Most Egyptians Have Heard of HIV, Yet Only 14 Percent Accept People Living With the Virus

Roughly three out of four Egyptians aged 15 to 59 have heard of HIV, yet fewer than half of those aware hold accurate knowledge about the virus, and only about one in seven would accept everyday social contact with people living with it. Those are the central findings of a secondary analysis of the 2015 Egypt Health Issues Survey, a nationally representative household survey of 16,671 citizens, published in AIDS Research and Therapy. The study, led by Moaz Elsayed Abouelmagd and colleagues, offers one of the most detailed population-level pictures to date of how HIV awareness, knowledge, and stigma-related attitudes align—or fail to align—across Egypt.

The research team drew on the 2015 Egypt Health Issues Survey, a stratified, two-stage cluster sample designed to represent the national population of citizens aged 15 to 59. Trained field workers administered standardized, pre-tested Arabic questionnaires, and the analysts weighted the data to restore national representativeness. HIV awareness was measured with a single yes-or-no question: whether the respondent had ever heard of HIV or AIDS. Among those who answered yes, knowledge was probed with ten UNAIDS-recommended questions covering transmission routes, prevention methods, and common misconceptions, such as whether a healthy-looking person can carry the virus or whether mosquito bites can transmit it. Accepting attitudes were assessed with four items borrowed from the Demographic and Health Survey toolkit: willingness to buy food from a vendor living with HIV, to care for a family member with the virus, to support an HIV-positive female teacher continuing to teach, and to keep a relative’s HIV status confidential.

The results reveal a steep gradient from awareness to understanding to acceptance. Overall, 74.3 percent of respondents had heard of HIV. Among the 12,392 respondents who were aware, only 45.4 percent scored as having good knowledge, using a modified Bloom’s cut-off that required at least 60 percent correct answers on the ten-item test. Acceptance was rarer still: just 14.2 percent of those aware expressed accepting attitudes toward people living with HIV, defined as an accepting response on at least three of the four attitude items. The authors note that dichotomizing the scores aids interpretation but may obscure gradations, and that other cut-offs could yield different results.

Misconceptions about casual transmission were widespread. Nearly one-third of respondents who had heard of HIV believed the virus could be transmitted by mosquito bites or by sharing food with a person living with it. Knowledge of condom use as a preventive method was limited. Awareness of mother-to-child transmission during pregnancy and delivery was moderate, but recognition of transmission through breastfeeding and of antiretroviral therapy’s ability to prevent vertical transmission was lower. Knowledge of where to obtain an HIV test was also scarce: only 14.2 percent of those aware could name a testing location, and just 9.9 percent had heard, seen, or received HIV-related information in the previous six months. Among those recently exposed to information, television was by far the dominant source. Among those who knew a testing site, private laboratories were named far more often than governmental hospitals, and only two participants identified non-governmental organizations as a place to get tested.

Education emerged as the strongest independent correlate of both awareness and knowledge. In the adjusted model, respondents with secondary education had more than twice the odds of having heard of HIV compared with those with no education (adjusted odds ratio 2.25, 95 percent confidence interval 1.61 to 3.16), while those with higher education had more than sevenfold higher odds (adjusted odds ratio 7.65, 95 percent confidence interval 5.08 to 11.53). For knowledge, respondents with higher education had 78 percent higher odds of good knowledge than illiterate respondents (adjusted odds ratio 1.78, 95 percent confidence interval 1.22 to 2.60). Adolescents aged 15 to 19 were substantially less likely than those aged 20 to 24 to have heard of HIV (adjusted odds ratio 0.30, 95 percent confidence interval 0.25 to 0.36) and also had lower odds of good knowledge (adjusted odds ratio 0.68, 95 percent confidence interval 0.58 to 0.80). Respondents aged 35 to 54 showed modestly higher odds of good knowledge, with adjusted odds ratios ranging from 1.24 to 1.35, and married respondents had higher odds than never-married ones (adjusted odds ratio 1.32, 95 percent confidence interval 1.16 to 1.51).

Media exposure also mattered, though unevenly. Newspaper or magazine reading, whether at least weekly or less than weekly, and weekly computer use were independently associated with better knowledge. Higher wealth, newspaper reading, radio exposure, computer use, and internet use all remained independently associated with awareness in the adjusted model. Yet the pattern reversed for attitudes: respondents who listened to the radio at least weekly had lower odds of expressing accepting attitudes toward people living with HIV (adjusted odds ratio 0.75, 95 percent confidence interval 0.65 to 0.87), and those who reported recent HIV-related information exposure in the previous six months also had lower odds (adjusted odds ratio 0.65, 95 percent confidence interval 0.56 to 0.77). The authors caution that because the dataset did not measure social distance, perceived morality, or fear of casual transmission, the mechanisms behind these associations cannot be determined.

