Global insights into healthcare providers' knowledge, attitudes, practices, and concerns on pre-exposure prophylaxis: A systematic review and meta-analysis.

Objective: To systematically synthesize global evidence on healthcare providers' knowledge, attitudes, practices, and barriers toward HIV pre-exposure prophylaxis (PrEP. Methods: A systematic review and meta-analysis was conducted following a PROSPERO-registered protocol (CRD42025632990) and the PRISMA 2020 guidelines. Four electronic databases (PubMed, Web of Science, Cochrane Library, and Google Scholar) were systematically searched for literature published between May 1, 2014 and December 31, 2024. Study selection, guided by the PICoS framework, involved independent screening by two reviewers. Results: This review includes twenty seven observational studies, with a total of 8960 participants globally. The pooled knowledge of healthcare providers' regarding pre-exposure prophylaxis was 65 % (95 % CI, 60-70 %), the attitude rate was 78 % (95 % CI, 71-85 %), and the practice rate was 37 % (95 % CI, 32-41 %). Healthcare providers with a positive attitude were more likely to have good knowledge [OR = 2.28, (95 % CI, 1.52-3.04)]. Conclusion: Despite generally favorable attitudes and moderate knowledge, pre-exposure prophylaxis practice among healthcare providers remains low. Targeted interventions to improve training, resource access, and guideline awareness, along with strategies to reduce stigma and misconceptions, are essential. Continuous education and innovations, including long-acting pre-exposure prophylaxis formulations, may further enhance adoption and strengthen global HIV prevention efforts.