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Lau LHW, Lee MP, Wong BCK, Kwong TS, Hui WM, Chan JMC, Lee SS. HIV-related public stigma in the era of "Undetectable = Untransmittable": a population-based study in Hong Kong. BMC Public Health 2024; 24:1517. [PMID: 38844889 PMCID: PMC11155177 DOI: 10.1186/s12889-024-18974-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/27/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND While global efforts are increasingly relying upon biomedical advancements such as antiretroviral therapy and pre-exposure prophylaxis (PrEP) to end the HIV epidemic, HIV-related stigma remains a concern. This study aimed to assess the general public's awareness and perception of "Undetectable = Untransmittable" (U = U) and PrEP, and the patterns of public stigma towards people living with HIV (PLWH) and their determinants in an Asian Pacific city. METHODS A population-based, self-administrated online survey was conducted between 10-20 March 2023. All adults aged ≥ 18 years and currently living in Hong Kong were eligible. Participants' socio-demographic characteristics, awareness and perception of U = U and PrEP, as well as HIV-related stigma drivers, experience and practices were collected. Latent class analysis was used to delineate population subgroups based on their stigma profiles as reflected by 1.) fear of infection, 2.) concern about socioeconomic ramification of the disease, 3.) social norm enforcement, 4.) perceived stigma in the community, and 5.) stigmatising behaviours and discriminatory attitudes. Memberships of identified subgroups were then correlated with sociodemographic factors, awareness and perception of U = U and PrEP, using multinominal logistic regression. RESULTS Responses from a total of 3070 participants (55% male; 79% aged 18-54) were analysed. A majority, 69% and 81%, indicated that they had never heard of U = U and PrEP respectively, and only 39-40% of participants perceived these to be effective in protection from HIV. Four distinct subgroups were identified, namely "Low stigma" (37%), "Modest stigma" (24%), "Moderate stigma" (24%), and "High stigma" (15%). Compared with "Low stigma", lack of awareness of and/or negative perceptions towards U = U and/or PrEP, not knowing any PLWH were associated with increased odds of higher stigma group membership. Lower educational level and not in employment were associated with increased odds of membership in "Moderate stigma" and "High stigma". While older people were more likely to belong to "High stigma", female were more likely to belong to "Moderate stigma". "Modest stigma" included more younger people who were economically active. CONCLUSION Two-thirds of participants endorsed modest-to-high HIV-related stigma, suggesting the prevalence of HIV-related stigma was high among the general population in Hong Kong. Tailored interventions targeting specific stigma drivers and manifestations of individuals as reflected from the stigma profiles of distinct subgroups could form an important strategy for stigma reduction.
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Affiliation(s)
| | - Man-Po Lee
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Bonnie Chun-Kwan Wong
- Department of Health, Centre for Health Protection, Hong Kong Special Administrative Region Government, Hong Kong, China
| | - Tsz-Shan Kwong
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - Wai-Man Hui
- Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Jacky Man-Chun Chan
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong, China
| | - Shui-Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
- S.H. Ho Research Centre for Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
- Postgraduate Education Centre, Stanley Ho Centre for Emerging Infectious Diseases, Prince of Wales Hospital, Hong Kong, China.
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Melkam M, Fente BM. Multilevel analysis of discrimination of people living with HIV/AIDS and associated factors in Ghana: demographic health survey of 2022 Ghana data. Front Public Health 2024; 12:1379487. [PMID: 38818442 PMCID: PMC11138154 DOI: 10.3389/fpubh.2024.1379487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/22/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction The negative effects of stigma and discrimination in communities and families include medication non-adherence, heightened psychological distress, verbal and physical abuse, a lack of social support, isolation, and dangerous health behaviors such as hiding prescriptions. Despite the huge burden of HIV/AIDS discriminatory attitudes, limited studies were conducted in Ghana. Therefore, this study examines the burden of discriminatory attitudes and their determinant factors on people who are living with HIV/AIDS in Ghana. Objective This study aimed to determine the prevalence of discriminatory attitudes and associated factors among people who are living with HIV/AIDS in Ghana based on recent DHS data. Method Secondary data analysis was used for this multilevel logistic regression analysis based on the Ghana Demographic Health Survey of 2022. Data extraction, cleaning, and analysis were conducted using Stata version 14. The community of Ghana, from the 15 to 49 age group, was used for this study, with a final sample size of 22,058 participants. Four separate models were fitted, incorporating individual and community levels. Multilevel logistic regression models were calibrated to determine the associated factors at the individual and community level with discriminatory attitudes, with a 95% CI and AOR. Results The prevalence of discriminatory attitudes toward people living with HIV/AIDS was 60.92%, with a 95% CI (60.13, 61.70) among Ghana DHS. Lower wealth status, having no comprehensive knowledge of HIV, low educational status at the individual level, and low wealth status at the community level, poorest and poorer [AOR =2.03; 95% CI: (1.04, 3.94)] and [AOR = 2.09; 95% CI: (1.84, 8.65)], respectively, no comprehensive knowledge [AOR = 3.42; 95% CI: (1.74, 6.73)], no and primary education [AOR = 3.18; 95% CI: (2.48, 5.51)] and [AOR = 3.78; 95% CI: (2.68, 5.92)], respectively, at the individual level and low wealth status [AOR = 1.58; 95% CI: (1.00, 2.46)] community level were the associated factors. Conclusion The prevalence of discriminatory attitudes toward people living with HIV/AIDS was high (60.92%) in Ghana's DHS. The associated factors for this study were lower wealth status, having no comprehensive knowledge of HIV, and low educational status at the individual level.
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Affiliation(s)
- Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, College of Medicine Health Science, University of Gondar, Gondar, Ethiopia
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Mendez-Lopez A, White TM, Fuster-RuizdeApodaca MJ, Lazarus JV. Prevalence and sociodemographic determinants of public stigma towards people with HIV and its impact on HIV testing uptake: A cross-sectional study in 64 low- and middle-income countries. HIV Med 2024; 25:83-94. [PMID: 37671459 DOI: 10.1111/hiv.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/06/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND HIV stigma and discrimination are drivers of adverse HIV outcomes because they deter individuals from engaging in the HIV care continuum. We estimate the prevalence of public stigma towards people with HIV, investigate individuals' sociodemographic determinants for reporting stigmatizing attitudes, and test the impact of HIV stigma on HIV testing uptake. METHODS This was an observational study based on an analysis of cross-sectional surveys from 64 low- and middle-income countries. We used nationally representative survey data for the population aged 15-49 years from 2015 to 2021, which was the latest available data. HIV public stigma was measured using an index of two questions about attitudes towards people with HIV. First, prevalence estimates of HIV stigma were calculated by country, across countries, and by sociodemographic characteristics. Second, country fixed-effects multivariable logistic regression models were fit to assess sociodemographic determinants of holding stigmatizing attitudes towards people with HIV. Additional logistic regression models assessed country-level income and HIV prevalence as determinants of stigma and assessed the role of HIV public stigma as a driver of testing uptake. RESULTS A total of 1 172 841 participants were included in the study. HIV stigma was prevalent in all countries, ranging from 12.87% in Rwanda to 90.58% in Samoa. There was an inverse dose-response association between HIV stigma and educational level, wealth quintile, and age group, whereby higher levels of each were associated with lower odds of holding stigmatized attitudes towards people with HIV. The odds of stigmatized attitudes were lower among men and individuals with adequate knowledge of HIV. HIV stigma was lower in countries with greater gross domestic product per capita and HIV prevalence. Holding stigmatized attitudes towards people with HIV was associated with lower testing uptake, including having ever tested or having tested in the last year. CONCLUSION HIV stigma is present to a highly varying degree in all countries studied, so different approaches to reducing stigma towards people with HIV are required across settings. Action to eliminate HIV stigma is crucial if we are to progress towards ending HIV because holding stigmatized attitudes towards people with HIV was associated with reduced testing.
