Knowledge, attitudes, and practices of male barbers on hepatitis B and C transmission in Herat City, Afghanistan: a cross-sectional study.

This study aimed to assess male barbers' knowledge, attitudes, and practices (KAP) in Herat City, Afghanistan, regarding HBV/HCV transmission and prevention. A cross-sectional survey using a structured, localized KAP questionnaire based on validated tools was conducted from April to June 2025, involving 283 practicing male barbers in Herat. Descriptive statistics summarized binary scores, while associations between KAP and sociodemographic factors were analyzed using chi-square or Fisher's exact tests, and logistic regression has also been applied (p < 0.05). Among 283 male barbers, good knowledge was higher among those aged 31-50 years (73.7%) compared with those aged 21-30 years (58.5%) and 18-20 years (48.5%) (p = 0.008), and among those with > 8 years of work experience (70.5%) compared with those with ≤ 8 years (45.8%) (p < 0.001). Good preventive practice was higher among barbers who had formal training (68.8%) compared with those without training (48.0%) (p < 0.001). In multivariable analysis, barbers with > 8 years of work experience had higher odds of good knowledge than those with ≤ 8 years (AOR = 2.74; 95% CI 1.40-5.35) (p = 0.003). For attitude, barbers with fair economic status had lower odds of a positive attitude compared with those with good economic status (AOR = 0.25; 95% CI 0.06-0.97) (p = 0.046), while those working > 12 h per day had higher odds of a positive attitude than those working ≤ 12 h (AOR = 1.98; 95% CI 1.11-3.51) (p = 0.020). For practice, barbers aged 21-30 years had lower odds of good practice than those aged 18-20 years (AOR = 0.32; 95% CI 0.16-0.66) (p = 0.002), barbers serving > 5 customers/day had lower odds of good practice than those serving ≤ 5 customers/day (AOR = 0.50; 95% CI 0.29-0.88) (p = 0.016), and barbers without formal training had lower odds of good practice than those with training (AOR = 0.50; 95% CI 0.29-0.89) (p = 0.017). Male barbers in Herat City demonstrate commendable hygiene practices but exhibit significant gaps in their knowledge and attitudes regarding HBV/HCV. These findings highlight the need for targeted education and vaccination programs, integrated into barber training, to improve preventive attitudes and reduce the risk of viral transmission. Public health interventions that incorporate barbers into hepatitis control strategies are essential for mitigating the spread of HBV/HCV in the community.