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Bhattacharyya A, Chakraborty R, Raj T, Padhi BK, Khubchandani J, Satapathy P, Rustagi S, Chattu VK. Comprehensive Knowledge about HIV/AIDS among Women of Reproductive Age in India. EPIDEMIOLOGIA 2023; 4:492-504. [PMID: 37987313 PMCID: PMC10660847 DOI: 10.3390/epidemiologia4040041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
HIV/AIDS has been a major threat to global public health, with India ranking third when it comes to the global burden of people living with HIV, especially women. It is imperative to assess the level of knowledge women have about transmission and prevention of this infection. This study sought to delineate the determinants of the comprehensive knowledge of HIV/AIDS among women in the reproductive age groups in India. Data from the fifth round of the National Family Health Survey conducted in India were analyzed. The sample included 95,541 women aged 15-49 years. Multilevel logistic regression was fitted with individual characteristics, household characteristics, and community characteristics to identify determinants of comprehensive knowledge on HIV/AIDS. Nearly a fourth (24.8%) of the women aged 15-49 in India who had ever heard of HIV had comprehensive knowledge of HIV/AIDS. Multilevel logistic regression showed that the likelihood of comprehensive knowledge of HIV/AIDS was higher among women aged 40-44 (AOR = 1.57) and 30-34 (AOR = 1.56). The likelihood of having comprehensive knowledge increased with the increase in the level of education. Women with secondary and higher levels of education were 1.9 times and 3.38 times more likely to have comprehensive knowledge, respectively, than those with no education. Household wealth, access to mass media, and having ever tested for HIV were also significant determinants of comprehensive knowledge of HIV/AIDS among women. The odds of having comprehensive knowledge about HIV/AIDS were higher for women with higher community wealth (AOR = 1.31), higher community education (AOR = 1.09), and higher community employment (AOR = 1.12). Factors at both the individual and community levels were shown to be indicators of comprehensive knowledge of HIV/AIDS. Policymakers and public health practitioners in India should come up with plans to close the information gaps about HIV/AIDS that exist among women and their demographic subgroups.
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Affiliation(s)
- Aritro Bhattacharyya
- International Institute for Population Sciences, Mumbai 400088, India; (A.B.); (R.C.); (T.R.)
| | - Ritankar Chakraborty
- International Institute for Population Sciences, Mumbai 400088, India; (A.B.); (R.C.); (T.R.)
| | - Tapasya Raj
- International Institute for Population Sciences, Mumbai 400088, India; (A.B.); (R.C.); (T.R.)
| | - Bijaya Kumar Padhi
- Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India;
| | - Jagdish Khubchandani
- Department of Public Health Sciences, New Mexico State University, Las Cruces, NM 88003, USA
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India; (P.S.); (V.K.C.)
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Sarvesh Rustagi
- Department of Food Technology, Uttaranchal University, Dehradun 248007, India;
| | - Vijay Kumar Chattu
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India; (P.S.); (V.K.C.)
- Department of Occupation Science and Occupational Therapy-Temerty, Faculty of Medicine, University of Toronto, Toronto, ON P3C 1T6, Canada
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Nutakor JA, Zhou L, Larnyo E, Addai-Dansoh S, Cui Y, Kissi J, Danso NAA, Gavu AK. A multiplicative effect of Education and Wealth associated with HIV-related knowledge and attitudes among Ghanaian women. BMC Public Health 2023; 23:1397. [PMID: 37474917 PMCID: PMC10357801 DOI: 10.1186/s12889-023-16311-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Knowledge and attitudes regarding HIV play a crucial role in prevention and control efforts. Understanding the factors influencing HIV-related knowledge and attitudes is essential for formulating effective interventions and policies. This study aims to investigate the possibility of an interaction between education and wealth in influencing HIV-related knowledge and attitudes among women in Ghana. METHODS Cross-sectional data from the Ghana Multiple Indicator Cluster Survey (MICS), a nationally representative sample, were analyzed. Statistical summaries were computed using place of residence, marital status, education level, wealth index quintile, use of insurance, functional difficulties, and exposure to modern media. Furthermore, a three-model Logistic regression analysis was conducted; Model 1 with main effects only, Model 2 with the interaction between education and wealth, and Model 3 with additional covariates. To account for the complexity of the survey data, the svyset command was executed in STATA. RESULTS Although most interaction terms between wealth index quintiles and education levels did not show statistical significance, a few exceptions were observed. Notably, women with primary education in the second, middle, and fourth wealth quintiles, along with those with secondary education in the second wealth quintile, exhibited a negative significant association with HIV-related attitude level. However, no significant associations were found between other factors, including age, place of residence, marital status, and health insurance, and HIV-related attitude. The study also found significant associations between socioeconomic variables and HIV-related knowledge. There was a significant positive association between higher levels of education and HIV-related knowledge level. Women in wealthier quintiles had a significant positive association with HIV-related knowledge level. Factors such as place of residence and media exposure, including radio and television were also observed to be associated with HIV-related knowledge level. CONCLUSIONS This study highlights the importance of socioeconomic status and media exposure in shaping HIV-related knowledge and attitudes among women in Ghana. Policy interventions should focus on reducing socioeconomic disparities, ensuring equitable access to education and healthcare services, and utilizing media platforms for effective HIV information dissemination.