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Affiliation(s)
- Ana Mendez-Lopez
- Department of Preventive Medicine, Public Health, and Microbiology, School of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Trenton M White
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - María José Fuster-RuizdeApodaca
- Department of Social Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- Spanish AIDS Interdisciplinary Society (SEISIDA), Madrid, Spain
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, New York, USA
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Sameen S, Lakhdir MPA, Azam SI, Asad N. Evaluating knowledge about HIV and discriminatory attitudes among Pakistani women of reproductive age using 2017-18 Demographic Health Survey data. Sci Rep 2023; 13:17849. [PMID: 37857793 PMCID: PMC10587286 DOI: 10.1038/s41598-023-45117-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 10/16/2023] [Indexed: 10/21/2023] Open
Abstract
A prominent issue associated with HIV is the stigma around it owing to a lack of awareness. This study aimed to find the association between HIV and AIDS-related knowledge and discriminatory attitudes amongst Pakistani women of reproductive age using the 2017-18 Pakistani Demographic Health Survey (PDHS) data. We analyzed a sample of 3381 Pakistani women of reproductive age using ordinal logistic regression for complex survey data. Two composite variables were created using the HIV module to denote the respondents' HIV-related knowledge and their attitude toward people living with HIV (PLHIV) and calculated using a scoring method. Additional variables included the respondents' age, education level, socioeconomic status, residential setting, and HIV testing history. More than half (58.8%) of the respondents presented with a negative attitude toward PLHIV and 64.3% of the respondents had poor knowledge regarding the illness. In the multivariable analysis, knowledge about HIV and level of education reported significant associations with discriminatory attitudes. We concluded that the odds of individuals living in a rural setting and hailing from a low socioeconomic background presenting with a negative attitude towards PLHIV were 2.52 times (95% CI 1.07-5.89) higher as compared to those living in an urban setting from a high socioeconomic background.
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Affiliation(s)
- Sonia Sameen
- Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O Box 3500, Karachi, Pakistan.
| | - Maryam Pyar Ali Lakhdir
- Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O Box 3500, Karachi, Pakistan
| | - Syed Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Stadium Road, P.O Box 3500, Karachi, Pakistan
| | - Nargis Asad
- Department of Psychiatry, Aga Khan University, Karachi, Pakistan
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Viola F, Formenti B, Arsuffi S, Polesini I, Focà E, Castelli F, Quiros-Roldan E. Knowledge and Attitudes towards HIV and HCV among the Population Attending the Fast-Track Cities Mobile Unit in Brescia, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6878. [PMID: 37835148 PMCID: PMC10572916 DOI: 10.3390/ijerph20196878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023]
Abstract
The Infectious and Tropical Diseases Department of the University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast-Track City commitment. A cross-sectional study was conducted, consisting of an anonymous multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18-40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Overall, only 107 (32%) of respondents knew how HIV is transmitted. Major differences were shown between different age groups, where people under the age of 40 had a significantly higher correct response rate than people over 40 (n = 101; 39% versus n = 6; 7.8%, p < 0.00001). Similarly, almost half of LGBTQI+ people (n = 28; 44.4%) gave the correct answer, versus 30% (n = 79) of heterosexuals (p = 0.0359). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. Our study highlights that misconceptions about HIV and HCV should be addressed in prevention and education programs, whose target should also be specific populations.
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Affiliation(s)
- Francesca Viola
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
| | - Beatrice Formenti
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
- UNESCO Chair in Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Piazza del Mercato, 25121 Brescia, Italy
| | - Stefania Arsuffi
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
| | - Itala Polesini
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
| | - Emanuele Focà
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
| | - Francesco Castelli
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
- UNESCO Chair in Training and Empowering Human Resources for Health Development in Resource-Limited Countries, University of Brescia, Piazza del Mercato, 25121 Brescia, Italy
| | - Eugenia Quiros-Roldan
- Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Piazzale Spedali Civili, 25123 Brescia, Italy; (F.V.)
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Liu Q, He H, He Q, Li N, Xiao W, Xiao J, Yang B, Li Y, Yang Y. HIV/AIDS Knowledge, Depression, and HIV-Related Stigma Among Elderly Men in Rural China: A Hierarchical Regression Analysis. Am J Mens Health 2023; 17:15579883231189622. [PMID: 37488960 PMCID: PMC10387684 DOI: 10.1177/15579883231189622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
This study explored the current status and influencing factors of HIV-related stigma among elderly men (≥50 years old) in rural Chengdu, China. A structured face-to-face interview survey was conducted among 286 elderly males from three towns in Chengdu using convenience sampling, 240 men (83.9%) who had heard of HIV/AIDS were included in the analysis. Hierarchical regression was used to examine the associated factors of HIV-related stigma, including demographic variables, HIV/AIDS knowledge level, receiving HIV/AIDS-related health education in the past year, depression, and anxiety, and to examine the moderating effect of educational level on HIV/AIDS knowledge and HIV-related stigma. Hierarchical regression analysis showed that men with lower HIV/AIDS knowledge scores, primary school or below educated, and depression had higher HIV-related stigma total score and social stigma dimensional scores than their counterparts. In addition, living alone was associated with higher HIV-related stigma, and elderly men with lower monthly income and those without HIV/AIDS-related health education in the past year had higher levels of social stigma. Higher HIV/AIDS knowledge score was significantly associated with lower HIV-related stigma level among those with middle school or above education level, but no such effect in those with primary school or below. In conclusion, the HIV-related stigma level among elderly men in rural Chengdu was high and positively associated with depression. HIV/AIDS education should target elderly men with low education, living alone, and low income, and interventions to promote mental health may work together to reduce HIV-related stigma in the rural elderly population.
