Knowledge of HIV/AIDS and its determinants in India: Findings from the National Family Health Survey-5 (2019– 2021)

Epidemiological determinants and quality of life in PLHIV patients with tuberculosis in Bihar State, India

BACKGROUND

This study aimed to determine the prevalence of TB among patients living with HIV in Patna district, India. It also assessed the factors contributing to co-infection and evaluated patients' quality of life.

METHODS

This cross-sectional study was conducted at the Antiretroviral Therapy (ART) Centre in Patna, India, for a period of eight months. The socio-demographic information was collected through a pre-defined semi-structured questionnaire administered by the interviewer during face-to-face interviews at the time of enrolment. Clinical details were obtained from the hospital records. The statistical analysis was performed using SPSS software.

RESULTS

The study showed that out of 289 people living with HIV, 31% had TB as a co-infection. Male patients had a higher probability of contracting HIV-TB co-infection compared to female patients. The study indicated that advanced WHO staging, male gender, past history of TB, and opportunistic infections were strong predictors. Conversely, the odds of HIV-TB co-infection reduced with a CD4 count of over 300 cells/mm3. However, an increase in age, lower socio-economic status, BMI below the normal range, and presence of comorbidities might increase the odds of HIV-TB co-infection but were not statistically significant. The QoL of HIV-TB patients was significantly lower than that of HIV-only patients.

CONCLUSIONS

People with low CD4+ T cell count are at a higher risk of developing TB due to HIV/TB co-infection. The baseline clinical staging of HIV is significantly correlated with TB co-infection. Those in WHO Clinical Stage III and IV have a four times higher risk of developing TB.

Spatial variation and predictors of composite index of HIV/AIDS knowledge, attitude and behaviours among Ethiopian women: A spatial and multilevel analyses of the 2016 Demographic Health Survey

BACKGROUND

Although the dissemination of health information is one of the pillars of HIV prevention efforts in Ethiopia, a large segment of women in the country still lack adequate HIV/AIDS knowledge, attitude, and behaviours. Despite many studies being conducted in Ethiopia, they mostly focus on the level of women's knowledge about HIV/AIDS, failing to examine composite index of knowledge, attitude, and behaviour (KAB) domains comprehensively. In addition, the previous studies overlooked individual and community-level, and spatial predictors. Hence, this study aimed to estimate the prevalence, geographical variation (Hotspots), spatial predictors, and multilevel correlates of inadequate HIV/AIDS-Knowledge, Attitude, and Behaviour (HIV/AIDS-KAB) among Ethiopian women.

METHODS

The study conducted using the 2016 Ethiopian Demographic and Health Survey data, included 12,672 women of reproductive age group (15-49 years). A stratified, two-stage cluster sampling technique was used; a random selection of enumeration areas (clusters) followed by selecting households per cluster. Composite index of HIV/AIDS-KAB was assessed using 11 items encompassing HIV/AIDS prevention, transmission, and misconceptions. Spatial analysis was carried out using Arc-GIS version 10.7 and SaTScan version 9.6 statistical software. Spatial autocorrelation (Moran's I) was used to determine the non-randomness of the spatial variation in inadequate knowledge about HIV/AIDS. Multilevel multivariable logistic regression was performed, with the measure of association reported using adjusted odds ratio (AOR) with its corresponding 95% CI.

RESULTS

The prevalence of inadequate HIV/AIDS-KAB among Ethiopian women was 48.9% (95% CI: 48.1, 49.8), with significant spatial variations across regions (global Moran's I = 0.64, p<0.001). Ten most likely significant SaTScan clusters were identified with a high proportion of women with inadequate KAB. Somali and most parts of Afar regions were identified as hot spots for women with inadequate HIV/AIDS-KAB. Higher odds of inadequate HIV/AIDS-KAB was observed among women living in the poorest wealth quintile (AOR = 1.63; 95% CI: 1.21, 2.18), rural residents (AOR = 1.62; 95% CI: 1.18, 2.22), having no formal education (AOR = 2.66; 95% CI: 2.04, 3.48), non-autonomous (AOR = 1.71; 95% CI: (1.43, 2.28), never listen to radio (AOR = 1.56; 95% CI: (1.02, 2.39), never watched television (AOR = 1.50; 95% CI: 1.17, 1.92), not having a mobile phone (AOR = 1.45; 95% CI: 1.27, 1.88), and not visiting health facilities (AOR = 1.46; 95% CI: 1.28, 1.72).

