Stigmatization of persons with HIV/AIDS in Saudi Arabia

The effect of HIV on patients' lives: a phenomenological qualitative study

INTRODUCTION

Human immunodeficiency virus (HIV) infection poses a significant threat to the immune system, compromising the body's ability to combat diseases and infections. The Ministry of Health in Saudi Arabia reported an HIV incidence rate of 3 cases per 10,000 individuals. This study aimed to gain insight into the lived experience of Saudi patients living with HIV.

METHODS

Employing a qualitative phenomenological approach, this study conducted in-depth interviews with 16 HIV patients (10 men, 6 women) between January 2023 and May 2023.

RESULTS

Thematic data analysis highlighted three overarching themes and four subthemes. "Fear of the Future" encompassed subthemes including the fear of infecting a family member, fear of marriage, fear of employment recruitment, and fear of scandals. "Hopelessness" reflected the profound emotional state experienced by patients. "Overcoming Adversity" captured the resilience and strength demonstrated by individuals facing the challenges of living with HIV.

CONCLUSION

Saudi patients diagnosed with HIV encounter numerous obstacles in their daily lives. The fear of the future, including concerns such as infecting family members, marriage prospects, employment opportunities, and potential social repercussions, significantly impacts their overall well-being. By understanding the lived experience of HIV patients in Saudi Arabia, healthcare providers and policymakers can better support and enhance the quality of life for this population.

The Impact of Social Media Applications on Donor Engagement and Retention in the Saudi Arabian Blood Donation System

STUDY PURPOSE

The objective of this study is to evaluate the influence of social media applications on donor engagement and retention within the blood donation system in Saudi Arabia.

METHODS

A cross-sectional survey design was adopted in this study. The population aged above 18 years and living in Saudi Arabia was included in the study. Using convenience and snowball sampling techniques, an online questionnaire was distributed using social media channels such as WhatsApp, Facebook, and Instagram. A total of 463 participants were included in the study.

RESULTS

The majority of the study participants (78.1%) engage on social media applications multiple times a day for charity causes such as blood donation by responding to requests, while 51.8% of them engage on social media applications for the same reason a few times a month. Focusing on donor engagement, 46.8% and 27.3% of the total participants were likely to engage in the blood donation process; 60% were likely to continue to use social media applications for blood donation. The ANOVA findings showed a significant difference (p<0.05) between participant groups characterized by age and educational level on their engagement on social media applications for the blood donation process. Younger participants and participants with bachelor's degrees and above were more likely to engage in social media applications for the blood donation process compared to minimum educated and older participants (p<0.05).

CONCLUSION

Charity or blood donation organizations must adopt strategies to actively engage the donors on the platforms, as social media can effectively contribute to donor engagement and retention.

Measuring public attitudes towards people living with chronic diseases in Arabic-speaking populations: adaptation and development of the Social Stigma Scale of Chronic Diseases (SSS-CD)

BACKGROUND

A large proportion of the population in Arab countries suffer from chronic diseases. According to the statistics by the Global Health Estimates, chronic illnesses contribute by 71% to total deaths in the Arab region. While chronic illnesses have been demonstrated to carry high levels of social stigma, it is only recently that little research attention has been given to this topic in the Arab world. It is well-established that the social stigma construct is culturally-dependent. Therefore, the lack of an Arabic measure highlighted the urgent need for developing a culturally adapted and valid instrument to assess social stigma toward people living with chronic diseases. In this study, we aimed to examine the psychometric properties of the Arabic translation, adaptation and development of "the Social Stigma Scale of Chronic Diseases" (SSS-CD).

METHOD

Fifteen items derived from the literature and assessing social stigma towards chronic diseases have been administered to 570 Arabic-speaking adults from the Lebanese general population (aged 24.59 ± 6.75years; 68.6% women). Items were translated into Arabic using a forward-backward translation method. Exploratory factor analysis (EFA) using a principal-axis EFA on the first split-half subsample, followed by a confirmatory factor analysis (CFA) tested on the model extracted from the EFA on the second split-half subsample, were conducted to examine the construct validity of the SSS-CD. Fit indices were deemed adequate if the normed model chi-square (χ²/df) ≤ 3, the Steiger-Lind root mean square error of approximation (RMSEA) ≤ 0.08, the Tucker-Lewis Index (TLI) and the comparative fit index (CFI) ≥ 0.90.

