Prejudice and misconceptions about tuberculosis and HIV in rural and urban communities in Ethiopia: a challenge for the TB/HIV control program

Abstract

BackgroundIn Ethiopia, where HIV and tuberculosis (TB) are very common, little is known about the prejudice and misconceptions of rural communities towards People living with HIV/AIDS (PLHA) and TB.MethodsWe conducted a cross sectional study in Gilgel Gibe Field Research area (GGFRA) in southwest Ethiopia to assess the prejudice and misconceptions of rural and urban communities towards PLHA and TB. The study population consisted of 862 randomly selected adults in GGFRA. Data were collected by trained personnel using a pretested structured questionnaire. To triangulate the findings, 8 focus group discussions among women and men were done.ResultsOf the 862 selected study participants, 750(87%) accepted to be interviewed. The mean age of the respondents was 31.2 (SD ± 11.0). Of the total interviewed individuals, 58% of them were females. More than half of the respondents did not know the possibility of transmission of HIV from a mother to a child or by breast feeding. For fear of contagion of HIV, most people do not want to eat, drink, and share utensils or clothes with a person living with HIV/AIDS. A higher proportion of females [OR = 1.5, (95% CI: 1.0, 2.2)], non-literate individuals [OR = 2.3, (95%CI: 1.4, 3.6)], rural residents [OR = 3.8, (95%CI: 2.2, 6.6)], and individuals who had poor knowledge of HIV/AIDS [OR = 2.8, (95%CI: 1.8, 2.2)] were more likely to have high prejudice towards PLHA than respectively males, literates, urban residents and individuals with good knowledge. Exposure to cold air was implicated as a major cause of TB. Literates had a much better knowledge about the cause and methods of transmission and prevention of TB than non-literates. More than half of the individuals (56%) had high prejudice towards a patient with TB. A larger proportion of females [OR = 1.3, (95% CI: 1.0, 1.9)] and non-literate individuals [OR = 1.4, (95% CI: 1.1, 2.0)] had high prejudice towards patients with TB than males and literate individuals.ConclusionTB/HIV control programs in collaboration with other partners should invest more in social mobilization and education of the communities to rectify the widespread prejudice and misconceptions.

Predictors of HIV/AIDS Knowledge and Attitude among Young Women of Nigeria and Democratic Republic of Congo: Cross-Sectional Study

“…Place of residence did not show a significant association with attitudes of young women towards PLWHA in both countries. In contrast to the present finding, study in Bolivia, Botswana and Ethiopia showed different result [35,40,43]. The probability of acceptance attitude towards PLWHA increases with increasing level of education.…”

“…In this study the understanding of the young women about HIV/AIDS in Nigeria and DRC was found to be stable. Similar results were also reported in sub-Sahara Africa [33][34][35] and elsewhere [36]. However, despite the high level of awareness of HIV/AIDS, the Nigerian and Congolese young women had low level of knowledge.…”

Health care seeking behavior and patient delay in tuberculosis diagnosis

“…However, the patients in our study demonstrate a lack of knowledge about TB, once almost one half did not know how the disease was transmitted. Misconceptions about TB transmission have been reported in other studies 33 , and it is related to delays in diagnosis and treatment non-adherence 33,34,35,36 . We could not show an association between patient delay and lack of knowledge about TB, but is important to develop strategies to improve patient education about their illness in the TB services, since it can have implications in treatment adherence.…”

Public perceptions about HIV/AIDS and discriminatory attitudes toward people living with acquired immunodeficiency syndrome in Iran

“…Moreover, showed that 40 -50% of the local population who suffering from HIV/AIDS are strongly discriminated. The discriminatory attitudes and stigmatization toward PLWHA in countries such as the UK (Ipsos MORI 2010) and Ethiopia (Aga et al 2009;Deribew et al 2010;Reilley et al 2004) were also reported.…”

“…For example, researches in Hong Kong reported discriminatory attitudes toward people with symptoms of HIV/AIDS among adults (Hong Kong AIDS Foundations 1996), teenagers (Davis, Noel, Chan & Wing 1998), workers (Lau & Ma 1995), Health service providers, (Lau & Lee 1996) and people at work (Lau & Wong 2001). Also, in countries such as the UK (Ipsos MORI 2010) and Ethiopia (Aga, Kylmä & Nikkonen 2009;Deribew et al 2010;Reilley, Hiwot & Mesure 2004), stigmatization and negative attitudes toward PLWHA have been reported. In Iran, several studies have shown negative attitudes about PLWHA (Etemad 2010;Rad, Hashemi & Alizadeh 2009;Sanei Moghaddam et al 2011;Sassani, Naji, Abedi & Taheri 2013) and also among nurses providing health care to PLWHA (Zeighami Mohamadi, Zeinali, Esmaily & Nikbakht Nasrabadi 2011).…”