Across sectional study: the knowledge, attitude, perception, misconception and views (KAPMV) of adult family members of people living with human immune virus-HIV acquired immune deficiency syndrome-AIDS (PLWHA)

Individual and community level factors associated with discriminatory attitudes against people living with HIV/AIDS among women of reproductive age in three sub-Saharan African countries: evidence from the most recent demographic and health survey (2021/22)

INTRODUCTION

HIV-related stigma and discrimination significantly affects health, and well-being, willingness to be tested for HIV, initiation and adherence to antiretroviral therapy, and quality of life. However, the findings of the prior studies revealed that the prevalence of discrimination against people living with HIV is high. Thus, we aimed to assess the magnitude of discriminatory attitudes against people living with HIV/AIDS and associated factors in three sub-Saharan African countries.

METHODS

The appended and most recent Demographic and Health Survey dataset of three sub-Saharan African countries from 2021 to 2022 was used for data analysis. A total of 56,690 women aged 15-49 years were included in this study as a weighted sample. The determinants of discriminatory attitudes against people living with HIV/AIDS were determined using a multilevel mixed-effects logistic regression model. Significant factors associated with discriminatory attitudes against people living with HIV/AIDS in the multilevel mixed-effect logistic regression model were declared significant at p-values < 0.05. The adjusted odds ratio (AOR) and confidence interval (CI) were used to interpret the results.

RESULT

The overall prevalence of discriminatory attitudes against people living with HIV/AIDS was 28.19% (95% CI: 27.74%, 28.64%). In the multivariable analysis, individual level (being young, being an internet user, being tested for HIV, and having comprehensive knowledge about HIV) and community level (being a rural dweller) were factors associated with discriminatory attitudes against people living with HIV/AIDS.

CONCLUSION

The prevalence of discriminatory attitudes against people living with HIV/AIDS in three sub-Saharan African countries was high. Individual and community-level variables were associated with discriminatory attitudes against people living with HIV/AIDS. Therefore, special consideration should be given to rural dwellers and young adults. In addition, better to strengthen the accessibility of Internet and HIV testing services, and improve HIV-related education to reduce the magnitude of discriminatory attitudes against people living with HIV/AIDS.

Determinants of HIV/Aids Knowledge Among Females in Somalia: Findings from 2018 to 2019 SDHS Data

Background

Immunodeficiency syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV), has become a serious global public health concern, particularly in underdeveloped countries. Even though the fact that just a few case studies have addressed on the HIV/AIDS in the context of Somalia, to the best of our knowledge, no national-scale study on the topic has been attempted. Limited knowledge of HIV/AIDS is highlighted as one of the major factors linked to the high prevalence of HIV among female population. This study aims to fill this knowledge gap in the literature by investigating the effects of several sociodemographic factors on females' knowledge about HIV/AIDS in Somalia.

Methods

Secondary data from the Somalia Demographic Health Survey 2018-19 were used in this study. A total of 16,335 women between the ages of 15 and 49 who fit our inclusion criteria have been chosen. The application of multiple logistic regressions was then performed to see if the predictors had a significant association with knowledge of HIV/AIDS.

Findings

Women aged 35-39 (AOR = 1.608; 95% CI: 1.372-1.886), women lived in urban (AOR: 2.833, 95% CI: 2.246-3.572), Women's education (AOR: 2.246, 95% CI: 1.988-2.537), frequency of listening to a radio (AOR = 2.312; 95% CI: 1.995-2.679), and frequency of watching television (AOR = 3.936; 95% CI: 3.445-4.497) were significantly related with current knowledge about HIV/AIDS among eligible women in Somalia.

Conclusion

This study highlights the importance of mass media (TV and radio) interventions, education, and place of habitation as the main significant predictors of women's knowledge of HIV/AIDS in Somalia. Based on the study, women are more likely to be aware of HIV/AIDS as their education level, frequency of listening a radio and watching a television watching rises. The research additionally indicates that women who reside in urban centers are nearly three times more likely than women who live in nomadic areas to know more about HIV/AIDS.

Investigation of discriminatory attitude toward people living with HIV in the family context using socio-economic factors and information sources: A nationwide study in Indonesia

Background

The well-being of people living with HIV (PLHIV) remains a concern. In addition to facing discrimination in their communities, many PLHIV have family members who have a discriminatory attitude. This study analyzes the discriminatory attitude toward PLHIV in the family context using socio-economic factors and information sources in Indonesia.