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Affiliation(s)
- Qinxi Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Huan He
- Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Qinying He
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Na Li
- Pengzhou Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Wei Xiao
- Pengzhou Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jie Xiao
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Bihui Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yuan Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yi Yang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Twisk DE, Watzeels A, Götz HM. Community-based HIV testing through a general health check event in a high HIV-prevalent multicultural area in Rotterdam, The Netherlands: a pilot study on feasibility and acceptance. Pilot Feasibility Stud 2023; 9:101. [PMID: 37328886 DOI: 10.1186/s40814-023-01327-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/26/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND HIV testing is crucial for finding the remaining cases in a declining HIV epidemic in The Netherlands; providing HIV testing in non-traditional settings may be warranted. We conducted a pilot study to determine the feasibility and acceptability of a community-based HIV testing (CBHT) approach with general health checks to improve HIV test uptake. METHODS CBHT's main conditions were low-threshold, free-of-charge, general health check, and HIV education. We interviewed 6 community leaders, 25 residents, and 12 professionals/volunteers from local organizations to outline these main conditions. Walk-in test events were piloted at community organizations, providing HIV testing along with body mass index (BMI), blood pressure, blood glucose screening, and HIV education (October 2019 to February 2020). Demographics, HIV testing history, risk perception, and sexual contact were collected via questionnaires. To evaluate the pilots' feasibility and acceptance, we utilized the RE-AIM framework and predefined goals, incorporating quantitative data from the test events and qualitative input from participants, organizations, and staff. RESULTS A total of 140 individuals participated (74% women, 85% non-Western, median age 49 years old). The number of participants during the seven 4-h test events ranged from 10 to 31. We tested 134 participants for HIV, and one was found positive (positivity 0.75%). Almost 90% of the participants were never tested or > 1 year ago, and 90% perceived no HIV risk. One-third of the participants had one or more abnormal test results on BMI, blood pressure, or blood glucose. The pilot was well-rated and accepted by all parties. The staff had concerns about waiting time, language problems, and privacy. Participants hardly indicated these concerns. CONCLUSIONS This CBHT approach is feasible, acceptable, and well-suited for testing not (recently) tested individuals and detecting new cases. Besides reducing HIV-associated stigma and increasing HIV test acceptance, offering multiple health tests may be appropriate as we frequently observed multiple health problems. Whether this laborious approach is sustainable in the micro-elimination of HIV and should be deployed on a large scale is questionable. CBHT like ours may be suitable as a supplement to more sustainable and cost-effective methods, e.g., proactive HIV testing by general practitioners and partner notification.
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Affiliation(s)
- Denise E Twisk
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands.
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
- Department Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, The Netherlands.
| | - Anita Watzeels
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
- Department Research and Business Intelligence, Municipality of Rotterdam, Rotterdam, The Netherlands
| | - Hannelore M Götz
- Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Chautrakarn S, Ong-Artborirak P, Naksen W, Thongprachum A, Wungrath J, Chariyalertsak S, Stonington S, Taneepanichskul S, Assanangkornchai S, Kessomboon P, Neelapaichit N, Aekplakorn W. Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6 th Thai National Health Examination Survey (NHES VI). J Glob Health 2023; 13:04006. [PMID: 36637802 PMCID: PMC9838688 DOI: 10.7189/jogh.13.04006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Thailand has an ongoing action plan to reduce human immunodeficiency virus (HIV) discrimination and stigma. We aimed to monitor the level of stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among the general adult population and to investigate its related factors. Methods This study was based on data from the 6th Thai National Health Examination Survey, a large-scale country-wide survey in 2019-2020. We used a multistage sampling technique and included 11 843 adults aged 20 to 59. We collected data through face-to-face interviews which included six items related to HIV stigma domains. We weighted all analyses to account for the probability of sampling the Thai population aged 20 to 59 years. Results We found that anticipated stigma had the highest percentage of negative stigmatizing attitude responses (78.5%), followed by perceived stigma (66.6%), fear of HIV infection (54.4%), and social judgment (28.2%). Regarding the UNAIDS global indicator for discriminatory attitude, 48.6% of respondents had negative perceptions to questions about experienced stigma or discrimination. Multiple logistic regression showed that factors associated with discriminatory attitudes toward PLWHA were being aged 20-39 (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.18-1.47) or 50-59 (aOR = 1.23, 95% CI = 1.09-1.40) compared to being aged 40-49, being Muslim compared to Buddhist (aOR = 1.73, 95% CI = 1.46-2.06), being married compared to being single (aOR = 1.15, 95% CI = 1.04-1.28), holding certificate degree or higher compared to not studying or studying at a primary level (aOR = 0.81, 95% CI = 0.68-0.97), living in the Northeast (aOR = 1.27, 95% CI = 1.12-1.45) and Bangkok (aOR = 1.30, 95% CI = 1.12-1.51) compared to living in the North, having no HIV/AIDS infected relative or acquaintance compared to having an HIV/AIDS infected relative or acquaintance (aOR = 1.56, 95% CI = 1.41-1.73), and not obtaining an HIV test compared to obtaining it (aOR = 1.10, 95% CI = 1.02-1.19). Conclusions We found that HIV stigmatizing and discriminatory attitudes toward PLWHA decreased, but remained concerning among Thai adult people. A public education and awareness campaign, as well as an intervention to reduce HIV-related stigma and discrimination in the country's health care facilities, must still be maintained.
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Affiliation(s)
| | | | - Warangkana Naksen
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | - Jukkrit Wungrath
- Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand
| | | | - Scott Stonington
- Departments of Internal Medicine and Anthropology, University of Michigan, Michigan, USA
| | | | | | | | | | - Wichai Aekplakorn
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand,National Health Examination Survey Office, Bangkok, Thailand
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Li C, Wang P, Zhang M, Qu M, Cai Q, Meng J, Fan H, Sun L. Analysis of intention and influencing factors on mobile information follow-up service in HIV/AIDS in a city in China. Front Public Health 2022; 10:997681. [PMID: 36438242 PMCID: PMC9685305 DOI: 10.3389/fpubh.2022.997681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to evaluate the willingness of patients with HIV/AIDS in Henan province to accept mobile information follow-up, to find the key factors that affect behavioral willingness to accept such follow-up, to explore the internal mechanism of the mobile service, and to provide a theoretical rationale for the further promotion of mobile follow-up. Methods This study used the technology acceptance model (TAM) as its main theoretical tool, which adopted a stratified random sampling method, and investigated 284 patients with HIV/AIDS in area six of Sanmenxia City. An on-site questionnaire survey method was adopted for this study. Confirmatory factor analysis was used for structural validity, with Cronbach's coefficient used for reliability. Data analysis mainly used SPSS23.0 and AMOS23.0 software. Results The acceptance rate of the HIV/AIDS mobile follow-up service was 68.53%. In the study, product factors (PFs) were considered important in the indirect path of the TAM. Our TAM model suggested that high perceived usefulness (PU), perceived ease of use (PEU), and perceived innovativeness (PI) of the service were significant in improving mobile health (mHealth) acceptance among patients with HIV/AIDS in China. Subjective norms (SNs) also contributed to popularizing the service in the HIV/AIDS community. The model fitting was considered acceptable (root mean square error of approximation, RMSEA = 0.074; goodness of fit index, GFI = 0.905; comparative fit index, CFI = 0.963, and Tucker-Lewis index, TLI = 0.593). Conclusion PFs and SNs exerted an important influence on the behavioral intentions of the patients with HIV/AIDS who accepted mobile health. PU was another important factor affecting behavioral intention. The practicality of mHealth services was crucial. Convenience and the innovativeness of the experience with the service will be conducive to the promotion and use of mHealth follow-up services.
