Public knowledge and attitudes towards HIV and people with HIV in Switzerland: results of a national survey

BACKGROUND: HIV-stigma impacts negatively on the quality of life of people with HIV (PWH) and can constitute a barrier to HIV prevention services, diagnosis and retention in care. Knowledge that HIV treated with effective antiretroviral therapy is a non-fatal chronic condition and awareness of the U = U (undetectable equals untransmittable) message can mediate stigmatising attitudes. We conducted a survey to assess public knowledge and attitudes regarding HIV and PWH in Switzerland. METHODS: Members of the public aged ≥ 18 years were randomly selected by a panel institute providing representative population surveys and quota sampling across demographic variables including gender, age, canton of residence and educational level. Participants were invited to complete a questionnaire with closed-ended questions via computer-assisted telephone and/or web interviews. RESULTS: A total of 1015 participants (50.7% women, 49.1% men, 0.2% diverse) completed the survey. While 76% stated they felt informed about HIV, misconceptions regarding HIV-acquisition risk were reported, including kissing (22%), insect bites (13%), and shared use of everyday objects (8%). Over half (55%) cited journalistic media as their source of HIV knowledge. Regarding the U = U message, 22% believed it to be true, 22% believed it to be untrue and 56% did not know. Awareness of U = U was higher in younger people and those with higher education. The majority had low (90%) or moderate (9%) HIV-stigma sum scores; higher scores were associated with lower education. In total, 12.6% had heard of pre-exposure prophylaxis (PrEP), of whom 54.7% identified the correct PrEP description. CONCLUSIONS: Although 76% of participants felt informed about HIV, only 22% agreed with the U = U message. Misconceptions regarding HIV acquisition risk were observed. High HIV-stigma scores were observed among a minority of participants and were associated with lower education. Tailored awareness campaigns could enhance HIV knowledge, disseminate the U = U message and address societal HIV-stigma.