Methods

A cross-sectional study design was adopted using secondary data from the 2017 Indonesian Demographic Health Survey (IDHS). A total sample of 28,879 respondents was selected using two-stage stratified cluster sampling. The study variables are information sources, sex, age, education, residence, earnings, and familial discriminatory attitude. We used the STATA 16.1 software to analyze Chi-square and binary logistics with a 95% confident interval (CI) with a significance of 5% (p-value < 0.05).

Results

In Indonesia, familial discriminatory attitude has a prevalence of 72.10%. In the survey, the respondents with access to some information about HIV (AOR: 0.794; 95% CI [0.722-0.873]), women (AOR: 0.768; 95% CI [0.718-0.820]), and those living in rural areas (AOR: 0.880; 95% CI [0.834-0.929]) were the least likely to have a familial discriminatory attitude. Meanwhile, the respondents aged 15-24 years (AOR: 1.329; 95% CI [1.118-1.581]) and those with a secondary level of education (AOR: 1.070; 95% CI [1.004-1.142]) were the most likely to have a familial discriminatory attitude.

Conclusion

In the study, we found that, the younger the age and the lower the educational level of the respondent, the more likely they were to have a familial discriminatory attitude. The government may consider these factors when designing policies to tackle familial discrimination faced by PLHIV; in particular, education on HIV and AIDS should be promoted.

Discriminatory attitude towards people living with HIV/AIDS and its associated factors among adult population in 15 sub-Saharan African nations

BACKGROUND

Discrimination of people living with HIV/AIDS is one of the reported obstacles to the achievement of universal access to HIV/AIDS prevention, treatment, care, and support programs. Many international agencies have made combating HIV/AIDS stigma and discrimination a top priority. However, previous evidence in different parts of Africa revealed that the magnitude of HIV/AIDS-related discriminatory attitude is significantly high.

OBJECTIVE

To assess discriminatory attitude towards people living with HIV/AIDS and its associated factors among the adult population in 15 sub-Saharan African nations.

METHODS

We have used the 15 Demographic and Health Survey data that were conducted in sub-Saharan Africa (SSA) from 2015 to 2019/20. Each country's data was appended and a total weighted sample of 318,186 (unweighted sample = 315,448) adults who had ever heard of AIDS was used for the final analysis. The two discriminatory attitude questions were used to get the outcome variable and those who answered "Yes" or "don't know" for both questions were counted as if they had no discriminatory attitude towards people living with HIV/AIDS. To assess the factors associated with discriminatory attitude towards people living with HIV/AIDS, we have fitted a multilevel binary logistic regression model. Bivariable analysis was done to select eligible variables for the multivariable analysis. Finally, variables with p<0.05, in the multivariable analysis, were considered as significant predictors of discriminatory attitude towards people living with HIV/AIDS.

RESULTS

The prevalence of discriminatory attitude towards HIV/AIDS in the 15 sub-Saharan African nations was 47.08% (95% CI: 47.08, 47.42), which ranges from 17.64% (95% CI: 17.22, 18.07) in Malawi to 79.75% (95% CI: 79.02, 80.45) in Guinea. In the multivariable analysis, both individual level and community level variables were significantly associated with discriminatory attitude towards people living with HIV/AIDS. Being younger age, no formal education, never married, low socioeconomic status, male-headed household, non-contraceptive use, no mass media exposure, and incorrect comprehensive knowledge towards HIV/AIDS were among the individual-level factors that were associated with higher odds of discriminatory attitude towards people living with HIV/AIDS. While being from urban residence and the western SSA region were among the community-level factors that were significantly associated with higher odds discriminatory attitude towards people living with HIV/AIDS.

CONCLUSION

The prevalence of discriminatory attitude towards people living with HIV/AIDS in 15 sub-Saharan African nations was high. Both individual and community-level factors were associated with discriminatory attitude towards people living with HIV/AIDS. Therefore, special attention should be given to those who are poor, uneducated, and younger adults. In addition, it is better to strengthen the accessibilities of different media for adult populations to create an appropriate attitude towards people with HIV/AIDS.