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Affiliation(s)
| | - Lulin Zhou
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China.
| | - Ebenezer Larnyo
- Center for Black Studies Research, University of California, Santa Barbara, CA, United States of America
| | | | - Yupeng Cui
- School of Management, Jiangsu University, Zhenjiang, Jiangsu Province, China
| | - Jonathan Kissi
- Department of Health Information Management, College of Health and Allied Sciences, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Alexander Kwame Gavu
- Department of Educational Administration, University of Saskatchewan, Saskatoon, SK, Canada
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Leonardo NL, Chien LY. Trends and factors associated with HIV testing among women aged 15-49 years in Belize: an analysis using the Multiple Indicator Cluster Survey 2006, 2011, and 2015-2016. BMC Womens Health 2023; 23:177. [PMID: 37041495 PMCID: PMC10091544 DOI: 10.1186/s12905-023-02313-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/29/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND Belize has one of the highest human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome prevalence rates in Central America, with women of reproductive age being particularly vulnerable to HIV. Therefore, this study examined the factors associated with HIV testing among women of reproductive age in Belize and trends in HIV testing in 2006, 2011, and 2015-2016. METHODS Cross-sectional data were analyzed using three Belize Multiple Indicator Cluster Surveys. The number of participants were 1,675, 4,096, and 4,699 women aged 15-49 years in 2006, 2011, and 2015-2016, respectively. We used variance-weighted least-squares regression to estimate annual changes. Multivariate logistic regression analysis was performed to evaluate the associated factors. Analyses were conducted using Stata version 15, and weights were applied for generalization to the population. RESULTS HIV testing rates increased from 47.7% in 2006 to 66.5% in 2015, with an average annual change of 0.082 (95% confidence interval: 0.07-0.09). Logistic regression models showed that women aged 15-24 years were less likely to have been tested for HIV compared to women aged 25-34 years. Women from the Mayan ethnic group were less likely to have been tested than those from other ethnic groups. Compared to women who spoke Spanish, those who spoke English/Creole were more likely to have been tested for HIV; additionally, those who spoke minority languages were less likely to have been tested. Being married and having given birth were associated with increased odds of HIV testing. Living in rural areas and households with the poorest wealth indices were associated with decreased odds of being tested for HIV. Women with good HIV knowledge and accepting attitudes towards people living with HIV were more likely to be tested. CONCLUSIONS From 2006 to 2015, HIV testing in women of reproductive age showed an increasing trend in Belize. We recommend interventions to expand HIV testing for women of reproductive age in Belize, particularly those aged 15-24 years, speaking minority languages, living in rural areas, and having a low socioeconomic status.
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Affiliation(s)
- Naudia L Leonardo
- International Health Program, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, Taiwan
- Government of Belize, Ministry of Health and Wellness, Bliss Parade Belmopan, Belmopan, Belize
| | - Li-Yin Chien
- Institute of Community Health Care, Collage of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei, 112304, Taiwan.
