Association between HIV-related knowledge and attitudes towards persons living with HIV in northern Kosovo: The quantile regression approach

Abstract

Knowledge about HIV and level of HIV-related stigma have been considered the main indicators of the community's readiness to combat and bring the HIV epidemic to an end. Of all Serbia, the northern Kosovo province is especially vulnerable to the HIV spread because the infrastructure and the entire regulatory system had to be rebuilt after the ethnic conflict. The study objective was to examine the association between HIV-related knowledge level and attitudes towards people living with HIV (PLHIV) among university students from northern Kosovo using the quantile regression. A total of 1,017 students filled in an anonymous questionnaire. The questionnaire examined socio-demographic characteristics, HIV-related knowledge, attitudes towards PLHIV, sources of information about HIV, past experiences with PLHIV, and health behaviours. The dependent variable in the model was the attitude score (ATS) divided into quantiles (Q) in quantile regression analysis: Q0.10, Q0.25, Q0.50, Q0.75, and Q0.90. The independent variable was the knowledge score (KNS). The model was adjusted for relevant covariates. The majority of students had adequate HIV-related knowledge (89.6%) and 10.4% had lower knowledge. Most students also had a positive attitude (83.9%), while 16.1% were indecisive towards PLHIV. No students exhibiting wrong knowledge and negative attitudes were observed. The KNS and ATS significantly correlated with one another (ρ = 0.383; p = 0.001). The quantile regression model adjusted for variables associated with both KNS and ATS showed a negative association between KNS and ATS in the lowest quantile (Q0.10) of the ATS. In all other quantiles (Q0.25-Q0.90), a higher KNS was associated with having stronger positive attitudes towards PLHIV. This study confirmed that higher knowledge about HIV was associated with stronger positive attitudes towards HIV. Still, some students remain indecisive despite being knowledgeable about HIV. These students could benefit the most from continuing educational programmes to reduce the HIV-related stigma. © The Author(s), 2025.