Individual-, household-, and community-level factors associated with pregnant married women's discriminatory attitude towards people living with HIV in sub-Saharan Africa: A multicountry cross-sectional study

BACKGROUND AND AIMS

Discriminatory attitude towards people living with human immunodeficiency virus (HIV) remains a major problem in the prevention and treatment of HIV in sub-Sahara Africa (SSA). Understanding the multiple factors linked to discriminatory attitude towards people living with HIV/AIDS (PLWHA) in SSA is necessary for developing appropriate interventions. This study aimed at investigating the individual, household, and community-level factors associated with pregnant married women's discriminatory attitude towards people living with HIV/AIDS.

METHODS

We used data from the Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2015 and 2019. Data on 17 065 pregnant married women were analyzed. Bivariate (chi-squared test) and multivariable multilevel logistic regression analyses were applied to investigate the factors associated with discriminatory attitude towards PLWHA. The results were reported as adjusted odds ratio (aOR) at 95% confidence interval (CI).

RESULTS

The mean age of participants was 31.2 ± 8.5. The prevalence of discriminatory attitude towards PLWHA was 36.2% (95% CI: 33.4%-39.1%). Individual/household-level factors associated with discriminatory attitude towards PLWHA were women's educational level (secondary school-aOR = 0.49, 95% CI: 0.26-0.93), husband's educational level (higher education-aOR = 0.35, 95% CI: 0.16-0.76), decision-making power (yes-aOR = 0.51, 95% CI: 0.38-0.69), wife-beating attitude (disagreement with wife beating-aOR = 0.58, 95% CI: 0.43-0.79), and religion (Muslim-aOR = 1.92, 95% CI: 1.22-3.04). Community socioeconomic status (medium-aOR = 0.61, 95% CI: 0.41-0.93) was the only community-level factor associated with discriminatory attitude towards PLWHA.

CONCLUSION

More than one-third of pregnant married women in SSA had discriminatory attitude towards PLWHA. Women's educational level, husband's educational level, decision-making power, wife-beating attitude, religion, and community socio-economic status were associated with discriminatory attitude towards PLWHA. To lessen the prevalence of discriminatory attitude towards PLWHA, considering these significant factors is needed. Therefore, governments and other stakeholders in the respective countries need to increase education coverage. Moreover, empowering women through education and economy is crucial. Finally, working with religious leaders to increase awareness about HIV and discriminatory attitude towards PLWHA should also be a priority in SSA.

Knowledge and attitude towards HIV/AIDS in India: A systematic review and meta-analysis of 47 studies from 2010-2020

Background: Several studies assessed the level of knowledge and general public behavior on human immunodeficiency virus/acquired immuno-deficiency syndrome (HIV/AIDS) in India. However, comprehensive scrutiny of literature is essential for any decision-making process. Our objective was to perform a systematic review and meta-analysis to examine the level of knowledge and attitude towards HIV/AIDS in India.

Methods: A systematic search using Medical Subject Headings (MeSH) and free terms was conducted in PubMed/Medline, Scopus, Embase, and Google Scholar databases to investigate the level of knowledge and attitude of HIV/AIDS in India population. Cross-sectional studies published in English from January 2010 to November 2020 were included. The identified articles were screened in multiple levels of title, abstract and full-text and final studies that met the inclusion criteria were retrieved and included in the study. The methodological quality was assessed using the Joanna Briggs Institute’s checklist for cross-sectional studies. Estimates with corresponding 95% confidence intervals (CIs) for each domain were pooled to examine the level of knowledge and attitude towards HIV/AIDS in India.

Results: A total of 47 studies (n= 307 501) were identified, and 43 studies were included in the meta-analysis. The overall level of knowledge about HIV/AIDS was 75% (95% CI: 69-80%; I2 = 99.8%), and a higher level of knowledge was observed among female sex workers (FSWs) 89% (95% CI: 77-100%, I2 = 99.5%) than students (77%, 95% CI: 67-87%, I2 = 99.6%) and the general population (70%, 95% CI: 62-79%, I2 = 99.2%), respectively. However, HIV/AIDS attitude was suboptimal (60%, 95% CI: 51-69%, I2 = 99.2%). Students (58%, 95% CI: 38-77%, I2 = 99.7%), people living with HIV/AIDS (57%, 95% CI: 44-71%, I2 = 92.7%), the general population (71%, 95% CI: 62-80%, I2 = 94.5%), and healthcare workers (HCWs) (74%, 95% CI: 63-84%, I2 = 0.0%) had a positive attitude towards HIV/AIDS. The methodological quality of included studies was "moderate" according to Joanna Briggs Institute’s checklist. Funnel plots are asymmetry and the Egger’s regression test and Begg’s rank test identified risk of publication bias.