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Factors Associated with HIV Testing among Reproductive Women Aged 15-49 Years in the Gambia: Analysis of the 2019-2020 Gambian Demographic and Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084860. [PMID: 35457730 PMCID: PMC9031325 DOI: 10.3390/ijerph19084860] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/30/2022] [Accepted: 04/14/2022] [Indexed: 11/17/2022]
Abstract
Voluntary counselling and testing for Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has always been one of the key policy interventions in the management and control of HIV/AIDS transmission. However, the prevalence of HIV testing among reproductive women in the Gambia remains low despite near universal information about HIV and Sexually Transmitted Infections (STIs) in the Gambia. Understanding factors influencing HIV testing uptake provides empirical data for the development of targeted evidenced-based strategies aimed at enhancing HIV testing uptake. Therefore, this study examined the factors associated with HIV testing among reproductive women aged 15−49 years in the Gambia. Data on weighted sample of 11,865 women from the 2019−2020 Gambia Demographic and Health Survey were analyzed in this study. Chi square, bivariate and multivariate logistic regression models were fitted and analysis conducted through Complex Samples Analysis in Statistical Package for Social Sciences (SPSS). Level of significance was set at p < 0.05 and 95% CI. Further analysis was conducted to determine the variability in HIV testing among women stratified by rural and urban centers. Prevalence of HIV testing among reproductive women was 42.1% (95% CI = 40.1−44.2%) in the Gambia. Women aged 20−24 years and 25−29 years (aOR = 3.10, 95% CI = 2.51−3.83) and (aOR = 4.52, 95% CI = 3.61−5.54) were more likely to test for HIV than those aged 15−19 years, respectively. Married women (aOR = 5.90, 95% CI = 4.84−7.02) were more likely to test for HIV compared to those who were not in any union. Respondents with higher education in urban centers (aOR = 2.65, 95% CI = 2.08−3.86) were likely to test for HIV compared to those in rural areas. HIV testing in the Gambia among reproductive women is low. Age, marital status, wealth index, place of residence, educational level, recent sexual activity, previous history of risky sexual behaviors, and history of an STI were associated with HIV testing. Health interventions targeted at increasing HIV testing uptake should factor in these.
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Arifin B, Rokhman MR, Zulkarnain Z, Perwitasari DA, Manggau M, Rauf S, Noor R, Padmawati RS, Postma MJ, Massi MN, van der Schans J. Adaptation and validation of the HIV Knowledge Questionnaire-18 for the general population of Indonesia. Health Qual Life Outcomes 2022; 20:55. [PMID: 35366891 PMCID: PMC8976362 DOI: 10.1186/s12955-022-01963-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/22/2022] [Indexed: 11/12/2022] Open
Abstract
Background Despite a global decline in new HIV/AIDS cases in low-middle countries, cases are increasing in Indonesia. Low knowledge about the disease among the general population is one of the major factors responsible for this trend. Indonesia does not have a validated instrument to assess HIV/AIDS knowledge. The HIV Knowledge Questionnaire-18 (HIV-KQ-18) has been translated into several languages and is one of the most extensively used instruments for assessing HIV/AIDS knowledge. This paper describes the process of adapting and validating the HIV-KQ-18, an instrument to assess the level of HIV/AIDS knowledge in the general population of Indonesia. Methods In the adaptation phase, feedback for the initial Bahasa Indonesia version was gathered from two HIV activists, an obstetrician, two general practitioners, and 60 pilot participants. At the validation stage, we distributed the instrument link via Google Form to 6 major regions in Indonesia. Validity was measured using known-group validity and construct validity. The construct validity was assessed using an exploratory factor analysis (EFA) with a polychoric correlation matrix. Cronbach’s alpha was used to analyze the internal consistency. Results Based on the findings in the adaptation phase, additional descriptions (namely synonyms or examples) were added to 6 items to make them more understandable. In the validation phase, 1,249 participants were recruited. The a priori hypothesis in known-group validity was supported. We also found three items that did not meet the construct validity. Based on the acceleration factor approach to interpret the scree tree in the factor analysis, using only two factors was preferable. Cronbach's alpha values were 0.75 and 0.71 representing good internal reliability. Conclusion The HIV-KQ-18 Bahasa Indonesia is considered a valid and reliable instrument to assess the level of HIV/AIDS knowledge in Indonesia.