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Affiliation(s)
- Chuancang Li
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Pengli Wang
- Shanghai Qingpu District Center for Disease Control and Prevention, Shanghai, China
| | - Mengge Zhang
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mengbing Qu
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Qian Cai
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Jingjing Meng
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haohao Fan
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Liang Sun
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, China,*Correspondence: Liang Sun
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Muluneh AG, Merid MW, Kassa GM, Bitew DA, Ferede MG. Hotspots and determinants of women's discriminatory attitude towards people living with HIV; evidence from ethiopian demographic and health survey data. BMC Womens Health 2022; 22:420. [PMID: 36271378 PMCID: PMC9587567 DOI: 10.1186/s12905-022-01997-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022] Open
Abstract
Background Human Immunodeficiency Virus (HIV) is the major public health concern in Ethiopia with more profound effect on women. Discriminatory attitude towards people living with HIV (PLWH) impose a significant impact on patient outcomes and related issues. Hence, this study aimed to investigate the hotspot areas and determinant factors of women’s discriminatory attitude towards people living with HIV. Methods An in-depth secondary data analysis was conducted based on Ethiopian demographic and health survey (EDHS) 2016. A total of weighed 13,822 reproductive-age women were included in the analysis. The non-spatial analysis was conducted using Stata 16. A mixed effect multi-level logistic regression model was fitted to identify determinant factors of discriminatory attitude towards PLWH. A p-value < 0.2 and 0.05 were used as a cut-off point to declare statistical significance for the bi- and multi-variable regression models, respectively. Four separate models i.e. the null, individual, community level model, and a fourth combined model were fitted. Model comparison was done using deviance. Random effect parameters such as correlation coefficient, median odds ratio, and proportional change in variance were used to explain the variation between and within clusters. Global and local level spatial analyses were conducted using Global Moran’s index, GetisOrd Gi* statistics, and Spatial scan statistics were conducted. Results The magnitude of women’s discriminatory attitude towards PLWH was 62.66% (95%CI: 60.12, 65.10). The discriminatory attitude of women towards PLWH was spatially clustered (Moran’s index = 0.41, P < 0.01). The hotspots of discriminatory attitude towards PLWH were detected in most parts of the Tigray region; Northern, and southeast borders of the Amhara region; Addis Ababa city; Central, Southern, and western Oromiya region; and East, south, and northeastern parts of South Nations, Nationalities and Peoples Region (SNNPR). Being rural resident, and having no media exposure were positively associated while better educational statuses, better wealth index, unmarried, having comprehensive HIV knowledge, Orthodox religion fellow, and ever being tested for HIV were negatively associated with women’s discriminatory attitude towards people living with HIV. Conclusion Discriminatory attitude of women towards PLWH was high in Ethiopia. Hotspots were detected in Amhara, Oromiya, SNNPR, Tigray regions, and Addis Ababa city. Socio-demographic, socio-economic, and HIV knowledge-related factors determine the women’s discriminatory attitude towards PLWH.
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Affiliation(s)
- Atalay Goshu Muluneh
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public health, college of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public health, college of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Getahun Molla Kassa
- grid.59547.3a0000 0000 8539 4635Department of Epidemiology and Biostatistics, Institute of Public health, college of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- grid.59547.3a0000 0000 8539 4635Department of Reproductive health, Institute of Public health, College of medicine and Health sciences, University of Gondar, Gondar, Ethiopia
| | - Menberesibhat Getie Ferede
- grid.59547.3a0000 0000 8539 4635Departments of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Wang M, Chen X, Ma S, Liu G, Chen C. Effectiveness of a mobile-based HIV prevention intervention for the rural and low-income population involving incentive policy to doctors in Liangshan, China: a randomized controlled trial protocol. BMC Public Health 2022; 22:1682. [PMID: 36064390 PMCID: PMC9447340 DOI: 10.1186/s12889-022-13930-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/02/2022] [Indexed: 11/14/2022] Open
Abstract
Background The HIV/AIDS epidemic is a concerning problem in many parts of the world, especially in rural and poor areas. Due to health service inequality and public stigma towards the disease, it is difficult to conduct face-to-face interventions. The widespread use of mobile phones and social media applications thus provide a feasible and acceptable approach for HIV prevention and education delivery in this population. The study aims to develop a generalizable, effective, acceptable, and convenient mobile-based information intervention model to improve HIV-related knowledge, attitudes, practices, and health outcomes in poverty-stricken areas in China and measure the impact of incentive policies on the work of village doctors in Liangshan, China. Methods A randomized controlled trial design is used to evaluate the effectiveness of an 18-month mobile-based HIV prevention intervention, collaborating with local village doctors and consisting of group-based knowledge dissemination and individualized communication on WeChat and the Chinese Version of TikTok in Liangshan, China. Each village is defined as a cluster managed by a village doctor with 20 adults possessing mobile phones randomly selected from different families as participants, totaling 200 villages. Clusters are randomized (1:1:1) to the Control without mobile-based knowledge dissemination, Intervention A with standardized compensation to the village doctors, or Intervention B with performance-based compensation to the village doctors. The intervention groups will receive biweekly messages containing HIV-related educational modules. Data will be collected at baseline and 6-, 12-, and 18-month periods for outcome measurements. The primary outcomes of the study are HIV-related knowledge improvement and the effectiveness of village doctor targeted incentive policies. The secondary outcomes include secondary knowledge transmission, behavioral changes, health outcomes, social factors, and study design’s acceptability and reproducibility. These outcomes will be explored via various qualitative and quantitative means. Discussion The findings will provide insights into the effectiveness, generalizability, and challenges of the mobile-based HIV prevention intervention for the population living in rural communities with low education levels and will guide the development of similar models in other low-income and culturally isolated regions. Trial registration ClinicalTrial.gov: NCT05015062; Registered on June 6, 2022.
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Affiliation(s)
- Meijiao Wang
- School of Public Administration and Humanities, Dalian Maritime University, Dalian, Liaoning, People's Republic of China.,National School of Development, Peking University, Beijing, People's Republic of China.,China Center for Health Economic Research, Peking University, Beijing, People's Republic of China
| | - Xiaotong Chen
- China Center for Health Economic Research, Peking University, Beijing, People's Republic of China
| | - Sai Ma
- China Center for Health Economic Research, Peking University, Beijing, People's Republic of China
| | - Gordon Liu
- National School of Development, Peking University, Beijing, People's Republic of China. .,China Center for Health Economic Research, Peking University, Beijing, People's Republic of China. .,PKU Institute for Global Health and Developmnent, Peking University, Beijing, People's Republic of China.
| | - Chen Chen
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, People's Republic of China.
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12
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Wen F, Wang Y, Zuo B, Yang J, Qiao Y, Ye H, Luo Z. Space-Focused Stereotypes About People Living With HIV/AIDS and the Effects on Community-Approaching Willingness. Front Psychol 2022; 13:772639. [PMID: 35496165 PMCID: PMC9051341 DOI: 10.3389/fpsyg.2022.772639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Targeting people living with Human Immunodeficiency Virus (HIV), this research examined the prevalence of space-focused stereotypes and their underlying mechanism on behavioral inclinations. Study 1 adopted the explicit nomination and implicit Go/No-Go association tests to explore the existence of space-focused stereotypes of people living with HIV/AIDS. The results demonstrated that space-focused stereotypes were only manifested explicitly with characteristics such as messy, dirty, and gloomy. Study 2 demonstrated a more negative evaluation and community-approaching willingness for communities that include people living with HIV/AIDS than those without HIV/AIDS. Additionally, space-focused stereotypes were found to have an indirect influence on community-approaching willingness; the influence was mediated by both emotional (threat perception) and cognitive factors (community evaluation). These results indicate the deviation of explicit and implicit space-focused stereotypes. More importantly, it revealed that space-focused stereotypes decreased community evaluation and influenced behavioral inclination. This research suggested the existence of space-focused stereotypes on another stigmatized social group. Characteristics of space (e.g., geographical segregation) might be the key to forming space-focused stereotypes.