Conclusion: The level of knowledge was 75%, and 40% had a negative attitude. This information would help formulate appropriate policies by various departments, ministries and educational institutions to incorporate in their training, capacity building and advocacy programs. Improving the knowledge and changing the attitudes among the Indian population remains crucial for the success of India’s HIV/AIDS response.

Determinants of overall knowledge of and attitudes towards HIV/AIDS transmission among ever-married women in Pakistan: evidence from the Demographic and Health Survey 2012-13

BACKGROUND

HIV/AIDS has emerged as a serious public health issue across the globe, and particularly in developing countries. Comprehensive knowledge and positive attitudes are cornerstones for the prevention, control and treatment of HIV/AIDS. However, there are various misconceptions associated with HIV/AIDS transmission, which lead to negative attitudes towards people living with AIDS. The present study aims to explore the effects of these determinants, related to socio-demographic characteristics and autonomy, on women's overall knowledge and attitudes regarding HIV/AIDS in Pakistan.

METHODS

Secondary data analysis was carried out using the national representative dataset of the 2012-13 Pakistan Demographic and Health Survey. A series of questions related to HIV/AIDS was asked of 13,558 ever-married women aged 15-49 years to assess respondents' knowledge regarding modes of HIV/AIDS transmission and preventative measures, as well as their attitudes towards people living with HIV/AIDS. Descriptive and bivariate statistics were used to identify associations with socio-demographic and autonomy-related variables. Furthermore, bivariate and multivariate logistic regression analyses were performed to assess the association between multiple factors and overall HIV/AIDS knowledge as well as attitudes towards people living with AIDS.

RESULTS

The results show that only 42% of Pakistani women have heard about HIV/AIDS. Amongst these women, the majority (68%) have good overall knowledge of HIV/AIDS and more than 55% have positive attitudes towards people living with AIDS. Furthermore, women residing in urban areas, having at least secondary-level education, with high autonomy, belonging to the richest wealth quintile and having exposure to mass media had high overall knowledge and positive attitudes towards people living with AIDS.

CONCLUSION

The findings of this research support the relevance of women's autonomy, education and exposure to mass media, particularly in rural areas of Pakistan, to address the lack of knowledge and eliminate various myths and stigmatisation of people living with HIV/AIDS. Furthermore, it reveals a need to increase focused and targeted interventions to enhance women's knowledge and positive attitudes towards people living with HIV/AIDS. In this regard, the media can play a proactive role to gauge wider audience in creating awareness and eradicating the myths and misconceptions regarding HIV/AIDS.

Knowledge, attitude and practice of infant feeding in the first 6 months among HIV-positive mothers at the Queen Mamohato Memorial hospital clinics, Maseru, Lesotho

BACKGROUND

The balance between the risks of transmission of human immunodeficiency virus (HIV) through breastfeeding and its life-saving benefits complicates decisions about infant feeding among HIV-positive mothers in the first 6 months.

OBJECTIVE

The aim of this study was to assess the knowledge, attitude and practice of infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission services in Maseru, Lesotho.Method and setting: This observational cross-sectional study was done by collecting data from HIV-positive mothers attending the filter clinics of Queen Mamohato Memorial hospital in Maseru, Lesotho. HIV-positive mothers with infants below the age of 6 months attending the clinics at the time of the study were interviewed using a standardised questionnaire. We described the sociodemographic profile of the mothers, the information and education received on prevention of mother-to-child transmission (PMTCT) infant feeding options, the mothers' knowledge, attitudes and practices of infant feeding, and assessed risk factors for improved knowledge, attitudes and practices.

RESULTS

The majority (96%) of the 191 HIV-positive mothers who participated in the survey knew about the PMTCT programme and related breastfeeding services. Most of the participants chose to breastfeed (89%), while only 8% formula-fed their infants. Knowledge received during the PMTCT programme was significantly associated with the decision to exclusively breastfeed their infants. Earlier infant feeding counselling and education was associated with more exclusively breastfeeding as compared to late infant feeding counselling (p < 0.001).

CONCLUSION

The study found that HIV-positive mothers attending health clinics in Maseru, Lesotho, had high knowledge, and appropriate attitudes and practices with respect to infant feeding; and that early counselling and education improved infant feeding methods among these mothers.