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Trends of HIV/AIDS knowledge and attitudes among Nigerian women between 2007 and 2017 using Multiple Indicator Cluster Survey data. BMC Public Health 2022; 22:440. [PMID: 35246087 PMCID: PMC8897895 DOI: 10.1186/s12889-022-12865-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 02/23/2022] [Indexed: 11/12/2022] Open
Abstract
Background Globally, Nigeria ranks third among the countries with the highest number of People Living with HIV (PLHIV). Given that HIV/AIDS knowledge is a key factor that determines the risk of transmission and certain attitudes towards PLHIV, there is a need to understand the trend of HIV knowledge within the population for the purpose of assessing the progress and outcome of HIV prevention strategies. The aim of the study was to understand the trends of HIV/AIDS knowledge and attitude towards PLHIV between 2007 to 2017 among Nigerian women, and to investigate change in the factors associated with HIV/AIDS knowledge and attitude towards PLHIV over years. Methods Data were derived from three Nigerian Multiple Indicator Cluster Surveys (2007, 2011 and 2016–2017) among women aged 15–49 years old from each geo-political zone (South South, South East, South West, North East, North West, North Central) in Nigeria. Participants who did not answer questions related to HIV/AIDS knowledge and attitude were excluded from the study. The final sample sizes were 17,733 for 2007, 26,532 for 2011 and 23,530 for 2017. In descriptive statistics, frequencies represented the study sample, while percentages represented weighted estimates for the population parameters. Rao-Scott chi-square test for complex survey design studies was used to assess bivariable associations. Factors associated with outcome variables were examined using the survey-weighted multivariable logistic regression models for the complex survey design while controlling for potential confounding variables. Results There was a relatively high level of HIV/AIDS knowledge level in 2007 and 2016–2017 surveys (64.6 and 64.1%, respectively), however a decrease in HIV/AIDS knowledge trend was observed in 2011 (45.6%). The positive attitude towards PLHIV progressively increased across the years (from 40.5 to 47.0% to 53.5%). Multivariable analysis revealed that women who had a higher educational level, higher wealth index, and lived in urban areas had higher odds for HIV/AIDS knowledge and positive attitude towards PLHIV across the years. In addition, the Northern zones had predominantly higher knowledge and attitude levels. Conclusions Our study found increasing tendency for high HIV/AIDS knowledge and positive attitude towards PLHIV over the years. Women’s age, wealth index, education level and residence were consistently associated with knowledge and attitude over the years. There is a need for more pragmatic HIV/AIDS-related knowledge action plan to target to cover all age groups, all geo-political zones while paying close attention to the rural areas and the less educated women. In addition, more replicative studies of HIV/AIDS knowledge and attitude trends is crucial in monitoring of the progress of HIV interventions in the country in the coming years.
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Teshale AB, Yeshaw Y, Alem AZ, Ayalew HG, Liyew AM, Tessema ZT, Tesema GA, Worku MG, Alamneh TS. Comprehensive knowledge about HIV/AIDS and associated factors among women of reproductive age in sub-Saharan Africa: a multilevel analysis using the most recent demographic and health survey of each country. BMC Infect Dis 2022; 22:130. [PMID: 35130865 PMCID: PMC8822699 DOI: 10.1186/s12879-022-07124-9] [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: 05/27/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background Women of reproductive age in sub-Saharan African (SSA) share the greatest burden of the HIV/AIDS epidemic. Comprehensive knowledge about HIV is seen as pivotal in combating the epidemic. Therefore, this study aimed to assess comprehensive knowledge about HIV/AIDS and associated factors among women of reproductive age in sub-Saharan Africa.