RESULTS

Findings revealed that the 10-item SSS-CD has a unidimensional factor structure, with the following fit indices: χ²/df = 92.95/34 = 2.73, RMSEA = 0.077 (90% CI 0.059, 0.096), SRMR = 0.062, CFI = 0.939, TLI = 0.919. A good internal consistency was demonstrated by a McDonald's omega value of 0.73 for the total score. Findings also supported invariance across gender, with men exhibiting higher levels of social stigma attached to chronic diseases than women. All three dimensions of stigmatization (social, psychological and evolutionary stigmatization) were positively correlated with SSS-CD scores (Social self-interest [r = .40; p < .001], Evolutionary self-interest [r = .37; p < .001], Psychological self-interest [r = .42; p < .001]), demonstrating relatively strong convergent validity.

CONCLUSION

Our findings suggest that the SSS-CD has robust psychometric qualities. We thus preliminarily suggest that the scale is valid, reliable and suitable for use among Arabic-speaking people from the general population to measure public attitudes towards people living with chronic diseases. Providing this psychometrically sound measure will hopefully enable to foster research in this area in order to draw a clear overview of the prevalence and characteristics of social stigma attached to chronic diseases in Arabic-speaking communities. However, given that this was the first study to examine the psychometric properties of the SSS-CD, the present findings and conclusions should be considered tentative pending future cross-national validation studies.

Experiences of Thai-Muslim patients regarding inconsistent antiretroviral therapy adherence: An exploratory descriptive qualitative study

Background

Antiretroviral therapy (ART) has played a crucial role in saving countless lives of patients with HIV/AIDS across the world. However, despite its effectiveness, ART adherence still falls short globally, and non-adherence remains the primary cause of treatment failure. In the rural areas of southern Thailand, where the population is predominantly conservative Muslims, there has been an observed increase in ART non-adherence.

Objective

This study aimed to explore experiences of inconsistent ART adherence among Thai-Muslim patients with HIV/AIDS (PWHAs) in southern Thailand. In addition, the perspectives of healthcare providers were also sought.

Methods

Data were collected by conducting semi-structured in-depth interviews with ten Thai-Muslim PWHAs and five healthcare providers at a Voluntary Counseling-and-Testing Clinic. A content analysis approach was utilized to analyze the data.

Results

Inconsistent ART adherence was reported. Religion/spiritual imperatives, forgetfulness, inadequate knowledge (of drug side effects and drug regime), misunderstandings (about being symptom-free and feeling well), boredom from long-term drug-taking regimes, as well as poor transportation and lack of family support (arising from non-disclosure of one's HIV-serostatus due to HIV stigma) were emergent themes derived from the interviews with Thai-Muslim PWHAs. The healthcare providers' interview data revealed their need for the integration of Islamic beliefs to provide better care.

Conclusion

It is essential for healthcare teams to work collaboratively with patients' religious beliefs to enhance ART adherence. Clinical nurses can contribute to the promotion of HIV-care services by integrating Islamic beliefs and Muslim culture into their practice, thus increasing patients' knowledge and motivation for ART adherence. This could entail utilizing Islamic prayer rituals as drug reminders, elaborating on Islamic moral beliefs concerning sickness and healing, and integrating the cultural imperatives of self-care in the Muslim community into ongoing care delivery. Cross-cultural nursing education and specialized training in HIV care should incorporate knowledge about Islamic and Muslim cultural beliefs.

Scoping review of sexual and reproductive healthcare for men in the MENA (Middle East and North Africa) region: a handful of paradoxes?

Background

No study appraised the knowledge gaps and factors impacting men’s sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task.

Methods

We searched PubMed and Web of Science (WoS) electronic databases for original articles on men’s SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men’s experiences of and access to SRH.

Results

A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men’s SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH.

Conclusion

Men’s SRH is not sufficiently prioritized. We observed five ‘paradoxes’: strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men’s involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men’s involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These ‘mismatches’ suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men’s SRH.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14716-2.

Stigmatization and discrimination towards human immunodeficiency virus seropositive patients in psychiatric and mental health facilities

Stigmatization and discriminatory attitudes of nurses towards human immunodeficiency (HIV) patients have been reported in many countries. The current study was undertaken to assess the knowledge, attitudes and factors associated with stigmatizing attitudes and discrimination among psychiatric and mental health nurses and nurse interns towards patients diagnosed with the human immunodeficiency virus; utilizing a single-centre hospital-based survey design. Primary data were collected using a previously validated questionnaire in a large mental health care hospital in Riyadh, Saudi Arabia. Knowledge, attitudes, acts of discrimination and associated factors on the part of mental health nurses towards those diagnosed with the HIV were identified. The study described herein is in accordance with the STROBE guideline. A total of 241 psychiatric and mental health nurses completed the questionnaire, yielding a completion rate of 74.4%. Overall, more than half of the nurses demonstrated gaps in knowledge and reported higher stigmatizing attitudes and acts of discrimination. Factors associated with stigmatization and/or discrimination include higher exposure to seropositive patients, no formal HIV training, lower religiousness, lower awareness of HIV testing policy and lower level of knowledge about HIV infection. There is an urgent need to implement a training program that will help to reduce stigma among nurses caring for people diagnosed with this illness.

