Attitudes of HIV healthcare Provider Attitudes Towards PWH who use Drugs and acceptance of harm reduction strategies: a cross-sectional study.

Background: Negative attitudes toward people who use drugs (PWUD) can hinder their engagement in healthcare and contribute to poor clinical outcomes. While harm reduction-informed care may improve healthcare worker attitudes and patient experiences, limited research has examined its acceptability within HIV clinical settings. Objectives: This study aimed to assess healthcare workers' attitudes toward PWUD and their acceptance of harm reduction principles within HIV care clinics and to examine associated sociodemographic and work-related factors. Design: Cross-sectional quantitative study. Design: In 2022, 128 healthcare workers from three HIV care clinics in Birmingham, AL and Pittsburgh, PA, completed a self-administered electronic survey via REDCap. Multivariable linear regression was used to examine associations between attitudes toward PWUD and acceptance of harm reduction practices, adjusting for relevant covariates. Methods: Overall, healthcare workers reported generally positive attitudes toward PWUD, though variations by location, race, and years of experience were observed. More negative attitudes toward PWUD were associated with lower harm reduction principles acceptance ( Results: These findings underscore the need for targeted interventions that improve harm reduction acceptability among HIV care workers, particularly those shaped by location, race, healthcare worker experience, and attitudes toward PWUD, to support the integration of harm reduction into HIV clinical practice.