Objective To examine comprehensive knowledge about HIV/AIDS and associated factors among women of reproductive age in sub-Saharan Africa. Methods We used the most recent SSA countries Demographic and Health Surveys (DHS) data. To assess comprehensive knowledge, a composite score of six separate questions (can get HIV by witchcraft or supernatural means, can reduce risk of getting HIV by using condoms during sex, reduce the risk of getting HIV by having one sex partner only, can get HIV from mosquito bites, can get HIV by sharing food with a person who has HIV/AIDS, and a healthy-looking person can have HIV) was used. Those who answered all six questions correctly were considered to have comprehensive knowledge. To assess the factors associated with comprehensive knowledge of HIV/AIDS, we used a multilevel binary logistic regression model since the data had hierarchical nature. Results In this study, the comprehensive knowledge about HIV/AIDS was 38.56% (95% CI: 38.32, 38.75). Both individual and community-level factors were associated with comprehensive knowledge about HIV/AIDS. Among individual-level factors, older age, having primary and above educational level, being from wealthy households, contraceptive use, listening to the radio, and reading newspaper were associated with higher odds of comprehensive knowledge about HIV/AIDS. Being from urban areas and the Eastern African region were the community-level factors that were associated with higher odds of comprehensive knowledge about HIV/AIDS. Conclusion The study found that comprehensive knowledge of HIV/AIDS is low. Individual and community-level factors were associated with comprehensive knowledge of HIV/AIDS. Therefore, giving special attention to those young women, women who had no formal education, those from poor socioeconomic status, and those who are from remote areas could decrease the epidemics of HIV/AIDS by increasing the comprehensive knowledge about HIV/AIDS. Besides, it is better to strengthen media campaigns regarding HIV/AIDS to increase comprehensive knowledge about HIV/AIDS.
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Affiliation(s)
- Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Suantari D. Misconceptions and stigma against people living with HIV/AIDS: a cross-sectional study from 2017 Indonesia Demographic and Health Survey. Epidemiol Health 2021; 43:e2021094. [PMID: 34749487 PMCID: PMC8920734 DOI: 10.4178/epih.e2021094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Data are not available in Indonesia to measure the main indicators of zero new infections, zero acquired immune deficiency syndrome (AIDS)-related deaths and zero discrimination. This study aimed to determine factors related to misconceptions about human immunodeficiency virus (HIV) transmission and the stigma against people living with HIV/AIDS (PLWHA) in Indonesia METHODS This cross-sectional study used secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS). The sample was women and men aged 17–45 years and married (n=3,023). RESULTS Education and wealth index quintile were significantly related to misconceptions about HIV transmission. Respondents with low levels of education were more likely to have misconceptions about HIV transmission. Respondents who were in the poorest, poorer, middle, and richer quintiles of the wealth index were more likely to have misconceptions about HIV transmission than those in the richest quintile. Educational level, employment status, and wealth index quintile were predictors of stigma against PLWHA. CONCLUSIONS There are still many Indonesian people with misconceptions about HIV transmission and stigma against PLWHA. Future studies should focus on educational programs or interventions aimed at increasing public knowledge and awareness, promoting compassion towards PLWHA, and emphasizing respect for the rights of PLWHA. These interventions are particularly important for populations who are uneducated and living in poverty.
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Yang F, Li Z, Subramianian SV, Lu C. Assessment of Knowledge of HIV/AIDS and Association With Socioeconomic Disparities Among Young Women in Low- and Middle-Income Countries, 2003 to 2018. JAMA Netw Open 2021; 4:e2035000. [PMID: 33481034 PMCID: PMC7823222 DOI: 10.1001/jamanetworkopen.2020.35000] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Knowledge of HIV/AIDS among the younger population is crucial for long-term control. Little research has been done on which groups of young women (aged 15-24 years) in low- and middle-income countries (LMICs) have been left behind with respect to obtaining this knowledge. OBJECTIVE To provide an up-to-date assessment of the levels of and changes in knowledge of HIV/AIDS and its associations with socioeconomic disparity among young women in LMICs. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used nationally representative Demographic and Health Surveys with available data on HIV/AIDS knowledge in 51 LMICs between 2003 and 2018. The final data set contained 282 757 young women. For 40 LMICs with multiple surveys available, we examined changes in knowledge and socioeconomic disparities. Analyses of the survey data were conducted between December 1, 2019, and July 31, 2020. MAIN OUTCOMES AND MEASURES The percentage of young women who were able to (1) correctly identify the 2 major ways of preventing the sexual transmission of HIV, (2) reject the 2 most common local misconceptions about HIV transmission and (3) know that a healthy-looking person can transmit HIV. The level of and changes in young women's knowledge of HIV/AIDS as well as knowledge disparities by residential area, wealth status, and level of education on the aggregate and country levels were assessed. RESULTS Of a total of 282 757 young women from 51 LMICs, 29.3% (95% CI, 24.1% to 34.5%) reported having knowledge of HIV/AIDS in the latest years, ranging from 1.0% (95% CI, 0.7% to 1.3%) in Afghanistan in 2015 to 64.9% (95% CI, 63.3% to 66.5%) in Rwanda in 2014 to 2015. Those living in rural areas, living in households in the lowest income quintile, or with low levels of education reported less knowledge about HIV/AIDS than their counterparts (-12.8 [95% CI, -10.6 to -14.9] percentage points; -21.8 [95% CI, -18.3 to -25.3] percentage points; and -19.4 [95% CI, -16.6 to -22.2] percentage points, respectively). Among the 40 countries that had undertaken at least 2 surveys during the period, the surveys indicated that there was a significant increase in knowledge of HIV/AIDS among young women in 24 countries (60.0%), but a significant decrease in 10 countries (25.0%). Less than half of countries experienced significant reductions in disparities associated with residential area (8 countries [20.0%]), wealth (5 countries [12.5%]), or education (17 countries [42.5%]). CONCLUSIONS AND RELEVANCE This cross-sectional study of women in 51 LMICs found low levels and large gaps in knowledge of HIV/AIDS between groups, suggesting that future HIV-prevention campaigns should emphasize providing easily accessible information to socioeconomically disadvantaged groups.
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Affiliation(s)
- Fan Yang
- Nanjing Medical University School of Health Policy and Management, Nanjing, Jiangsu Province, People’s Republic of China
| | - Zhihui Li
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - S. V. Subramianian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Chunling Lu
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
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Abate BB, Kassie AM, Reta MA, Ice GH, Haile ZT. Residence and young women's comprehensive HIV knowledge in Ethiopia. BMC Public Health 2020; 20:1603. [PMID: 33097014 PMCID: PMC7585223 DOI: 10.1186/s12889-020-09687-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 10/13/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection is a global health problem. The epidemic is very serious in sub-Saharan Africa with approximately 70% of the global cases. The disease particularly affects youth, accounting for half of the new HIV infections yearly. Inadequate knowledge may contribute to the high rates among youth. Hence, the main aim of this study was to examine the association between residence and comprehensive HIV knowledge among women aged 15-24 years in Ethiopia. METHODS This cross-sectional study used nationally representative data from the 2016 Ethiopian demographic health survey (n = 5926). Chi-square tests and multivariable logistic regression modeling were performed. RESULTS Approximately 23.9% of the study participants had a comprehensive HIV knowledge and 74.7% were rural residents. In the multivariable-adjusted model, we found a significant interaction between place of residence and HIV testing on comprehensive HIV knowledge (P for interaction = 0.005). In the subgroup analysis, a statistically significant associations between place of residence and comprehensive HIV knowledge was found only in women who have never been tested for HIV. In this subgroup, rural women had lower odds of having a comprehensive HIV knowledge compared to their urban counterparts (OR 0.42, 95% CI: 0.23-0.74; P = 0.003). Furthermore, in the subgroup of women who have never been tested for HIV, education and region were significantly associated with comprehensive HIV knowledge. Compared to women with no education, the odds of having a comprehensive HIV knowledge were higher in women who had primary (OR 2.86, 95% CI: 1.63-5.02; P < 0.001) and secondary or above education (OR 5.49, 95% CI: 2.92-10.32; P < 0.001), respectively. The odds of having a comprehensive HIV knowledge were lower in women from the Somali region compared to women from Addis Ababa region (OR 0.41, 95% CI: 0.18-0.90; P = 0.027). CONCLUSIONS Rural residence was negatively associated with comprehensive HIV knowledge only in women who have never been tested for HIV. These findings suggest that the development and implementation HIV education and awareness programs should target rural areas, especially where there is limited access to HIV testing.