Knowledge of HIV/AIDS transmission modes and attitudes toward HIV/AIDS infected people and the level of HIV/AIDS awareness among the general population in the kingdom of Saudi Arabia: A cross-sectional study

Introduction

The human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (HIV/AIDS) are worldwide public health issues. Since Saudi Arabia is growing more accessible to the outside world, it is critical to analyze the general population's knowledge of HIV/AIDS transmission modes and attitudes toward HIV/AIDS infected people, and the level of HIV/AIDS awareness. Therefore, this study aimed to assess the knowledge of HIV/AIDS transmission modes and attitudes toward HIV/AIDS infected people, as well as the level of HIV/AIDS awareness among the general population in the Kingdom of Saudi Arabia.

Methods

The current online community-based cross-sectional descriptive study was conducted among the general population of the Kingdom of Saudi Arabia using a self-administrated electronic questionnaire between October 2017 and February 2018. A score <3 was considered a negative response. In contrast, scores of 3 and 4 were considered positive responses. The sum score of each outcome was evaluated according to Bloom's cutoff point. The scores for knowledge and attitude were transformed into mean percentage scores by dividing the sum scores obtained by the respondents by the number of items multiplied by 100. Consequently, the overall mean percentage of scores for each category of knowledge and attitude at 60% and above was considered a good level, whereas <60% was deemed a poor level.

Results

A total of 2,081 subjects residing in the Kingdom of Saudi Arabia participated in this survey. The mean score of the participant's responses to knowledge items on HIV/AIDS transmission modes was 84.2 ± 15.8%. The mean score of the participant's responses to attitude items toward HIV/AIDS infected people was 50.1 ± 49.9%. The mean score of the participant's responses to attitude items toward the level of HIV/AIDS awareness in Saudi Arabia was 55.7 ± 3.6%. Many socio-demographic variables were significantly associated with mean scores of knowledge of HIV/AIDS transmission modes, mean scores of attitude toward HIV/AIDS infected people, and mean scores of attitude toward the level of HIV/AIDS awareness (P-value ≤ 0.05). The Spearman rank correlation explained significant negative linear correlations between knowledge of HIV/AIDS transmission modes-attitudes toward HIV/AIDS infected people and knowledge of HIV/AIDS transmission modes-attitudes toward the level of HIV/AIDS awareness of r = -0.040 and r = -0.070, respectively (P-value ≤ 0.05). Otherwise, there was a positive linear correlation between attitudes toward HIV/AIDS infected people-attitudes toward the level of HIV/AIDS awareness (r = 0.080, P-value = 0.072).

Conclusions

The study showed that a high percentage of the respondents had good knowledge of HIV/AIDS transmission modes. However, a low rate of the study respondents had positive attitudes toward HIV/AIDS infected people and the level of HIV/AIDS awareness among the general population in Saudi Arabia. Therefore, there is a dire need for advocacy campaigns and policies to help reduce HIV stigmatization levels.

Assessment of Using the Syndromic Approach in Managing Patients With Sexually Transmitted Diseases Among the National Guard Primary Health Care Physicians, Jeddah City, Saudi Arabia

Background

Sexually transmitted infections (STIs) include a group of clinical syndromes that can be transmitted mainly through sexual activity. Using STIs’ syndromic approach for diagnosis and management is widely recommended to control and reduce the burden of these transmissible diseases.

Objective

The objective of this article is to assess the knowledge and practice of physicians concerning syndromic management of STIs in National Guard Primary Health Care (PHC) centers in Jeddah city, Saudi Arabia.

Materials and methods

This observational study was conducted at the National Guard PHC centers in Jeddah City, Saudi Arabia. An interview-administered questionnaire was designed. Fifty physicians have met the inclusion criteria, and all of them were included in the present study.

Results

Of the study population, 47 PHC physicians (response rate was 94%) were interviewed and the questionnaire was completed. Overall, the physicians' knowledge was different from one syndrome to another; it was highest for urethral discharge (72%) and lowest for vaginal discharge in pregnant women (21%). During the last 10 days, the physicians in the present study reported that two-thirds of their cases of STI were urethral discharge cases. However, during the previous 10 days, the practice assessment revealed that most physicians (76%) were correctly prescribed the medications as indicated by specific patients' syndromes.

