General HIV-Related Knowledge and Attitudes Among Nurses and Nursing Students: A Systematic Review and Meta-Analysis with Narrative Synthesis of Clinical Practices (2011-2026).
6 affiliations
- 1Department of Nursing, Faculty of Medicine and Public Health, Al-Farabi Kazakh National University, Almaty 050038, Kazakhstan.
- 2Department of Public Health and Health Care, Kyrgyz-Russian Slavic University Named After B.N. Yeltsin, Bishkek 720000, Kyrgyzstan.
- 3Department of Nursing, Kazakhstan Medical University "KSPH", Almaty 050060, Kazakhstan.
- 4Salidat Kairbekova National Scientific Center for Healthcare Development, Ministry of Healthcare of the Republic of Kazakhstan, Almaty 050010, Kazakhstan.
- 5Department of Research Management, JSC Research Institute of Cardiology and Internal Diseases, Almaty 050012, Kazakhstan.
- 6Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA.
Abstract
Background/Objectives: Nurses and nursing students are central to HIV prevention and care, but studies of their general HIV-related knowledge, attitudes, and practices use heterogeneous populations, instruments, scoring systems, and thresholds. This review had three objectives: (1) to meta-analyze, separately, the prevalence of study-defined high/good general HIV knowledge, mean general knowledge scores, prevalence of study-defined positive/favorable general attitudes, and mean favorable-attitude scores; (2) to synthesize HIV-related clinical-practice findings narratively when measures were not comparable; and (3) to explore whether pooled knowledge and attitude estimates differed between practicing nurses and nursing students. General outcomes excluded narrowly focused PrEP-, PEP-, stigma-only, and item-level constructs. Methods: PubMed/MEDLINE, Scopus, PsycINFO, and CINAHL Complete were searched for eligible quantitative studies. Four knowledge and attitude outcomes were meta-analyzed in separate random-effects models; practice outcomes were not pooled. Heterogeneity, 95% prediction intervals, leave-one-out influence, possible small-study effects, subgroup differences, and certainty of evidence were assessed. Results: Thirty-four studies were included. The pooled prevalence of high/good HIV-related knowledge was 52.4% (95% CI 30.4-73.5%; I² = 97.5%; 95% prediction interval 3.6-97.0%), and the pooled mean knowledge score was 66.3% of the possible score (95% CI 60.8-71.8%; I² = 99.8%; prediction interval 40.0-92.5%). Positive/favorable attitudes had a pooled prevalence of 41.6% (95% CI 7.3-86.5%; I² = 99.1%; prediction interval 0.0-99.9%), and the pooled mean favorable-attitude score was 48.1% of the possible range (95% CI 41.9-54.2%; I² = 99.7%; prediction interval 21.3-74.8%). Thus, all four meta-analyses showed extreme heterogeneity and wide prediction intervals. Prespecified subgroup tests did not detect nurse-versus-student differences for either knowledge outcome or favorable-attitude prevalence; a higher pooled mean favorable-attitude score among students was observed in one exploratory comparison. Four studies reported non-equivalent practice indicators (16.0-85.3%), which were not pooled. Certainty was very low for all meta-analyzed outcomes. Conclusions: The pooled estimates should be interpreted as descriptive summaries across heterogeneous operationalizations rather than as precise global nursing-workforce benchmarks or common competency thresholds. More standardized measurement, objective assessment of clinical practice, and longitudinal and interventional research are needed.
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BibTeX
@article{alekesheva2026general,
title = {{General HIV-Related Knowledge and Attitudes Among Nurses and Nursing Students: A Systematic Review and Meta-Analysis with Narrative Synthesis of Clinical Practices (2011-2026).}},
author = {Roza Alekesheva and Dzhyldyz Ibraimova and Shnara Svetlanova and Zhanar Ibraimzhanova and Ainur Seitmanova and Galiya Bilibayeva and Sholpan Karzhaubayeva and Indira Karibayeva},
journal = {Healthcare (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/healthcare14193159},
url = {https://europepmc.org/article/MED/42881598},
note = {CC BY},
}
RIS
TY - JOUR
TI - General HIV-Related Knowledge and Attitudes Among Nurses and Nursing Students: A Systematic Review and Meta-Analysis with Narrative Synthesis of Clinical Practices (2011-2026).
AU - Roza Alekesheva
AU - Dzhyldyz Ibraimova
AU - Shnara Svetlanova
AU - Zhanar Ibraimzhanova
AU - Ainur Seitmanova
AU - Galiya Bilibayeva
AU - Sholpan Karzhaubayeva
AU - Indira Karibayeva
PY - 2026
DA - 2026/09/23
JO - Healthcare (Basel, Switzerland)
DO - 10.3390/healthcare14193159
UR - https://europepmc.org/article/MED/42881598
AB - Background/Objectives: Nurses and nursing students are central to HIV prevention and care, but studies of their general HIV-related knowledge, attitudes, and practices use heterogeneous populations, instruments, scoring systems, and thresholds. This review had three objectives: (1) to meta-analyze, separately, the prevalence of study-defined high/good general HIV knowledge, mean general knowledge scores, prevalence of study-defined positive/favorable general attitudes, and mean favorable-attitude scores; (2) to synthesize HIV-related clinical-practice findings narratively when measures were not comparable; and (3) to explore whether pooled knowledge and attitude estimates differed between practicing nurses and nursing students. General outcomes excluded narrowly focused PrEP-, PEP-, stigma-only, and item-level constructs. Methods: PubMed/MEDLINE, Scopus, PsycINFO, and CINAHL Complete were searched for eligible quantitative studies. Four knowledge and attitude outcomes were meta-analyzed in separate random-effects models; practice outcomes were not pooled. Heterogeneity, 95% prediction intervals, leave-one-out influence, possible small-study effects, subgroup differences, and certainty of evidence were assessed. Results: Thirty-four studies were included. The pooled prevalence of high/good HIV-related knowledge was 52.4% (95% CI 30.4-73.5%; I² = 97.5%; 95% prediction interval 3.6-97.0%), and the pooled mean knowledge score was 66.3% of the possible score (95% CI 60.8-71.8%; I² = 99.8%; prediction interval 40.0-92.5%). Positive/favorable attitudes had a pooled prevalence of 41.6% (95% CI 7.3-86.5%; I² = 99.1%; prediction interval 0.0-99.9%), and the pooled mean favorable-attitude score was 48.1% of the possible range (95% CI 41.9-54.2%; I² = 99.7%; prediction interval 21.3-74.8%). Thus, all four meta-analyses showed extreme heterogeneity and wide prediction intervals. Prespecified subgroup tests did not detect nurse-versus-student differences for either knowledge outcome or favorable-attitude prevalence; a higher pooled mean favorable-attitude score among students was observed in one exploratory comparison. Four studies reported non-equivalent practice indicators (16.0-85.3%), which were not pooled. Certainty was very low for all meta-analyzed outcomes. Conclusions: The pooled estimates should be interpreted as descriptive summaries across heterogeneous operationalizations rather than as precise global nursing-workforce benchmarks or common competency thresholds. More standardized measurement, objective assessment of clinical practice, and longitudinal and interventional research are needed.
SN - 2227-9032
ER -