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

Teshale, Achamyeleh Birhanu; Tesema, Getayeneh Antehunegn

doi:10.1371/journal.pone.0261978

Cited by 16 publications

(30 citation statements)

References 24 publications

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“…We also discovered that married Thai adults had more discriminatory attitude than those who had never married. This is similar to studies conducted in Ethiopia [49] and Nigeria [34], but contradicts studies conducted in sub-Saharan Africa [50], which found that married individuals have a lower discriminatory attitude toward PLWHA than singles. It is possible that those who had married had a more discriminatory attitude toward PLWHA because most married people are older and may have faced HIV/AIDS stigma through their experiences.…”

Section: Discussionsupporting

confidence: 80%

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)

et al. 2023

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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 6 th 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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Section: Discussionsupporting

confidence: 80%

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)

et al. 2023

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“…This finding aligns with a recently published study from an analysis of discriminatory attitudes in 15 sub-Saharan African nations using demographic and health survey data, which found that (a) young adults and individuals with (b) lower income and (c) lower education had higher odds of holding discriminatory attitudes toward PLHIV (Teshale & Tesema, 2022). Teshale and Tesema (2022) posit that the reason for the higher prevalence of discriminatory attitudes in younger populations could be attributed to younger adults relying on their parents for information related to HIV/AIDS rather than obtaining this information in a more formal setting, such as the workplace or in an educational setting. This theory may be supported by the results of the present study, as over half (55%) of those ages 15-25 have either no education (6%) or primary education (49%).…”

Section: Discussionsupporting

confidence: 91%

Associations between HIV-related knowledge and discriminatory attitudes in Lesotho, Malawi, Tanzania, Zambia, and Zimbabwe: Results from population-based HIV impact assessments.

Yonko,

Low,

Carpino

2024

Stigma and Health

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Stigma and discrimination toward people living with HIV are barriers to achieving the Joint United Nations Programme on HIV/AIDS 95-95-95 targets. Despite the high prevalence of negative attitudes toward people living with HIV in sub-Saharan Africa, factors associated with these attitudes are understudied. Using population-based HIV impact assessment (PHIA) data among adults aged 15-59 in Lesotho, Malawi, Tanzania, Zambia, and Zimbabwe, the relationship between HIV-related knowledge and discriminatory attitudes (DA) toward people living with HIV was assessed in a multivariable logistic regression model. Among 64,458 individuals, median age was 29 years (range 15-59), 51% were female, 63% rural, 65% self-reported HIVnegative, and 29% reported never testing for HIV. The study population was from Tanzania (44%), Zimbabwe (16%), Zambia (16%), Malawi (15%), and Lesotho (10%). Lesotho had the highest prevalence of insufficient HIV knowledge (70%), and Tanzania had the highest prevalence of DA (25%). Poor HIV prevention knowledge was significantly associated with having a DA, after adjustment for country, urbanicity, age, wealth quintile, education level household head HIV status, and self-reported HIV status (aOR: 2.65, 95% CI [2.47, 2.83]). Other variables that had a strong association with DA included a lack of formal education (aOR: 3.75, 95% CI [2.97, 4.74]), reporting of an "unknown" HIV status (aOR: 3.49, 95% CI [2.55, 4.78]), as well as being from Lesotho, Tanzania, Zambia, or Zimbabwe, from a rural area, aged 15-25 years, being HIV-negative, never testing for HIV, and lack of a head of household living with HIV ( p < .05). Inverse dose-response relationships were observed for education level and wealth quintile with DA (Table 2). Gender had no association with DA. Though this is not an intervention study, attention to factors associated with DA, especially modifiable factors such as HIV-related knowledge, can inform intervention development to globally reach the 95-95-95 targets. Clinical Impact StatementThis study adds to the literature by providing an update on the state of discriminatory attitudes in several HIV-impacted countries using nationally representative populations. Individuals with lower HIV prevention knowledge, aged 15-25 years, of rural residence, the lowest wealth quintile, without formal education or with only primary education, without an HIV-positive head of household, and people who reported their HIV status as "unknown" or never being tested had significantly higher odds of holding a discriminatory attitude than their comparison groups. These individuals could be prioritized for intervention development, and further investigation of country-level causes of negative attitudes towards people living with HIV could be a focus for future research.

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“…A study conducted by Teshale and Tesema[ 15 ] using the 15 Demographic and Health Survey data in Sub-Saharan Africa (SSA) from 2015 to 2019/20 with a total weighted study sample of 318,186 showed that the prevalence of discriminatory attitude towards HIV/AIDS in the 15 sub-Saharan African nations was 47.08% (95% CI: 47.08, 47.42).…”

Section: Discussionmentioning

confidence: 99%

A cross-sectional study on stigma and discrimination confronted by HIV positive patients in the economic capital of India

Akhade

Sahu

2022

Journal of Family Medicine and Primary Care

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Context: HIV/AIDS is a serious public health, economic and social problem. Stigma is a common human reaction to disease and discrimination follows stigma. Stigma and discrimination act as impediments to uptake of HIV testing, treatment, care and adherence to treatment. Aim: The aim of this study was to estimate the prevalence of the stigma and discrimination faced by HIV positive patients receiving antiretroviral therapy (ART). Settings and Design: A cross-sectional, observational study conducted at ART center of a tertiary care hospital in an urban area. Methods and Material: Participants were selected by simple random sampling among HIV positive patients. A predesigned, pretested and self-administered, semi-structured questionnaire in local language was used to assess stigma and discrimination. Statistical Analysis Used: The data were entered in Microsoft Excel and analyzed with SPSS version 20 statistical software. Simple proportions, mean, standard deviation, median, range and inter-quartile range were calculated. Results: Of 336 participants, 170 were male, whereas 166 were females. The mean age was 36.42 years. The total mean scores for Berger’s HIV stigma scale experienced was 122.82, whereas for individual subscale Personalized stigma, Negative self-image, public attitudes and disclosure of HIV status were 38.31, 27.46, 33.09 and 23.97, respectively. The maximum participants expressed the stigma regarding disclosure concerns (58.63%) followed by negative self-image stigma (43.45%). Conclusions: Stigma hurdles the delivery of effective medical social care. People Living with HIV and AIDS (PLWHA) need to have greater involvement in their care, support and treatment. Support groups of PLWHA need to be established so that stigma and discrimination at various levels can be challenged collectively.

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

Cited by 16 publications

References 24 publications

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)

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)

Associations between HIV-related knowledge and discriminatory attitudes in Lesotho, Malawi, Tanzania, Zambia, and Zimbabwe: Results from population-based HIV impact assessments.

A cross-sectional study on stigma and discrimination confronted by HIV positive patients in the economic capital of India

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

Cited by 16 publications

References 24 publications

Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6th Thai National Health Examination Survey (NHES VI)

Stigmatizing and discriminatory attitudes toward people living with HIV/AIDS (PLWHA) among general adult population: the results from the 6th Thai National Health Examination Survey (NHES VI)

Associations between HIV-related knowledge and discriminatory attitudes in Lesotho, Malawi, Tanzania, Zambia, and Zimbabwe: Results from population-based HIV impact assessments.

A cross-sectional study on stigma and discrimination confronted by HIV positive patients in the economic capital of India

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Product

Resources

About

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)

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)