Conclusion

Syndromic management is essential guidance to control and reduce the burden of STIs. Overall knowledge and practice of physicians were different from one syndrome to another. There is a need to design continuing medical education programs targeting PHC physicians to be clinically and culturally competent against socially sensitive diseases like STIs.

HIV Knowledge and Stigmatizing Attitude towards People Living with HIV/AIDS among Medical Students in Jordan

The stigmatizing attitude towards people living with HIV/AIDS (PLWHA) can be a major barrier to effective patient care. As future physicians, medical students represent a core group that should be targeted with focused knowledge and adequate training to provide patient care without prejudice. The aim of the current study was to examine HIV/AIDS knowledge, and the stigmatizing attitude towards PLWHA, among medical students in Jordan. The current study was based on a self-administered online questionnaire, which was distributed during March–May 2021, involving students at the six medical schools in Jordan, with items assessing demographics, HIV/AIDS knowledge, and HIV/AIDS stigmatizing attitude, which was evaluated using the validated HIV-stigma scale. The total number of respondents was 1362, with predominance of females (n = 780, 57.3%). Lack of HIV/AIDS knowledge among the study participants was notable for the following items: HIV transmission through breastfeeding (40.8% correct responses), HIV is not transmitted through saliva (42.6% correct responses), and vertical transmission of HIV can be prevented (48.8% correct responses). Approximately two-thirds of the respondents displayed a positive attitude towards PLWHA. For six out of the 14 HIV/AIDS knowledge items, lack of knowledge was significantly correlated with a more negative attitude towards PLWHA. Multinomial regression analysis showed that a significantly more negative attitude towards PLWHA was found among the pre-clinical students compared to the clinical students (odds ratio (OR): 0.65, 95% confidence interval (CI): 0.43–0.97, p = 0.036); and that affiliation to medical schools that were founded before 2000 was associated with a more positive attitude towards PLWHA compared to affiliation to recently founded medical schools in the country (OR: 1.85, 95% CI: 1.42–2.42, p < 0.001). About one-third of medical students who participated in the study displayed a negative attitude towards PLWHA. Defects in HIV/AIDS knowledge were detected for aspects involving HIV transmission and prevention, and such defects were correlated with a more negative attitude towards PLWHA. It is recommended to revise the current medical training curricula, and to tailor improvements in the overall HIV/AIDS knowledge, which can be reflected in a more positive attitude towards PLWHA, particularly for the recently established medical schools in the country.

Stigmatisation of COVID-19 in Riyadh, Saudi Arabia: A cross-sectional study

Objectives

Infectious diseases are the most common cause of disease stigmatisation, which can lead to a denial of healthcare, education, housing and employment as well as physical violence. Such stigmatisation is common during pandemics. This study aimed to examine the social stigmatisation of COVID-19 among residents of Riyadh, Saudi Arabia.

Methods

A cross-sectional descriptive study was conducted in Riyadh in May 2020. Non-probability convenient sampling was used to recruit 847 participants through social media platforms, including WhatsApp. The data were analysed using descriptive statistics, the Pearson correlation coefficient and the chi-squared test were used along with a multiple linear regression model.

Results

There was a high level of stigma among 21% of the participants and an intermediate level in almost 49% of the participants. Low stigma was indicated among 30% of the study’s sample. A highly significant association existed between stigma, on the one hand, and older age groups, being married and lower levels of education, on the other.

Conclusion

Future awareness programmes should educate patients and their families about stigma as well as the consequences of stigmatising COVID-19. Stigma eradication policies and interventions should be implemented to avoid potentially harmful consequences for public health.

Knowledge, attitudes and practices towards people living with HIV/AIDS in Lebanon

Background

Up till today, studies carried in Lebanon have focused more on the prevalence of HIV and behaviors and quality of life of infected individuals, however, none of these studies discussed the degree of stigma towards these populations. Therefore, the aim of this study is to measure the rate of stigma in terms of knowledge, attitude and practice towards patients living with Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) (PLWHA) and examine the factors associated with this stigma.

Methods

A cross-sectional survey, enrolling 862 participants, was carried across the five governorates in Lebanon: Beirut, Mount Lebanon, North, South and Bekaa. The survey was a self-administered questionnaire which covered information about participants’ general demographics, their knowledge, attitudes, practices and awareness towards HIV/AIDS in Lebanon., attitudes towards PLWHA, practices related to HIV/AIDS and awareness regarding HIV/AIDS situation in Lebanon.