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Affiliation(s)
- Biruk Beletew Abate
- Department of Nursing, College of Health Sciences Woldia University, P.O.Box 400, Woldia, Ethiopia
| | - Ayelign Mengesha Kassie
- Department of Nursing, College of Health Sciences Woldia University, P.O.Box 400, Woldia, Ethiopia
| | - Melese Abate Reta
- Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Medical Laboratory Science, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Gillian H. Ice
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH USA
| | - Zelalem T. Haile
- Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH USA
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Agegnehu CD, Geremew BM, Sisay MM, Muchie KF, Engida ZT, Gudayu TW, Weldetsadik DS, Liyew AM. Determinants of comprehensive knowledge of HIV/AIDS among reproductive age (15-49 years) women in Ethiopia: further analysis of 2016 Ethiopian demographic and health survey. AIDS Res Ther 2020; 17:51. [PMID: 32787881 PMCID: PMC7425582 DOI: 10.1186/s12981-020-00305-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 07/25/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The key cause of HIV transmission is failure to provide adequate information about HIV/AIDS which is a substantial public health issue in low and middle-income countries. While global health coverage continues, there is still little understanding of HIV/AIDS among women of reproductive age (15-49 years) in Ethiopia. Therefore, the purpose of this study was to identify the determinants of comprehensive knowledge of HIV/AIDS among women of reproductive age in Ethiopia. METHODS A secondary data analysis was employed using the 2016 Ethiopian demographic and health survey data. Data were extracted about comprehensive knowledge of HIV/AIDS among women of reproductive age. We used multi-variable mixed-effect binary logistic regression to identify factors associated with comprehensive knowledge of HIV/AIDS among women of reproductive age. The adjusted odds ratio with 95% confidence interval was used to declare statistical significance. RESULTS We found that having primary (AOR = 1.75, 95% CI 1.56-1.97),secondary (AOR = 2.74, 95% CI 2.33-3.22), and higher (AOR = 4.07, 95% CI 3.32-4.99) educational statuses, being in highest wealth quintiles; richer (AOR = 1.20, 95% CI 1.01-1.43) and richest (AOR = 1.51, 95% CI 1.22-1.87), knowing the place for HIV test (AOR = 2.13, 95% CI 1.88-2.42), use of traditional contraceptive method (AOR = 1.93,95% CI 1.12-3.35), female household head (AOR = 1.18, 95% CI 1.07-1.31), watching television (AOR = 1.22, 95% CI 1.06-1.41) and own mobile phone (AOR = 1.18, 95% CI 1.05-1.33) were positively associated with comprehensive knowledge of HIV/AIDS among women of reproductive age in Ethiopia. CONCLUSION Women with higher education and higher wealth quintiles, knowing the place of HIV test, watching television, a traditional contraceptive method use, having a mobile phone and being in female headed household were positively associated with comprehensive knowledge of HIV/AIDS among women of reproductive age in Ethiopia. Programs working on HIV/AIDS should target women based on the identified factors so as to scale up their comprehensive knowledge towards HIV/AIDS. In this context, the media should actively contribute to raising awareness of HIV/AIDS.
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Trends and Factors Associated with Comprehensive Knowledge about HIV among Women in Vietnam. Trop Med Infect Dis 2020; 5:tropicalmed5020091. [PMID: 32503317 PMCID: PMC7345800 DOI: 10.3390/tropicalmed5020091] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess the trends and associated factors of comprehensive knowledge about HIV among women in Vietnam using the dataset of the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000, 2006, 2011, and 2014. The outcome variable was comprehensive knowledge about HIV, defined as the ability to correctly answer three knowledge questions and to reject the three most common misconceptions about HIV prevention. We found that comprehensive knowledge about HIV increased from 26.1% in 2000 to 44.1% in 2011, but it decreased slightly between 2011 and 2014, from 44.1% to 42.4%. Increased comprehensive knowledge about HIV was associated with women who had higher education and those in the fourth and fifth quintiles of household wealth in all four rounds of the MICS. Comprehensive knowledge about HIV among women was also associated with those who had ever been tested for HIV and those with knowledge of where to be tested for HIV. Women in the urban areas were more likely to have higher levels of comprehensive knowledge about HIV as compared to the women in the rural areas in 2000, 2006, and 2011 but not in 2014. Comprehensive knowledge about HIV among women in Vietnam increased from 2000 to 2014, but it was still relatively low.