Good knowledge itself predicted more accepting attitudes. After adjustment for covariates, respondents with good HIV knowledge had 22 percent higher odds of expressing accepting attitudes than those with poorer knowledge (adjusted odds ratio 1.22, 95 percent confidence interval 1.09 to 1.36). Employment was likewise associated with more accepting attitudes (adjusted odds ratio 1.21, 95 percent confidence interval 1.04 to 1.42), as was newspaper or magazine reading at least weekly (adjusted odds ratio 1.25, 95 percent confidence interval 1.03 to 1.53) or less than weekly (adjusted odds ratio 1.22, 95 percent confidence interval 1.03 to 1.43). By contrast, respondents in the middle, richer, and richest wealth quintiles had lower odds of expressing accepting attitudes than those in the poorest quintile, with adjusted odds ratios ranging from 0.65 to 0.71—an unexpected pattern the authors say should be interpreted cautiously and warrants further qualitative investigation.

The individual attitude items told a revealing story. Most respondents reported willingness to care for a family member living with HIV and to keep a relative’s status confidential, but far fewer indicated willingness to buy food from a vendor living with the virus or to support an HIV-positive female teacher continuing to teach. The authors emphasize that while they could not study stigma itself, attitudes toward people living with HIV form part of the stigma this population faces, and that stigma can discourage disclosure, testing, care-seeking, and treatment adherence, and is associated with poorer quality of life.

The findings sit within a regional context of rising HIV burden. Although HIV prevalence in Egypt remains below 0.02 percent, the number of people living with HIV has risen sharply, from fewer than 500 cases in 1990 to over 50,000 in 2024, surpassing previous projections; forecasts for 2024 had indicated approximately 39,325 people living with HIV. Across the Middle East and North Africa, the population living with HIV has more than doubled since 2010, with UNAIDS estimating a 116 percent surge between 2010 and 2023 despite a historically low baseline prevalence. Egypt has not yet achieved the UNAIDS 95-95-95 targets, which aim for 95 percent of people living with HIV to know their status, 95 percent of those diagnosed to receive sustained antiretroviral therapy, and 95 percent of those on treatment to achieve viral suppression. The authors argue that closing the awareness and knowledge gaps documented here is a prerequisite for that progress.

The study has limitations the authors spell out plainly. Its cross-sectional design precludes causal inference and cannot establish the temporal direction of the observed associations. Responses were self-reported and may be affected by recall and social desirability bias, particularly for sensitive attitudes. The dichotomized scores and the use of Bloom’s cut-off were practical choices that other thresholds might not reproduce. As a secondary analysis, the study was confined to variables collected in the original survey, leaving constructs such as direct stigma dimensions, cultural beliefs, perceived morality, and detailed risk perceptions unmeasured. Clustering and stratification were not fully modeled in the regression analyses, so standard errors and confidence intervals should be interpreted with caution. No significant differences by religion were found for any outcome, though the dataset did not directly measure cultural beliefs or social norms. Still, the authors conclude, the pattern is clear: awareness alone is not enough, and targeted education and stigma-reduction efforts—particularly among younger and less educated Egyptians—are needed to translate familiarity with HIV into accurate understanding and acceptance.

Subject of Research: HIV awareness, knowledge, and accepting attitudes toward people living with HIV in Egypt

Article Title: Awareness, knowledge, and accepting attitudes toward people living with HIV in Egypt: a secondary analysis of a nationally representative sample

Article References: Abouelmagd, M. E., Alnajjar, A. Z., Hamed, B. M., Elsebaie, E. H., & Ghazy, R. M. (2026). Awareness, knowledge, and accepting attitudes toward people living with HIV in Egypt: a secondary analysis of a nationally representative sample. AIDS Research and Therapy, 23(1), Article 97. https://doi.org/10.1186/s12981-026-00942-w

Image Credits: AI Generated

DOI: 10.1186/s12981-026-00942-w

Keywords: HIV, Egypt, stigma, health knowledge, DHS survey, public health, health education, UNAIDS 95-95-95, Middle East and North Africa, attitudes toward PLHIV, cross-sectional study, health literacy