Results

The response rate to the survey was 78.36% (862 participants). Being Muslim (Beta = -2.56) or Druze (Beta = -2.64) compared to Christians were significantly associated with lower knowledge towards HIV/AIDS, whereas having a secondary (Beta = 2.71) and a university (Beta = 3.04) levels of education compared to illiteracy and higher age (Beta = 0.05) were significantly associated with higher knowledge. Higher knowledge (Beta = 0.66) was significantly associated with better attitude, whereas higher age (Beta = -0.14) and being Muslim compared to Christian (Beta = -3.44) were significantly associated with worse attitude. Better attitude (Beta = 0.02) was significantly associated with better practice, whereas females compared to males (Beta = -0.39), having a secondary level of education compared to illiteracy (Beta = -0.88) and being Muslim compared to Christian (Beta = -0.32) were significantly associated with worse practice.

Conclusion

Our results stress the need for educational programs, advocacy campaigns and policies to help reduce HIV stigma. This will then help start developing interventions and strategies for a possible reduction in the stigmatization level.

HIV/AIDS-knowledge and attitudes in the Arabian Peninsula: A systematic review and meta-analysis

BACKGROUND

HIV/AIDS prevention has been widely adopted worldwide, but little is known about HIV/AIDS knowledge and attitudes in the Arabian Peninsula.

AIM

To summarize the level of knowledge and attitude about HIV/AIDS in seven Arabian Peninsula countries (Saudi Arabia, Oman, Kuwait, Qatar, Bahrain, Yemen, and the United Arab Emirates (UAE)).

METHODS

A systematic literature search was performed using combined keywords in four scientific databases of peer-reviewed publications from January 2010 to June 2019. Twenty-five articles were included in the systematic review, and twenty studies in the meta-analysis. The data was analyzed using a random-effect model due to the heterogeneity between the studies.

RESULTS

Seventeen studies reported on the level of knowledge and overall knowledge about HIV/AIDS in this region: 74.4% (95% confidence interval (CI): 66.8%-82.0%, p<0.001) and the attitude was 52.8% (95% CI: 36.9%-68.6%, p<0.001). A study from Oman reported higher knowledge levels (95.5%, 95% CI: 94.2%-96.8%) while less than a quarter of the Bahrain population had positive attitudes 22.5% (95% CI: 20.5%-24.5%). Medical doctors showed higher knowledge (94.1%, 95% CI: 92.9%-95.3%), but a positive attitude was only observed in 32.5% (95% CI: 28.8%-36.2%) of the dentists toward HIV/AIDS.

CONCLUSION

The overall knowledge about HIV/AIDS was found to be satisfactory (74.4%), but about half (52.8%) of those displayed negative attitudes toward HIV/AIDS. Regular training courses as well as reviewing and reinforcing HIV/AIDS prevention guidelines can be useful to update knowledge and improve attitudes in this region.

Characterising HIV/AIDS knowledge and attitudes in the Middle East and North Africa: Systematic review and data synthesis

This article reviews HIV/AIDS knowledge and attitudes in various population groups in the Middle East and North Africa (MENA), and highlights their relevance to HIV epidemiology and the design and implementation of preventions and treatment efforts. PubMed and the MENA HIV/AIDS Epidemiology Synthesis Project database of grey/unpublished literature were searched. Levels of knowledge were categorised based on presence of basic knowledge, comprehensive knowledge, and misconceptions and misinformation. Attitudes towards people living with HIV/AIDS (PLHIV) were classified into positive or negative. Basic knowledge was overall high among key populations at higher risk of infection (KPAR), and bridging and general population groups, but still a few population pockets had low basic knowledge. Level of comprehensive knowledge was overall low, and misinformation and misconceptions were prevalent. Some KPAR, including people who inject drugs, men who have sex with men, and female sex workers, were unaware of some modes of HIV transmission. Perception of risk of infection was low even among KPAR. We found differentials in knowledge putting women, rural populations, refugees, and other marginalised minorities at a disadvantage. Attitudes towards PLHIV tended to be negative. These findings are of concern, particularly for KPAR currently experiencing emerging HIV epidemics.

HIV-Related Discrimination among Senior Dental Students in Jeddah

Aims and Objectives:

Advances in the medical management of HIV infection have increased life expectancy and reduced the mortality rate of infected individuals. As a result, dental and medical health-care workers have a higher chance to meet HIV-positive patients in their clinics. People living with HIV and AIDS (PLWHA) are frequently experiencing discrimination. That negative attitude toward HIV remains quite common among health-care professionals. The purpose of this study was to assess students’ attitudes toward PLWHA.