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Devarayasamudram S, De Gagne JC, Kurudi NP, Kang HS. Effectiveness of a Structured Teaching Program on Knowledge and Attitudes Toward HIV among Young Women in India. J Community Health Nurs 2018; 35:49-56. [PMID: 29714504 DOI: 10.1080/07370016.2018.1446632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
India has the third highest number of persons living with HIV in the world. We evaluated the effectiveness of a structured teaching program on HIV-related knowledge and attitudes among 600 young women, aged 20-40 years, in India. This study employed a quasi-experimental pre-post design. Significant differences were found in the level of the participants' knowledge of (t = 78.89, p < .05) and attitudes toward (t = 64.14, p < .05) HIV after the intervention. Our findings suggest that the structured teaching program could be utilized in increasing young women's knowledge of, and improving their attitudes about, HIV.
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Affiliation(s)
| | | | | | - Hee Sun Kang
- d Red Cross College of Nursing , Chung-Ang University , Seoul , South Korea
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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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Sheikh MT, Uddin MN, Khan JR. A comprehensive analysis of trends and determinants of HIV/AIDS knowledge among the Bangladeshi women based on Bangladesh Demographic and Health Surveys, 2007-2014. ACTA ACUST UNITED AC 2017; 75:59. [PMID: 28975026 PMCID: PMC5618732 DOI: 10.1186/s13690-017-0228-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/31/2017] [Indexed: 01/09/2023]
Abstract
Background South-Asian countries are considered to be a potential breeding ground for HIV epidemic. Although the prevalence of this incurable disease is low in Bangladesh, women still have been identified as more vulnerable group. The aim of this study is to assess the knowledge about HIV/AIDS: its trends and associated factors among the women in Bangladesh. Methods We analysed the nationally representative repeatedly cross-sectional Bangladesh Demographic and Health Surveys (BDHSs) data: 2007, 2011, and 2014. These data were clustered in nature due to the sampling design and the generalized mixed effects model is appropriate to examine the association between the outcome and the explanatory variables by adjusting for the cluster effect. Results Overall, women’s knowledge about HIV/AIDS has been decreasing over the years. Education plays the leading role and secondary-higher educated women are 6.6 times more likely to have HIV/AIDS knowledge. The likelihood of knowledge is higher among the women who had media exposure (OR: 1.6) and knowledge on family planning (OR: 2.3). A rural-urban gap is noticed in women’s knowledge about HIV/AIDS and significant improvement has been observed among the rural and media exposed women. Results reveal that age, region, religion, socio-economic status, education, contraceptive use have significant (p<0.01) effects on women’s knowledge about HIV/AIDS. Conclusion This study recommends to emphasis more on women’s education, media exposure, and family planning knowledge in strengthening women’s knowledge about HIV/AIDS. In addition, residence specific programs regarding HIV/AIDS awareness also need to be prioritized.
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Affiliation(s)
- Md Tuhin Sheikh
- Institute of Statistical Research and Training, University of Dhaka, Shahbagh, Dhaka, 1000 Bangladesh
| | - Md Nizam Uddin
- Institute of Statistical Research and Training, University of Dhaka, Shahbagh, Dhaka, 1000 Bangladesh
| | - Jahidur Rahman Khan
- Institute of Statistical Research and Training, University of Dhaka, Shahbagh, Dhaka, 1000 Bangladesh
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Van Minh H, Oh J, Hoat LN, Lee JK, Williams JS. Millennium Development Goals in Vietnam: Taking Multi-sectoral Action to Improve Health and Address the Social Determinants. Glob Health Action 2016; 9:31271. [PMID: 26950569 PMCID: PMC4780116 DOI: 10.3402/gha.v9.31271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - Juhwan Oh
- Center for Global Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;
| | | | - Jong-Koo Lee
- Seoul National University College of Medicine, Seoul, South Korea
| | - Jennifer Stewart Williams
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Faculty of Medicine, Umeå University, Umeå, Sweden
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