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13
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Arifin H, Ibrahim K, Rahayuwati L, Herliani YK, Kurniawati Y, Pradipta RO, Sari GM, Ko NY, Wiratama BS. HIV-related knowledge, information, and their contribution to stigmatization attitudes among females aged 15-24 years: regional disparities in Indonesia. BMC Public Health 2022; 22:637. [PMID: 35365099 PMCID: PMC8976340 DOI: 10.1186/s12889-022-13046-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stigmatization attitudes among youths toward people living with HIV (PLWH) is still an issue and concern in Indonesia. The purpose of this study was to determine the regional disparities, levels of HIV-related knowledge, information, and contributions related to stigmatization attitudes among females aged 15-24 years in Indonesia. METHODS A cross-sectional study with The 2017 Indonesian Demographic Health Survey (IDHS) was used. A total of 12,691individual records of females aged 15-24 years were recruited through two-stage stratified cluster sampling. The endpoint was stigmatization attitude. Then, bivariate and multivariate binary logistics were performed. RESULTS The findings showed that female youths who have no HIV-related knowledge (62.15%) and some source of information (52.39%). The highest prevalence of stigmatizing attitude was 59.82%, on Java Island. Multivariate analysis showed that females living in Sulawesi and Kalimantan; those living in a rural area; and those with more HIV-related knowledge were less likely to have a stigmatizing attitude. Conversely, females with the middle- to richest-wealth index and had some HIV-related information were more likely to have a stigmatizing attitude. CONCLUSION An understanding of stigmatizing attitudes should be considered through demographic factors, knowledge, and source of HIV-related information. The Indonesian government should pay more attention to indicators of HIV-related knowledge and information. Moreover, we suggest that the government collaborates with youths to disseminate information and restructure and reanalyze policies about HIV.
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Affiliation(s)
- Hidayat Arifin
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia.
| | - Kusman Ibrahim
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Laili Rahayuwati
- Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia
| | - Yusshy Kurnia Herliani
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung, KM. 21, Jatinangor, Sumedang, 45363, West Java, Indonesia
| | - Yulia Kurniawati
- Department of Medical and Surgical Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia
| | - Rifky Octavia Pradipta
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Gevi Melliya Sari
- Department of Medical and Surgical Nursing, Stikes Husada Jombang, Jombang, Indonesia
| | - Nai-Ying Ko
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bayu Satria Wiratama
- Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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14
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Becker TD, Poku OB, Chen X, Wong J, Mandavia A, Huang M, Chen Y, Huang D, Ngo H, Yang LH. The impact of China-to-US immigration on structural and cultural determinants of HIV-related stigma: implications for HIV care of Chinese immigrants. ETHNICITY & HEALTH 2022; 27:509-528. [PMID: 32668975 PMCID: PMC7854980 DOI: 10.1080/13557858.2020.1791316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Objectives: Asian Americans have poor HIV-related outcomes, yet culturally salient barriers to care remain unclear, limiting development of targeted interventions for this group. We applied the 'what matters most' theory of stigma to identify structural and cultural factors that shape the nature of stigma before and after immigration from China to the US.Design: Semi-structured interviews were conducted with 16 immigrants to New York from China, recruited from an HIV clinic and community centers. Deductive followed by focal inductive qualitative analyses examined how Chinese cultural values (lian, guanxi, renqing) and structural factors influenced stigma before and after immigration.Results: In China, HIV stigma was felt through the loss of lian (moral status) and limited guanxi (social network) opportunities. A social structure characterized by limited HIV knowledge, discriminatory treatment from healthcare systems, and human rights violations impinged on the ability of people living with HIV to fulfill culturally valued goals. Upon moving to the US, positions of structural vulnerability shifted to enable maintenance of lian and formation of new guanxi, thus ameliorating aspects of stigma.Conclusions: HIV prevention and stigma reduction interventions among Chinese immigrants may be most effective by both addressing structural constraints and facilitating achievement of cultural values through clinical, peer, and group interventions.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ohemaa B Poku
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Xinlin Chen
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Jeffrey Wong
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Amar Mandavia
- Teachers College, Columbia University, New York, NY, USA
| | - Minda Huang
- Department of Psychology, University of Hartford, West Hartford, CT, USA
| | - Yuqi Chen
- Department of Educational and Psychological Studies, University of Miami, Miami, FL, USA
| | - Debbie Huang
- Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong Ngo
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Lawrence H Yang
- Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Social & Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA
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15
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Sun S, Yang C, Zaller N, Zhang Z, Zhang H, Operario D. PrEP Willingness and Adherence Self-Efficacy Among Men Who have Sex with Men with Recent Condomless Anal Sex in Urban China. AIDS Behav 2021; 25:3482-3493. [PMID: 33932186 PMCID: PMC8558112 DOI: 10.1007/s10461-021-03274-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 12/23/2022]
Abstract
This study investigates PrEP willingness, adherence self-efficacy and potential impact of PrEP among HIV-negative, Chinese men who have sex with men (MSM; n = 622) with recent condomless anal sex. Facilitative factors of PrEP willingness included migrant status, sexual risk, and prior PrEP use, whereas barriers included concerns over being treated as an HIV/AIDS patient, recent HIV testing, identity concealment, and HIV prevention service usage. Adherence self-efficacy was associated with PrEP knowledge and confidence in PrEP efficacy of HIV prevention. A total of 39.3% anticipated increase in sex partners, 25.6% anticipated decrease in condom use, and 38.0% anticipated increased HIV testing following PrEP uptake. Results suggest a two-step approach to (1) promote PrEP acceptance among Chinese MSM and (2) enhance adherence and risk monitoring among PrEP-willing MSM. Efforts to reduce stigma, incorporate PrEP in the HIV prevention continuum, and increase PrEP knowledge will be crucial to optimize PrEP implementation.
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Affiliation(s)
- Shufang Sun
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main St, Providence, RI, 02903, USA.
| | - Cui Yang
- Johns Hopkins University, Baltimore, USA
| | - Nickolas Zaller
- University of Arkansas for Medical Sciences, Little Rock, USA
| | | | | | - Don Operario
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main St, Providence, RI, 02903, USA
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16
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Smith LE, Potts HWW, Amlȏt R, Fear NT, Michie S, Rubin GJ. Holding a stigmatizing attitude at the start of the COVID-19 outbreak: A cross-sectional survey. Br J Health Psychol 2021; 27:588-604. [PMID: 34606149 PMCID: PMC8646234 DOI: 10.1111/bjhp.12564] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/24/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To identify the prevalence of a stigmatizing attitude towards people of Chinese origin at the start of the COVID-19 outbreak in the UK population and investigate factors associated with holding the stigmatizing attitude. DESIGN Online cross-sectional survey conducted 10-13 February 2020 (n = 2006, people aged 16 years or over and living in the UK). METHODS We asked participants to what extent they agreed it was best to avoid areas heavily populated by Chinese people because of the COVID-19 outbreak. Survey materials also asked about: worry, perceived risk, knowledge, information receipt, perception of government response to COVID-19, and personal characteristics. We ran binary logistic regressions to investigate associations between holding a stigmatizing attitude, personal characteristics, and psychological and contextual factors. RESULTS 26.1% people (95% CI 24.2-28.0%, n = 524/2006) agreed it was best to avoid areas heavily populated by Chinese people. Holding a stigmatizing attitude was associated with greater worry about COVID-19, greater perceived risk of COVID-19, and poorer knowledge about COVID-19. CONCLUSIONS At the start of the COVID-19 pandemic, a large percentage of the UK public endorsed avoiding areas in the UK heavily populated by people of Chinese origin. This attitude was associated with greater worry about, and perceived risk of, the COVID-19 outbreak as well as poorer knowledge about COVID-19. At the start of future novel infectious disease outbreaks, proactive communications from official sources should provide context and facts to reduce uncertainty and challenge stigmatizing attitudes, to minimize harms to affected communities.
