From Misunderstanding to Marginalization: The Role of Knowledge in HIV-Related Discrimination and Risk Behavior Among Adolescents in Germany

Adolescents frequently demonstrate limited knowledge about HIV/AIDS, contributing to persistent stigma, misconceptions, and risky behaviors. These knowledge gaps and stigmatizing attitudes hinder effective HIV prevention and health outcomes. Understanding the sources of adolescents' HIV knowledge and identifying demographic disparities can inform targeted educational interventions. We conducted a cross-sectional, anonymous survey with 2110 adolescents aged 14-18 in Munich, Germany, prior to an extracurricular sexual health lecture between November 2023 and February 2024. The questionnaire assessed sociodemographics, HIV knowledge, sources of information, attitudes toward people living with HIV (PLHIV), and risk perceptions. Data were analyzed using descriptive and inferential statistics to identify knowledge gaps and demographic trends. Significant misconceptions about HIV transmission and prevention were observed, with 40.9% of students uncertain about transmission routes. Male students and those in nonacademic school tracks exhibited higher rates of uncertainty and misinformation. Social media, particularly TikTok, emerged as a major but inconsistent source of HIV information, alongside schools. Stigmatizing attitudes, such as discomfort with PLHIV, were linked to knowledge gaps and misinformation. Demographic factors, including gender and educational background, significantly influenced both knowledge and attitudes. These findings underscore the need for targeted, inclusive educational interventions to bridge HIV knowledge gaps and reduce stigma among adolescents. Leveraging both traditional school-based education and reliable digital platforms can address misconceptions and promote empathy toward PLHIV. Efforts to standardize comprehensive sexual health curricula and develop accurate online resources are critical to improving adolescent health literacy and fostering inclusive attitudes.