Materials and Methods:

The present study was a cross-sectional survey to assess the attitudes of senior dental students toward HIV/AIDS in Jeddah, Saudi Arabia. Data were collected using an online self-administered questionnaire. Data analysis was done using the statistical package of social sciences. Descriptive statistics including means, standard deviations, frequencies, and percentages were calculated and used to present the data. A binary logistic regression model was constructed to estimate the effect of different predictors on the level of HIV-related discrimination.

Results:

A total of 400 individuals took part in the study. Bivariate analysis of HIV discrimination in relation to other variables showed that those reluctant to treat HIV patients, the majority (82%) showed a negative tendency toward HIV/AIDS patients, while 75% who were willing to treat them exhibited more positive attitudes, which was statistically significant (P < 0.0001). The discrimination was high, almost 87%, among those who feared accidental exposure to HIV patients; however, 73% of those who did not experience fear, felt nondiscriminative, which was also statistically significant (P < 0.0001).

Conclusions:

Stigmatizing views toward PLWHA exist among senior dental students in Jeddah. The most significant predictors of discrimination included fear of accidental exposure, reluctance to provide treatment to these patients, and self-protective concerns.

Reducing Susceptibility to Courtesy Stigma

In light of the chronic shortage of health professionals willing to care for HIV/AIDS patients, and rising epidemics in many Muslim countries, this qualitative study examined susceptibility and resistance to courtesy stigma as experienced by nurses, doctors, and social workers in Morocco. Forty-nine in-depth interviews provided rich insights into the process of courtesy stigma and how it is managed, within the context of interactions with Islam, interactions within the workplace (patients, other health professionals), and interactions outside the workplace (the general public, friends, and family). Theoretically, the findings extend understanding of courtesy stigma and the dirty work literature. The findings also offer practical suggestions for the development of culturally appropriate strategies to reduce susceptibility to courtesy stigmatization. This study represents the first to explore courtesy stigma as a process experienced by health professionals providing HIV/AIDS care in an Islamic country.

Assessing Knowledge of, and Attitudes to, HIV/AIDS among University Students in the United Arab Emirates

BACKGROUND

The Middle East and North Africa (MENA) region is among the top two regions in the world with the fastest growing HIV epidemic. In this context, risks and vulnerability are high as the epidemic is on the rise with evidence indicating significantly increasing HIV prevalence, new HIV infections and AIDS-related deaths.

OBJECTIVE

The aim of the survey was to assess HIV/AIDS knowledge and attitudes related to HIV/AIDS among a wide group of university students in the United Arab Emirates (UAE).

METHODS

In a cross-sectional survey, a total sample of 2,294 students (406 male; 1,888 female) from four universities in three different Emirates in the UAE were approached to take part in the study. Students self-completed a questionnaire that was designed to measure their knowledge and attitudes to HIV/AIDS.

RESULTS

The overall average knowledge score of HIV.AIDS was 61%. Non-Emirati and postgraduates demonstrated higher levels of knowledge compared to Emirati and undergraduate students respectively. No significant differences between males and females; and marital status were found. Eighty-five percent of students expressed negative attitudes towards people living with HIV, with Emirati and single students significantly holding more negative attitudes compared to non-Emiratis and those that are married respectively.

CONCLUSIONS

The findings provide strong evidence that there is a need to advocate for appropriate National HIV/AIDS awareness raising campaigns in universities to reduce the gaps in knowledge and decrease stigmatizing attitudes towards people living with HIV/AIDS.

HIV Stigma Toward People Living With HIV and Health Providers Associated With Their Care: Qualitative Interviews With Community Members in Egypt

We explored perceived HIV stigma by community members in a low-HIV-prevalence setting toward people living with HIV (PLWH) and physicians associated with HIV in order to develop operational stigma reduction recommendations for HIV referral hospitals. In-depth interviews (N = 30) were conducted with educated and less-educated men and women in Egypt. Thematic analysis was applied to identify drivers, manifestations, and outcomes of stigma. Stigma toward PLWH was rooted in values and fears, manifesting in reluctance to use the same health facilities as PLWH. Stigma toward physicians providing care for PLWH was caused by fear of infection and developed into unwillingness to use those physicians' services. Stigma toward physicians who refused to provide care was linked to perceptions of unethical behavior. HIV referral hospitals in low HIV prevalence settings could benefit from stigma reduction interventions with a special focus on addressing moral-based stigma and fear of casual transmission.

