Knowledge and Perceptions of HIV Prevention and Transmission Among Healthcare Professionals in Bahrain: A Cross-Sectional Survey

BackgroundAdvances in antiretroviral therapy have transformed HIV into a chronic, manageable condition.Contemporary prevention strategies, including pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) and the principle that undetectable equals untransmittable (U=U), depend on clinicians' accurate understanding for effective implementation.Data assessing healthcare professionals' knowledge of modern HIV prevention concepts in the Gulf region remain limited. MethodologyA national cross-sectional survey was conducted in the Kingdom of Bahrain between January and December 2025 among healthcare professionals and clinical students engaged in patient care across public primary healthcare centres and secondary and tertiary governmental hospitals.The questionnaire assessed demographic and professional characteristics, self-reported confidence in discussing HIV, eight evidencebased knowledge items and the perceived need for further HIV education.Knowledge scores ranged from 0 to 8 and were categorised as low (0-3), moderate (4-6) or high (7-8).Non-parametric tests were used for group comparisons. ResultsA total of 395 participants were included; 306 (77.5%) were female and 198 (50.1%) were nurses.The mean knowledge score was 3.83 ± 2.15.Overall, 189 participants (47.8%) demonstrated low knowledge, 153 (38.7%) demonstrated moderate knowledge and 53 (13.4%) demonstrated high knowledge.Correct identification of PEP as the appropriate intervention following occupational exposure was reported by 255 participants (64.6%), while 230 (58.2%) recognised that HIV transmission would not occur following a needlestick injury involving a patient with an undetectable viral load.In contrast, only 129 participants (32.7%) correctly identified that individuals with sustained viral suppression do not transmit HIV sexually, and 148 (37.5%) were aware of the U=U concept.Physicians demonstrated significantly higher knowledge scores than nurses and other professionals (P < 0.001).No significant differences were observed across healthcare settings, specialties, age groups or gender.Confidence in discussing HIV was not significantly associated with knowledge score (P = 0.105).A majority of participants (362, 91.6%) expressed a desire for additional HIVrelated education. ConclusionsHIV-related knowledge among healthcare professionals in Bahrain was modest, with substantial gaps in contemporary biomedical prevention concepts, particularly U=U and PrEP.Professional disparities were evident, although deficits were observed across all care settings.The near-universal demand for further training identifies a modifiable, systems-level opportunity for competency-based HIV education.