Abstract: Background: Human Immunodeficiency Virus (HIV) and tuberculosis (TB) co-infection poses a significant challenge to public health systems due to its complex clinical management and high mortality. This study aimed to reveal the specific mechanisms through which knowledge influences practice in HIV/TB co-infection management among healthcare providers (HCPs) using structural equation modeling (SEM).
Methods: An exploratory cross-sectional study using convenience sampling was conducted from May to June 2025 involving healthcare providers (HCPs) across various medical institutions in Beijing, which included university-affiliated tertiary hospitals, specialized hospitals, and community health centers.
Results: A total of 565 valid questionnaires were collected, with 364 (64.42%) completed by medical doctors. The knowledge, attitude, and practice scores were 18.51 ± 7.75 (possible range: 0-30), 43.64 ± 5.51 (possible range: 10-50), and 30.75 ± 7.44 (possible range: 8-40), respectively. Spearman correlation analysis revealed significant positive correlations between knowledge and attitude (r = 0.500, P < 0.001), between attitude and practice (r = 0.584, P < 0.001) and between knowledge and practice (r = 0.592, P < 0.001). SEM analysis indicated that knowledge had a direct influence on both attitudes (β = 0.458, P = 0.002) and practices (β = 0.491, P = 0.011), while attitudes influenced practices (β = 0.272, P = 0.008). Furthermore, knowledge indirectly affected practices through attitudes (β = 0.124, P = 0.005).
Conclusion: In our sample, respondents demonstrated limited knowledge, generally positive attitudes, and moderately adequate practices regarding HIV and TB co-infection. These preliminary findings suggest that targeted educational interventions designed to enhance knowledge may effectively improve both attitudes and practical behaviors, though more rigorous research is needed to confirm these relationships.
(Copyright: © 2026 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
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