CONCLUSION

The level of inadequate HIV/AIDS-KAB in Ethiopia was high, with significant spatial variation across regions, and Somali, and Afar regions contributed much to this high prevalence. Thus, the government should work on integrating HIV/AIDS education and prevention efforts with existing reproductive health services, regular monitoring and evaluation, and collaboration and partnership to tackle this gap. Stakeholders in the health sector should strengthen their efforts to provide tailored health education, and information campaigns with an emphasis on women who lack formal education, live in rural areas, and poorest wealth quintile should be key measures to enhancing knowledge. enhanced effort is needed to increase women's autonomy to empower women to access HIV/AIDS information. The media agencies could prioritise the dissemination of culturally sensitive HIV/AIDS information to women of reproductive age. The identified hot spots with relatively poor knowledge of HIV/AIDS should be targeted during resource allocation and interventions.

Knowledge and Attitudes About HIV/AIDS Among Adolescent Students in 15-19 Years Age Group Based on the Adolescent Education Programme: A Cross-Sectional Study Conducted in Kamrup (Metro), Assam

INTRODUCTION

There has been a rising trend in human immunodeficiency virus (HIV) cases globally as well as regionally. To combat the rising cases, it is very crucial to understand the perception of knowledge and attitude among the adolescent age group, as they constitute a majority of the population in India. The adolescent age group is quite vulnerable; hence, special attention has to be given to this particular age group to prevent them from acquiring high-risk behaviours. The Government of India initiated the Adolescent Education Programme to help adolescents cultivate a positive attitude and learn life skills to live a better and dignified life. Educational institutions have a significant role in imparting effective sex education to adolescents. This programme focuses on making the students aware of the dangers, stigma, and discrimination associated with HIV/acquired immunodeficiency syndrome (AIDS) as well as modes of transmission of HIV/AIDS, helping them to acquire the necessary life skills to enable them to avoid risky situations and to develop healthy and responsible behaviour. The study aims to assess the knowledge and attitude about HIV/AIDS among adolescent students aged 15-19 years and help them achieve a healthy attitude and responsible behaviour towards HIV/AIDS.

METHODS

A cross-sectional study was conducted in the educational institutions of Kamrup (Metro), Assam, catering to the adolescent age group of 15-19 years for two months, beginning on March 15, 2024, and ending on May 15, 2024. Simple random sampling was done to select seven schools, and students were selected via systematic random sampling. The knowledge and attitude about HIV were assessed using a self-designed questionnaire that was pilot-tested; Cronbach's alpha was used to check the internal consistency of the questionnaire; and content validation was done by a group of four experts on the subject matter. The survey questionnaire was administered to the participants in their classrooms after obtaining prior permission from the school authorities. Fisher's exact test and Chi-square tests were done to test the associations, taking a p-value <0.05 as statistically significant. A binary logistic regression model was put up to show the influence of certain socio-demographic variables on knowledge and attitude about HIV/AIDS, taking a p-value <0.05 as statistically significant. A two-factor analysis of variance with measurement repetition was also performed.

RESULTS

The majority, 165 (52.5%) of the participants, had good knowledge and attitudes regarding HIV/AIDS. The socio-demographic variables such as age, institution, grade, and religion were significantly associated with knowledge and attitude about HIV/AIDS (p-value <0.05). Regarding sources of knowledge about HIV/AIDS, the majority, 178 (56.7%) of the participants, mentioned it being taught in school or college as a part of the curriculum.

CONCLUSION

It is critical to address the current lack of information and unfavourable attitudes regarding HIV/AIDS among adolescents through school-based health programmes. This should be accomplished through proactive campaigns by educators, community leaders, non-governmental organizations (NGOs), and other groups in partnership with the government.

Evaluating knowledge about HIV and discriminatory attitudes among Pakistani women of reproductive age using 2017-18 Demographic Health Survey data

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.