Healthcare workers’ knowledge, attitudes and practices towards people living with HIV in the low-and middle-income member states of the Pacific community: A scoping review of the literature

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BACKGROUND: Human immunodeficiency virus (HIV) transmission continues to be a global public health concern, disproportionately affecting low- and middle-income (LMI) countries. Although Pacific Island countries have historically reported low HIV prevalence, both Papua New Guinea (PNG) and Fiji have experienced increasing HIV transmission rates since 2010. In January 2025, the Government of Fiji officially declared an HIV outbreak, following a 300% increase in new cases during 2024 (UNAIDS, 2025a). This outbreak poses a significant threat to the broader Pacific region, highlighting the requirement for a coordinated response to decrease disease transmission (Pacific Heads of Health, 2025). This scoping review aims to examine the evidence on knowledge, attitudes, and practices (KAP) of healthcare workers (HCWs) in LMI Pacific Island countries toward people living with HIV (PLWH) to better inform policy and identify research gaps. METHODS: A scoping review of the literature was conducted following the Arksey and O'Malley framework (2005), guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist (Page et al., 2021). A systematic search of six databases and grey literature sources was conducted. RESULTS: The initial search identified 111 articles. Following the title and abstract screen and full article review by two independent researchers, a total of seven articles met the inclusion criteria. Data was extracted into a data extraction table, and the quality of evidence was assessed using the Mixed Methods Appraisal Tool (MMAT) (Hong et al., 2018). CONCLUSION: This review highlights a significant gap in recent literature regarding HCWs KAP toward PLWH in Pacific Island communities. The available evidence suggests the need for ongoing professional development to address negative attitudes and practices, enhance HCW safety, and improve the quality of care. The findings provide synthesised evidence to support policy recommendations and emphasise the need for further research.

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