{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:15:23Z","timestamp":1783318523529,"version":"3.54.6"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HIV post-exposure prophylaxis (PEP) is effective when initiated promptly and used correctly, but uptake remains limited partly because potential users and future providers may not recognize when or how PEP should be used. Medical students are relevant for assessment because they represent future clinicians and may also encounter occupational exposure during training. Evidence on PEP-specific knowledge and attitudes among Chinese medical students remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multi-center cross-sectional survey between March and August 2025 among 1,382 medical students at three medical schools in China. A structured 54-item online questionnaire assessed PEP knowledge, PEP attitudes, and HIV-related stigma. Knowledge and attitude scores were analyzed as continuous outcomes. Multivariable linear regression models were used to examine factors associated with knowledge and attitudes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean PEP knowledge score was 12.1 (SD\u202f=\u202f4.3) on a 0\u201320 scale, and the mean attitude score was 52.8 (SD\u202f=\u202f8.6) on a 15\u201375 scale. Knowledge was highest for basic PEP definition, the 72-h initiation window, and the 28-day regimen, but lower for delaying PEP until a baseline HIV test result is available, the HIV testing window period, and cost-related access. In adjusted analyses, higher knowledge was associated with academic year (beta\u202f=\u202f0.26), prior PEP training (beta\u202f=\u202f0.22), formal HIV curriculum exposure (beta\u202f=\u202f0.12), and attendance at Site 1 relative to Site 3 (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f= 0.004). More favorable attitudes were associated with higher knowledge (beta\u202f=\u202f0.28), prior PEP training (beta\u202f=\u202f0.15), clinical rotation completion (beta\u202f=\u202f0.09), female sex (beta\u202f=\u202f0.07), and attendance at Site 1 relative to Site 3 (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f= 0.022). Knowledge and attitude scores were positively correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large multi-site convenience sample, PEP knowledge was uneven and was weaker for applied clinical details than for general facts, whereas attitudes toward PEP were broadly favorable. Prior PEP-specific training was consistently associated with stronger scores. Because recruitment relied on institutional WeChat distribution rather than probability sampling, the findings should be interpreted as evidence from participating schools and should not be generalized directly to all medical students in China.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1875173","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:38:36Z","timestamp":1783316316000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Knowledge, attitude, and correlates of HIV post-exposure prophylaxis among medical students at three medical schools in China: a multi-center cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Maoqi","family":"Xiong","sequence":"first","affiliation":[{"name":"Clinical Skills Training Center, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"He","sequence":"additional","affiliation":[{"name":"Clinical Skills Training Center, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manqing","family":"He","sequence":"additional","affiliation":[{"name":"Clinical Skills Training Center, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Clinical Skills Training Center, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Duo","sequence":"additional","affiliation":[{"name":"Department of Dermatology & Medical Aesthetics, Chengdu Seventh People\u2019s Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Services Management, Peking University People\u2019s Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjie","family":"Ren","sequence":"additional","affiliation":[{"name":"Education & Healthcare Research Center, Chengdu Gongyun Education & Management Research Institute","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Pu","sequence":"additional","affiliation":[{"name":"Clinical Skills Training Center, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1097\/cm9.0000000000000647","article-title":"Human immunodeficiency virus prevention strategies in China","volume":"133","author":"Wu","year":"2020","journal-title":"Chin Med J"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1136\/sextrans-2020-054791","article-title":"HIV non-occupational postexposure prophylaxis (nPEP) usage among five key populations in China","volume":"97","author":"Li","year":"2021","journal-title":"Sex Transm Infect"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.3760\/cma.j.cn112138-20211006-00676","article-title":"Chinese guidelines for diagnosis and treatment of HIV\/AIDS (2021 edition)","volume":"60","year":"2021","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2654","DOI":"10.1097\/CM9.0000000000003383","article-title":"Chinese guidelines for the diagnosis and treatment of human immunodeficiency virus infection\/acquired immunodeficiency syndrome (2024 edition)","volume":"137","year":"2024","journal-title":"Chin Med J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12879-023-08873-x","article-title":"Analysis of HIV drug prophylaxis services cascade in healthcare workers: a cross-sectional study in China","volume":"24","author":"Hu","year":"2024","journal-title":"BMC Infect Dis"},{"key":"ref6","first-page":"292","article-title":"Analysis of knowledge level and use of antiretroviral pre-exposure and post-exposure prophylaxis among MSM - China, 2019-2022","volume":"5","author":"Guo","year":"2023","journal-title":"China CDC Wkly"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1007\/s10461-024-04604-8","article-title":"Can HIV post-exposure prophylaxis services change the sexual behavior characteristics of men who have sex with men? 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