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Affiliation(s)
- Louise E Smith
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
| | - Henry W W Potts
- University College London, Institute of Health Informatics, UK
| | - Richard Amlȏt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK.,Emergency Response Department Science and Technology, Public Health England, Behavioural Science Team, UK
| | - Nicola T Fear
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,Academic Department of Military Mental Health, King's Centre for Military Health Research, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, UK
| | - G James Rubin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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17
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Armoon B, Higgs P, Fleury MJ, Bayat AH, Moghaddam LF, Bayani A, Fakhri Y. Socio-demographic, clinical and service use determinants associated with HIV related stigma among people living with HIV/AIDS: a systematic review and meta-analysis. BMC Health Serv Res 2021; 21:1004. [PMID: 34551772 PMCID: PMC8459487 DOI: 10.1186/s12913-021-06980-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 09/02/2021] [Indexed: 01/11/2023] Open
Abstract
Background Defining HIV-related stigma (HRS) can be problematic due to structural inequalities, cultural differences, discrimination by health care providers and the limitations of tools measuring stigma for people living with HIV (PLWH). This meta-analysis aimed to determine self-reported HRS and its association with socio-demographic and clinical determinants. Methods PubMed, Scopus, Web of Science, PsycInfo, SciELO and Cochrane electronic databases were searched and after reviewing for study duplicates, the full-text of selected articles were assessed for eligibility using Population, Intervention, Comparator, Outcomes criteria. We used fixed and random-effects meta-analysis models to estimate the pooled prevalence, pooled odds ratio (OR) and 95% confidence intervals. Results Thirty-one studies containing 10,475 participants met the eligibility criteria. Among the potential risk factors: age > 30 years (OR = 0.93, 95%CI = 0.86, 1), living with a spouse (OR = 0.07, 95%CI = 0.02, 0.17), CD4 count < 200 (OR = 0.5, 95% CI = 0.31, 0.68), medication adherence (OR = 0.96, 95%CI = 0.94, 0.99), poor access to care (OR = 0.79, 95%CI = 0.65, 0.93), time since diagnosis, and accessibility to care (OR = 0.37, 95%CI = 0.11, 0.86) were all significantly associated with self-reported HIV stigma among PWLH. Conclusion Stigma is correlated with numerous negative consequences in marginalised populations including PLWH. Considering the negative association that stigma has on HIV prevention and treatment targeted evidence-based stigma reduction interventions are recommended. Interventions that are focused on a particular group, such as healthcare professionals are warranted. Rigorously designed studies with specific and validated outcome measures associated with targeted interventions may help to improve the reduction of HRS for PLWH.
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Affiliation(s)
- Bahram Armoon
- Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada. .,Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC, H3A 1A1, Canada.
| | - Peter Higgs
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Marie-Josée Fleury
- Research Center, Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada.,Department of Psychiatry, McGill University, 1033, Pine Avenue West, Montreal, QC, H3A 1A1, Canada.,Management, Evaluation and Health Policies Department, School of Public Health, Université de Montréal, 7101 av. du Parc, Montreal, QC, H3X1X9, Canada
| | - Amir-Hossien Bayat
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ladan Fattah Moghaddam
- Department of nursing, faculty of nursing and midwifery, Tehran medical sciences, Islamic Azad University, Tehran, Iran
| | - Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yadollah Fakhri
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Milic M, Dotlic J, Gazibara T, Parlic M, Nicholson D, Mitic K, Lazic D, Stevanovic J. Positive attitudes towards persons living with HIV in North Kosovo: The university students' perspective. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1100-1114. [PMID: 32881208 DOI: 10.1111/hsc.13144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 07/24/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
HIV-related stigma could delay the identification and treatment of persons living with HIV (PLHIV), particularly in regions affected by ethnic conflicts. The aims of this study were to assess attitudes towards PLHIV and examine factors associated with stronger positive attitudes towards PLHIV among university students in the Serbian province of Kosovo. A cross-sectional study was conducted at the University of Pristina temporarily settled in Kosovska Mitrovica during the academic year 2013-2014. A total of 1,017 first- and fourth-year students completed an anonymous questionnaire about socio-demographic characteristics, PLHIV, high-risk groups for acquiring HIV and health behaviour. The main outcome measure was the Attitude Score (ATS), calculated as a sum of points awarded for all attitude-related items. The majority of students (84%) expressed positive attitudes towards PLHIV, while others were indecisive. Most students held negative opinions about persons who use drugs (64%), homosexual persons of both genders (50%) and sex workers (42%). Being female (odds ratio [OR] = 1.49, 95% confidence interval [CI] 1.05-2.09) and older (OR = 1.13, 95% CI 1.03-1.24), not doing paid work while studying (OR = 3.35, 95% CI = 1.63-6.84), studying health-related disciplines (β = -0.113, 95% CI = -0.085 to -2.747), having stronger positive attitudes towards homosexual persons of both genders (OR = 0.77, 95% CI = 0.64-0.94) and not using illicit drugs (β = 2.08, 95% CI = 1.03-4.20) were associated with stronger positive attitudes towards PLHIV. Social inclusion of PLHIV and individuals at high risk for acquiring HIV could help reduce the HIV-related stigma.
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Affiliation(s)
- Marija Milic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovo, Serbia
| | - Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milan Parlic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovo, Serbia
| | - Desmond Nicholson
- Department of Regional Health Services Region Five, Ministry of Public Health, Georgetown, Guyana
| | - Katarina Mitic
- Emergency Relief Project "Solidarity", SOS Children's Villages, Belgrade, Serbia
| | - Dragoslav Lazic
- Faculty of Dentistry, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovo, Serbia
| | - Jasmina Stevanovic
- Department of Epidemiology, Faculty of Medicine, University of Pristina temporarily settled in Kosovska Mitrovica, Kosovo, Serbia
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19
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Nursalam N, Sukartini T, Arifin H, Pradipta RO, Mafula D, Ubudiyah M. Determinants of the Discriminatory Behavior Experienced by People Living with HIV in Indonesia: A Cross-sectional Study of the Demographic Health Survey. Open AIDS J 2021. [DOI: 10.2174/1874613602115010001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
The discriminatory behavior experienced by People Living With HIV (PLWH) remains an unresolved problem in Indonesia. The aims of this research were to determine the factors associated with the discriminatory behavior experienced by PLWH in Indonesia.