Attitudes Toward Restricting the Sexual and Reproductive Rights of Women Living With HIV Infection in Yemen

A considerable amount of research has demonstrated the pervasive and destructive power of discrimination against people living with HIV, which limits their full and equal participation in society. This study surveyed 613 young adults from Yemen about their attitudes toward the sexual and reproductive rights of women living with HIV (WLWH). Among survey respondents, 80% believed that WLWH should be sterilized and not allowed to get married. Furthermore, 62% thought that WLWH should be forced to have abortions if they became pregnant. Men were more likely than women to impose restrictions on the sexual and reproductive rights of WLWH. HIV stigma predicted respondent attitudes toward WLWH, but religiosity and knowledge about HIV did not. The results of the study have implications for developing programs to protect and promote the rights of WLWH in Yemen.

Systematic review of human immunodeficiency virus (HIV) knowledge measurement instruments used on the Arabian Peninsula

Background

In 1984, the Kingdom of Saudi Arabia (KSA) began surveillance for human immunodeficiency virus (HIV) incidence and prevalence. However, no culturally-appropriate standardized questionnaire has been developed to measure HIV prevention knowledge in this population. Evidence exists that married Saudi women are especially at higher risk for infection, but lack knowledge of HIV modes of transmission and underestimate their personal risk of becoming infected. The objective of this paper is to present a critical review of existing HIV knowledge measurement tools developed for the KSA and other Arabian Peninsula populations, and to utilize this review to guide the development of a culturally- and gender-sensitive tool. Studies included were in English reporting results of a quantitative survey instrument as either an interview or self-reported questionnaire with questions about knowledge of HIV or AIDS. Surveys must have been given in English or Arabic, and must have been done in a population in the KSA or the Arabian Peninsula. The following data sources were searched for eligible studies: Google Scholar, Google Web, PubMed, PLoS, WHO publications, UN publications, news, and other peer-reviewed publication databases.

Results

Sixteen articles met criteria, and of these, 10 (63 %) were conducted in a KSA population, and a majority of the articles studied students of primary, secondary, or post-secondary schools (n = 9, 56 %). Five studies included only men, while the other 11 included both sexes.

Conclusions

The KSA’s public health goals should more specifically focus on measuring and improving knowledge in high-risk populations such as married women—an option currently limited by commonly available measurement instruments.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-015-1614-x) contains supplementary material, which is available to authorized users.

Knowledge and Attitudes about HIV/AIDS in Illegal Residents in the Kingdom of Saudi Arabia

Objectives:

To study the knowledge, attitudes, and practices with regard to human immunodeficiency virus infection / acquired immune deficiency syndrome (HIV/AIDS) in illegal residents, in the Kingdom of Saudi Arabia (KSA).

Materials and Methods:

A questionnaire study was conducted among the illegal residents from four regions in Saudi Arabia: Jeddah, Makkah, Riyadh, and Jazan.

Results:

The survey enrolled 5,000 participants, 79%male (39.6% from Jeddah; 20% from Riyadh; and 20% from Jazan), aged between 15 and 45 years. Of the total, 1288 (25.8%) had not heard about HIV/AIDS. Knowledge of HIV transmission was poor in 90% of the respondents. Of the total, 737 had read about HIV/AIDS materials and 649 participants had been previously tested for HIV. The majority of participants (85%) held a negative attitude toward people living with HIV/AIDS. Those who were knowledgeable about HIV/AIDS expressed more a positive attitude. One-fifth (968, majority were men; single 55%, married 45%) had engaged in non-marital sexual activity. The largest proportion of the individuals who had engaged in non-marital sex were single (54.9%) followed by the married ones (40.4%). Men cited pleasure as the main reason for such activity (84.6%), whereas women (73.4%) cited financial gain. Of the respondents, 53.9 and 32.1% believed that TV and schools were the best media through which information with regard to HIV/AIDS could be imparted.

Conclusions:

Knowledge of HIV/AIDS, its mode of transmission, and prevention measures was poor. Educational programs specifically targeted toward this group were required.

Knowledge and Attitudes of Doctors Toward People Living With HIV/AIDS in Saudi Arabia

OBJECTIVES

Reports showed that Saudi Arabia has low prevalence of HIV/AIDS despite increasing influx of foreign nationals from countries with high risk of HIV. Knowledge and stigmatizing attitudes of health care workers contribute to difficulties of people living with HIV/AIDS (PLWHA) accessing prevention, care, and treatment services. Nothing is known about stigma and discrimination about PLWHA in Saudi Arabia.

DESIGN

We assessed knowledge of Saudi Arabian doctors about HIV and their attitudes toward PLWHA using a cross-sectional study design.

