Abstract
BACKGROUND: HIV-related stigma and discrimination are significant barriers to public health interventions, particularly among youth. In Malaysia, discriminatory attitudes towards people living with HIV (PLHIV) hinder efforts to achieve the National Strategic Plan for Ending AIDS by 2030. Stigma deters individuals from HIV testing, disclosure, treatment-seeking, and antiretroviral therapy adherence, undermining the cascade of care needed to reach the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 goals. OBJECTIVES: This study aimed to identify risk factors for HIV-related discriminatory attitudes among pre-university students. METHOD: A cross-sectional study was conducted at a public foundation centre in Selangor. A total of 329 pre-university students were recruited via simple random sampling. The study included active students who could read and write in Malay. Data were collected using a self-administered questionnaire. Descriptive and multivariate logistic regression analyses were conducted using SPSS version 29.0. RESULTS: Among the 329 participants, 224 (68.1%) met the criteria for discriminatory attitudes based on global HIV stigma indicators, which assess attitudes towards interacting with PLHIV in everyday settings. Multivariate analysis identified two significant risk factors: (1) female gender (adjusted odds ratio [aOR] = 1.776, 95% confidence interval [CI] = 1.064-2.964, P = 0.028) and (2) inadequate HIV knowledge (aOR = 4.546, 95% CI = 2.715-7.610, P = 0.001). CONCLUSION: This study revealed a high prevalence of discriminatory attitudes among pre-university students. Female gender and inadequate HIV knowledge were significant predictors. These findings support the development of targeted interventions to reduce HIV stigma and strengthen national prevention and treatment efforts.