Methods:
This study used cross-sectional design data by processing secondary data from the Indonesian Demographic Health Survey (IDHS) conducted in 2017. The total sample in this study was 15,413 records obtained via the two-stage stratified cluster sampling technique. The variables in this study were knowledge, information, socioeconomic and demographic details and the discriminatory behavior experienced by PLWH. The instrument refers to IDHS 2017. The data were analyzed using a chi-squared test and multinomial logistic regression.
Results:
The results obtained show that approximately 78.87% of respondents exhibited discriminatory behavior against PLWH in Indonesia. Respondents who had more knowledge about HIV [RRR: 25.35; CI: 2.85, 225.18] and who had earnings [RRR: 2.15; CI: 1.18, 3.92] were more at risk of discriminatory behavior than others. Respondents who lived in a rural area were less likely to engage in discriminatory behavior against PLWH than those who lived in urban areas [RRR: 0.51; CI: 0.29, 0.91].
Conclusion:
An increased understanding of HIV-AIDS and Indonesian people's acceptance of PLWH can occur through the provision of accurate information that is designed to prevent discriminatory behavior against PLWH. The government can consider this problem and further related policies so that PLWH can coexist in society and enjoy the same rights as those living without discrimination.
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20
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Shim MS, Kim GS. Factors Influencing Young Korean Men's Knowledge and Stigmatizing Attitudes about HIV Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8076. [PMID: 33147834 PMCID: PMC7663464 DOI: 10.3390/ijerph17218076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/30/2020] [Accepted: 10/31/2020] [Indexed: 11/16/2022]
Abstract
Stigma against people living with HIV (PLHIV) fosters depression and negatively impacts the quality of life in PLHIV and is a barrier to the whole process of treatment. This study aimed to identify the levels of knowledge and stigmatizing attitudes toward HIV infection among Korean men in their 20s and the factors influencing them. A cross-sectional design was used. Two hundred and eight Korean men in their 20s responded to self-report questionnaires that included items on knowledge and stigmatizing attitudes about HIV infection, subjective norms for safer sexual behaviors (SSBs), participants' HIV-related characteristics, sex-related characteristics, and general characteristics. The mean score (±SD) for knowledge was 13.9 (±5.28) and for stigmatizing attitudes was 64.1 (±11.42). In quantile regression analysis, exposure to HIV-related information was a significant factor for knowledge in every quantile, and experience of HIV education was a significant factor in the 50th quantile. Experience of meeting PLHIV was a significant factor for stigmatizing attitudes in the 25th quantile, and subjective norms for SSB were a significant factor for stigmatizing attitudes in the 25th and 50th quantiles. Findings suggest the need for intervention to improve young Korean men's knowledge, as well as intervention focusing on norms for SSB, to prevent stigmatizing attitudes.
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Affiliation(s)
| | - Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul 03722, Korea;
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HIV-Related Knowledge and Stigma Among the General Population in the Southeast of Iran. SHIRAZ E-MEDICAL JOURNAL 2020. [DOI: 10.5812/semj.96311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: HIV-related stigma is a barrier to effective HIV responses among people living with HIV (PLHIV). Objectives: The current study aimed at measuring HIV-related stigma, and its associated factors among the general population in the Southeast of Iran. Methods: The current cross-sectional study was conducted on a convenience sample of 900 individuals in Kerman, Southeast of Iran, from July to September 2016. Data was collected using a self-administered questionnaire, including (I) demographic and background characteristics; (II) HIV-related stigma; and (III) HIV-related knowledge. Data were analyzed with SPSS version 20 using descriptive statistics, as well as bivariable and multivariable linear regressions. Results: Low, moderate, and high levels of stigmatizing attitudes toward PLHIV were reported by 39.1%, 57.8%, and 3.1% of the participants, respectively. Female sex(beta = 0.33, P value = 0.01) and those not having a history of HIV testing (beta = 0.45, P value < 0.001) had, on average, higher levels of stigmatizing attitudes, while those with a higher level of education (beta = -0.97, P value < 0.001) had, on average, lower levels of stigmatizing attitudes. Conclusions: Gender-sensitive educational interventions need to be developed to reduce the negative attitude towards PLHIV in Iran.
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Alkaff FF, Salamah S, Syamlan AT, Sukmajaya WP, Nugraha RA, Jonatan M, Sulistiawati S. Standard precaution adherence among clinical medical students in HIV and non-HIV ward in Indonesia. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:122. [PMID: 32642478 PMCID: PMC7325780 DOI: 10.4103/jehp.jehp_45_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/01/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Health-care workers, especially medical intern, are at risk of exposed to blood and other body fluids in the course of their work. To reduce the risk, standard precaution (SP) is introduced. Among all communicable diseases that could be transmitted, human immunodeficiency virus (HIV) is the most stigmatized disease. However, there are some government hospitals that separated adult HIV patients with other patients to prevent additional infection. This study aims to evaluate the impact of ward separation on SP adherence. MATERIALS AND METHODS This was an observational study conducted in March 2017 in a tertiary referral hospital for the eastern part of Indonesia. The participants were 150 medical students who underwent the past year of their clinical rotation. They were given a three-part questionnaire, consisting of their background, their SP practice in the HIV ward and non-HIV wards, and their perception and attitude regarding SP. McNemar's test and Fisher's exact test were used for the statistical analysis, using SPSS version 23.0 for Windows. RESULTS Participants were more adhered to SP (hand hygiene, wear mask as indicated, and wear glove as indicated) in the HIV ward compare to non-HIV wards (P = 0.002, P = 0.001, and P = 0.001, respectively). Almost all participants were more careful in implementing SP in the HIV ward than in non-HIV wards and were more concerned of getting needlestick injury in the HIV ward than in non-HIV ward. CONCLUSION HIV and non-HIV ward separation negatively impact medical students' SP adherence.
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Affiliation(s)
- Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Sovia Salamah
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Adila Taufik Syamlan
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - William Putera Sukmajaya
- Department of Orthopedics and Traumatology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Michael Jonatan
- Department of Biomedicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Sulistiawati Sulistiawati
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
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Huang J, Shum YY, Zhang J, Yu NX. Social distance mediates the association between fear of infection and better-off-dead beliefs about people living with HIV. J Int Med Res 2019; 48:300060519890819. [PMID: 31849260 PMCID: PMC7605012 DOI: 10.1177/0300060519890819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The better-off-dead belief, the idea that death is preferable for people living with human immunodeficiency virus, is a highly devaluing attitude, but little is known about its determinants among the general population. Guided by the instrumental model of stigma, this study examined the contributive roles of fear of infection and social distance to this stigmatizing belief. METHODS A total of 304 Chinese university students recruited in Guangzhou and Hong Kong responded to questionnaires assessing the better-off-dead belief, fear of infection and social distance. Structural equation modelling was used to test associations among the variables. RESULTS Fear of infection and social distance were associated with higher levels of the better-off-dead belief. Social distance mediated the association between fear of infection and the better-off-dead belief. CONCLUSIONS Fear of infection and social distance are determinants of the better-off-dead belief, with social distance serving as a mediator. This study highlights the importance of addressing fear and avoidance in future public health efforts to reduce the prevalence of the better-off-dead belief.
