To assess HIV knowledge, stigma and perceived adequacy of HIV curricular coverage among medical students in Egypt and to identify factors associated with HIV stigma.

An online-based cross-sectional study.

Medical schools across Egypt. Data were collected in August 2025 using a bilingual (Arabic/English) online questionnaire using convenience sampling.

First- through fifth-year students enrolled in Egyptian medical schools.

HIV knowledge was assessed using the Brief HIV Knowledge Questionnaire (HIV-KQ-18); HIV-related stigma was assessed using the Healthcare Providers HIV/AIDS Stigma Scale (HPASS) and perceived adequacy of HIV curricular coverage.

A total of 1503 students participated (mean age 20.6 years; 57.4% female), half of whom (48.9%) rated curricular coverage of stigma and psychosocial aspects of HIV as inadequate. The mean HIV-KQ-18 score was 8.96/18 (SD 4.26). Only 39.9% recognised that HIV cannot be transmitted through kissing, 47% believed washing after sex is protective and just 41.3% knew that not all infants born to mothers with HIV will have AIDS. The mean HPASS score was 60.1/108 (SD 17.6). Most students (76.8%) worried about contracting HIV from patients, 52% believed patients acquired HIV through risky behaviours and 43.6% endorsed a right to refuse providing care. Knowledge and stigma were inversely but weakly correlated (r = –0.17, p<0.001), and higher knowledge was independently associated with lower stigma on multivariable regression (B=–0.16, p<0.001). Despite higher knowledge, males reported significantly higher stigma (B=0.25, p<0.001) compared with their female counterparts. Similarly, participants who completed the Arabic form had significantly lower knowledge and higher stigma (B=0.24, p<0.001).

HIV stigma is prevalent among medical students in Egypt, with significant variations observed across gender, survey language and levels of HIV knowledge. These findings call for multifaceted interventions and curriculum reform to reduce stigma among future clinicians.

Previous studies and meta-analyses suggest an association between hypertension and tinnitus; however, the influence of hypertension severity and control status remains unclear.

We aimed to investigate the association between hypertension and tinnitus in detail using a large, population-based dataset from a rural setting.

Design

Observational cross-sectional study.

Setting

Sheshdeh, Fasa, Iran.

We analysed data from 9775 individuals in the general population, aged 35–70 years, excluding those with a history of cancer, pregnancy or medical conditions known to cause tinnitus, such as stroke, seizures or multiple sclerosis. Additionally, although the study design aimed to exclude participants using aminoglycosides because of their significant ototoxic effects, no such users were identified during the study period.

Hypertension was defined as a systolic blood pressure (SBP) of ≥140 mm Hg or a diastolic blood pressure (DBP) of ≥90 mm Hg on at least two separate measurements or as current use of antihypertensive medications following a prior diagnosis. These medications included ACE inhibitors, angiotensin receptor blockers, diuretics, aldosterone antagonists and atenolol. Stage I hypertension was classified as an SBP of 140–159 mm Hg or a DBP of 90–99 mm Hg, while stage II was defined as an SBP of ≥160 mm Hg or a DBP of ≥100 mm Hg. Controlled blood pressure was defined as values below these thresholds. Tinnitus, assessed by a self-reported questionnaire, was defined as a continuous wheezing sound in the ear persisting for more than 1 week.

Among participants (4446 males, 5309 females; mean age 48.55 (SD 9.53) years), the prevalence of tinnitus and hypertension was 7.4% and 19.3%, respectively. Hypertension was significantly associated with higher odds of tinnitus (adjusted OR=1.34; 95% CI 1.10 to 1.62). Notably, even participants with controlled hypertension had a 27% increased odds (OR=1.27; 95% CI 1.02 to 1.59) compared with normotensive individuals. The odds were highest in those with uncontrolled grade II hypertension (OR=2.08; 95% CI 1.25 to 3.47), demonstrating a dose-response relationship.

Our findings suggest a positive association between hypertension and tinnitus, with odds increasing alongside the severity and poor control of hypertension. Importantly, even controlled hypertension was associated with elevated odds, indicating that tinnitus screening may be warranted in all hypertensive patients, regardless of control status. These results underscore the need for heightened clinical awareness and further research into the pathophysiological mechanisms linking vascular health and auditory symptoms.