Knowledge, attitudes, and practices of medical students regarding syphilis-related stigma.

BACKGROUND: This study aimed to investigate medical students’ knowledge, attitudes, and practices (KAP) concerning syphilis-related stigma. METHODS: A cross-sectional survey was conducted on medical students between January and March 2025 at Jinzhou Medical University and Mudanjiang Medical University. A structured questionnaire, consisting of 10 knowledge items, 10 attitude items, and 10 practice items, was used to collect demographic information and assess KAP regarding syphilis-related stigma. The questionnaire was pre-tested in a pilot study (n = 53) and demonstrated good internal consistency (Cronbach’s α = 0.866). A performance threshold of 80% or above the possible maximum score was established to define good knowledge, positive attitudes, and proactive practices. RESULTS: A total of 723 valid questionnaires were collected, with 60.03% from females. The mean knowledge, attitude, and practice scores were 7.06 ± 2.72 (possible range: 0–10), 40.00 ± 6.11 (possible range: 10–50), and 35.98 ± 5.92 (possible range: 10–50), respectively. Correlation analysis showed significant positive associations among all KAP dimensions: knowledge-attitude (r = 0.4492), knowledge-practice (r = 0.3134), and attitude-practice (r = 0.5805), all with P < 0.001. Structural equation modeling further indicated that knowledge had a direct effect on attitude (β = 0.30, P < 0.001) and that attitude exerted a direct effect on practice (β = 0.97, P < 0.001). Although the direct effect of knowledge on practice was not statistically significant, an indirect effect mediated by attitude was observed (β = 0.33, P < 0.001). CONCLUSION: Medical students demonstrated insufficient knowledge, generally positive attitudes, and suboptimal practices concerning syphilis-related stigma. These findings highlight the need for targeted educational interventions that not only enhance knowledge but also strengthen positive attitudes, thereby promoting more proactive and stigma-reducing practices among future healthcare providers. CLINICAL TRIAL NUMBER: not applicable.