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Affiliation(s)
- Jiasheng Huang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Yuen Yee Shum
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Jianxin Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
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Huang J, Lin D, Yu NX. Variations in Dyadic Adjustment Among Heterosexual HIV-Discordant Couples in Rural China: A Latent Profile Analysis. AIDS Patient Care STDS 2019; 33:323-335. [PMID: 31194573 DOI: 10.1089/apc.2019.0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The systemic framework of resilience and dyadic perspective of couple coping suggests that HIV-discordant couples may show heterogeneous profiles of dyadic adjustment, shaped by contextual risks and resources. This study aimed to identify heterogeneous profiles of dyadic adjustment and thus investigate the expression of resilience among 159 heterosexual HIV-discordant couples in rural China. We hypothesized that the couples could be grouped into distinct profiles: both members showing poor well-being, both members showing good well-being, and discrepant well-being across the two members. A latent profile analysis classified the couples into three subgroups based on well-being, which was measured using the World Health Organization Well-Being Index. As expected, one subgroup, labeled Maladapted Couples (n = 58, 36.5%), reported poor well-being in both people living with HIV/AIDS (PLWHA) and the seronegative spouse. The second subgroup, labeled Resilient Couples (n = 50, 31.4%), was characterized by relatively good well-being in both partners. In the third subgroup, labeled Maladapted PLWHA and Resilient Spouses (n = 51, 32.1%), the PLWHA showed poor well-being, while the seronegative spouses demonstrated good well-being. The identified subgroups were validated against external well-being measures, including depression and self-rated health measures. Exploratory analyses identified distinct patterns of contextual risks (including HIV stigma and financial difficulties) and resource factors (including individual resources and relational resources) across the subgroups. These findings underscore the heterogeneity of adjustment among heterosexual HIV-discordant couples in rural China and suggest the potential usefulness of services tailored to specific subgroups.
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Affiliation(s)
- Jiasheng Huang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
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Naserirad M, Hadiji K, Tavakol M. Societal attitudes toward sexual and reproductive rights of HIV-positive women in Iran: A nation-wide web-based survey. Health Care Women Int 2018; 39:1259-1274. [PMID: 30388937 DOI: 10.1080/07399332.2018.1501052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of the researchers was to assess the community attitudes toward sexual and reproductive rights of women living with HIV (WLWH) in Iran. A descriptive cross-sectional study was conducted. A national web-based survey was used. A substantial portion of the respondents with a mean percentage of 68.5 ± 13.66 hold negative attitudes toward sexual and reproductive rights of WLWH. Being a female, having a 25-34 age and being a graduate and above were independent predictors of positive attitudes toward sexual and reproductive rights of WLWH. WLWH are faced with discriminatory attitudes in respect of their rights of childbearing and sexuality.
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Affiliation(s)
- Mohsen Naserirad
- a Department of Sociology, Faculty of Social Sciences , University of Tehran , Tehran , Iran.,b Centre de Recherche, Médecine, Sciences, Santé, Santé Mentale, Société, École des Hautes Études en Sciences Sociales , Paris , France
| | - Karine Hadiji
- b Centre de Recherche, Médecine, Sciences, Santé, Santé Mentale, Société, École des Hautes Études en Sciences Sociales , Paris , France
| | - Mohamad Tavakol
- a Department of Sociology, Faculty of Social Sciences , University of Tehran , Tehran , Iran
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Li Z, Morano JP, Khoshnood K, Hsieh E, Sheng Y. HIV-related stigma among people living with HIV/AIDS in rural Central China. BMC Health Serv Res 2018; 18:453. [PMID: 29903006 PMCID: PMC6003113 DOI: 10.1186/s12913-018-3245-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/29/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND HIV-related stigma among people living with HIV/AIDS (PLWHA) has been associated with many negative consequences, including poor adherence to therapy and undue psychological stress. However, the relative influence of specific demographic and situational factors contributing to HIV-related stigma among rural PLWHA in central China remains unknown. The aim of this study was to explore the level of HIV-related stigma among rural PLWHA across specific demographic and situational factors in central China. METHODS A cross-sectional study was conducted among PLWHA receiving care through the Chinese Centers for Disease Control of Zhenping county in Henan Province, China. Participants completed a 55-item questionnaire which included demographic and disease-related factors, HIV-related stigma was measured utilizing the validated Berger HIV Stigma Scale which has good psychometric characteristics in Chinese PLWHA. RESULTS A total of 239 PLWHA completed the survey. The mean total HIV-related stigma score was 105.92 (SD = 12.35, 95% CI: 104.34, 107.49). Multivariable linear regression analysis revealed a higher level of HIV-related stigma in younger PLWHA (β = - 0.57, 95% CI = - 0.78,-0.35, p<0.001) and those who self-reported opportunistic infections (β = 6.26, 95% CI = 1.26, 11.26, p < 0.05). CONCLUSIONS The findings in the current study suggest that rural PLWHA in central China suffer from the burden of HIV-related stigma at a moderate to high level. Younger PLWHA and PLWHA that have opportunistic infections tend to perceive a higher level of HIV stigma.
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Affiliation(s)
- Zhen Li
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Jamie P Morano
- Division of Infectious Diseases and International Medicine, University of South Florida, Tampa, FL, USA.,Yale University Center for Interdisciplinary Research on AIDS (CIRA), New Haven, USA
| | | | - Evelyn Hsieh
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Yu Sheng
- Department of Basic Nursing, School of Nursing, Peking Union Medical College, Beijing, China.
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Stigmatizing attitudes toward people living with HIV among general adult Thai population: Results from the 5th Thai National Health Examination Survey (NHES). PLoS One 2017; 12:e0187231. [PMID: 29145519 PMCID: PMC5690635 DOI: 10.1371/journal.pone.0187231] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background HIV-related stigma and discrimination is a significant driver of the HIV and AIDS epidemic. UNAIDS encourages all nations to monitor progress toward elimination of this problem. This study measured the level of stigmatizing attitudes toward people living with HIV (PLHIV) among Thai adults in the general population using recommended global tools. Methods Data from the 5th National Health Examination Survey, conducted in 2014 were used. The survey utilized six questions recommended by the Global Stigma and Discrimination Indicator Working Group and was administered to participants aged 20–59 years old. All analyses were weighted to take into account of the probability of sampling the same-age Thai population. Factors related to a discriminatory attitude according to UNAIDS, defined as agreed to at least one of the two discriminatory issues, were evaluated using Chi square tested and multivariable logistic regression. Results Of the 10,522 respondents, the most prevalent stigmatizing attitude was anticipated stigma (76.9%), followed by perceived stigma (69.2%), fear of HIV infection (57.0%), and social judgment (38.2%). Fifty-eight point six percent had discriminatory attitudes according to the UNAIDS global indicator. Independent predictors were being female (AOR = 1.21: 95% CI 1.14–1.29), aged 20–39 (AOR = 1.19: 95% CI 1.09–1.30) or 50–59 (AOR = 1.18: 95%CI 1.12–1.26), being Muslim (AOR = 2.03: 95%CI 1.55–2.66), earning < 10,000 Baht/month (AOR = 0.93: 95%CI 0.88–0.99), and living in the Northeast (AOR = 1.67: 95%CI 1.39–2.00) or in Bangkok (AOR = 1.73: 95%CI 1.45–2.07). Conclusions More than half of the general adult Thai population had stigmatizing attitudes toward PLHIV. The study provided valuable baseline information which could be used as comparison for follow-up surveys with other countries. Interventions to improve Thai society’s knowledge and attitudes toward HIV/AIDS are urgently needed.
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