Knowledge, attitutes and perceptions of medical and pharmacy students about HIV pre-exposure prophylaxis: a cross-sectional survey from Pakistan.

BACKGROUND: Despite the rising HIV burden in Pakistan, utilization of HIV pre-exposure prophylaxis (PrEP) remains critically low. As future healthcare providers, medical and pharmacy students play a pivotal role in expanding PrEP access. Yet, their readiness to integrate PrEP into practice remains underexplored. This study assessed knowledge, attitudes, and perceptions (KAP) of clinical-year medical and pharmacy students regarding PrEP in Pakistan. METHODS: A cross-sectional survey was conducted between May and June 2025 among fourth- and final-year medical and pharmacy students across Pakistan. A validated, structured questionnaire evaluated PrEP-related knowledge, attitudes, and perceptions. Descriptive statistics summarized participant characteristics, Mann-Whitney U tests, and Spearman’s correlation examined associations between demographic factors and KAP scores. RESULTS: A total of 359 responses were analyzed; 70.5% reported PrEP awareness. The mean knowledge score was modest (6.54/10), with over 50% mistakenly identifying PrEP as a vaccine and 55.6% believing HIV testing is unnecessary before initiation. Medical students demonstrated significantly higher in knowledge (p < 0.001), while pharmacy students exhibited more favorable attitudes (p < 0.001) and perceptions (p = 0.023). A strong positive correlation was observed between attitudes and perceptions (r = 0.555, p < 0.001), but knowledge did not significantly correlate with either. Encouragingly, most participants supported PrEP promotion (87.4%), government-funded provision (84.7%), and inclusion in HIV education (82.7%). CONCLUSION: While both medical and pharmacy students expressed supportive attitudes and accurate perceptions of PrEP, considerable knowledge gaps persist, particularly among pharmacy students, posing barriers to effective PrEP implementation. Misconceptions regarding PrEP’s mechanism and initiation protocols highlight curricular shortcomings, especially in pharmacy education. Integrating evidence-based, stigma-sensitive, and case-based HIV prevention modules into health professional curricula is critical. Strengthening training at the undergraduate level will better equip future healthcare providers to champion PrEP delivery, thereby enhancing PrEP uptake and HIV prevention in Pakistan.