METHOD

In this study, 1483 doctors completed a self-administered questionnaire.

RESULT

Knowledge scores and stigma index were computed from responses to relevant statements in the questionnaire. Stigmatizing attitudes of contact, reproductive rights, blaming, and judgmental were identified. HIV knowledge was a significant predictor of high stigma. Doctors' year of medical practice, status/specialty, and location of practice in Saudi Arabia were major predictors of HIV knowledge.

CONCLUSIONS

Evidence of poor knowledge of HIV suggests the need for further training of health workers on HIV transmission mode.

Perception of HIV Prevention Programs Among Ayoreo Sex Workers in Bolivia

The Ayoreo population constitutes one of Bolivia’s most vulnerable ethnic groups in terms of HIV/AIDS. Being a woman, indigenous, and a sex worker signifies belonging to a high-risk group. The aim of this study is to explore the Ayoreo sex workers’ and health agents’ perceptions of HIV/AIDS prevention programs in order to identify variables that could influence their success or failure. This study used an ethnographic methodology that included participant observation and semistructured interviews. In the data collection, participant observation and semistructured interviews with sex workers and key informants were conducted. Three themes emerged from the inductive data analysis: health prevention efforts, cultural inadequacy of prevention programs, and the eventuality of interventions. We conclude that nursing can develop culturally-adequate HIV/AIDS prevention interventions and programs as well as promote health within these populations.

HIV in the Middle East and North Africa: priority, culture, and control

OBJECTIVES

This study aimed to assess the priority of HIV/AIDS in the Middle East and North Africa region and compare it with other regions. This review examines the social, cultural and religious features of HIV in the region, and considers their influence on perception of risk and approaches to control, such as condom use and antiretroviral therapy.

METHODS

We screened a wide range of sources for comprehensive and reliable data; the search of PubMed, ISI Web of Science, ScienceDirect, and grey literature databases were unrestricted by language and year of publication.

RESULTS

Studies of HIV/AIDS in the region are limited, especially studies of social aspects of HIV/AIDS and their relevance for control. Findings suggest low condom use across the region among high-risk groups, and the general population, and low antiretroviral therapy uptake among people with HIV/AIDS.

CONCLUSIONS

The review indicates gaps in the literature and needs for more academic engagement and political commitment. Cultural norms have notable implications for HIV control, which are discussed, considering implications for the priority, prevention, treatment, and control of HIV/AIDS.

Experiences and Perceptions of Patients Living With Hepatitis C in Karachi, Pakistan

Purpose: Hepatitis C (HCV) is a chronic disease that affects an individual’s physical, financial, social, and emotional well-being throughout the illness. Although extensive literature is available on experiences of patients with hepatitis C in developed countries, very little exists in developing countries, particularly in Pakistan. This article describes experiences of patients living with HCV in Karachi, Pakistan. Method: Using descriptive exploratory design, data were collected through semistructured interviews from 10 patients with HCV. The interviews were tape recorded and transcribed verbatim. Findings: The three categories—perceptions and misperceptions, challenges and sufferings, support and shortcomings—were subsumed under the theme “deadly, dangerous, and devastating.” Conclusion and implications for practice: Patients with HCV experience profound challenges that are influenced by their level of education, financial capacity, cultural norms, family support, and the sensitivity of health care professionals. Several cultural practices existing in Pakistan identify the need for public awareness. The findings on health care professionals have implications for nursing and allied health continuing education.

Infectious diseases in the Arabian Peninsula and Egypt

Infectious diseases are important causes of morbidity and mortality globally. Epidemiologically, differences in the patterns of infectious diseases and antimicrobial resistance exist across diverse geographical regions. In this review on infectious diseases in the Arabian Peninsula and Egypt, the epidemiology of tuberculosis, malaria and human immunodeficiency virus (HIV) infections will be addressed. The challenges of the hepatitis C epidemic in Egypt and the epidemiology of this infection across the region will be reviewed. In recent years, we have seen dengue endemicity become established, with major outbreaks in parts of the region. Emerging data also indicate that, across the region, there is an increasing burden of antibiotic resistance, with endemicity in healthcare settings and dissemination into the community. New challenges include the emergence of the Alkhurma haemorrhagic fever virus in Saudi Arabia. The annual Hajj pilgrimage in Saudi Arabia serves as a model for the control of infectious disease in mass gatherings. As most of these countries constantly experience a uniquely dynamic population influx in the form of expatriate workers, tourists, or pilgrims, concerted regional and international collaboration to address these public health concerns in a region that lies at the crossroads for the global spread of infectious pathogens is imperative.