Wealth inequality as a predictor of HIV-related knowledge in Nigeria

Abstract

IntroductionConsidering the high state-level heterogeneity of HIV prevalence and socioeconomic characteristics in Nigeria, it is a relevant setting for studies into the socioeconomic correlates of HIV-related knowledge. Although the relationship between absolute poverty and HIV transmission has been studied, the role of wealth inequality in the dynamics of the HIV epidemic has yet to be investigated in Nigeria. The current study, therefore, investigates wealth inequality and other sociodemographic covariates as predictors of HIV-related knowledge, in order to identify subgroups of the Nigerian population that would benefit from HIV preventive interventions.MethodsThis study used the nationally representative 2013 Nigerian Demographic and Health Survey (NDHS). HIV-related knowledge was computed as a total score based on HIV-related knowledge indicators in the NDHS, dichotomised using the sample median as the cut-off. Wealth inequality and other relevant sociodemographic variables were introduced into a logistic regression model based on their significance in bivariate analyses. ORs derived from the model were interpreted to identify risk groups for low HIV-related knowledge after adjusting for confounding factors.ResultsThe regression model indicated that individuals with lower literacy levels were almost twice as likely as literate respondents to have low HIV-related knowledge (adjusted OR (AOR): 1.95, 95% CI 1.85 to 2.05, P<0.001), and individuals in the upper wealth quintile were less than half as likely than those in the lower wealth quintile to have low HIV-related knowledge (AOR: 0.40, 95% CI 0.35 to 0.46, P<0.001). Women were also more than twice as likely as men to have low HIV-related knowledge at each level of wealth inequality. In addition, women were 80% less likely to have low mother-to-child transmission knowledge than men, but had over 1.5 times higher odds of having poor knowledge of HIV risk reduction measures. Ethnicity, religious affiliation, relationship status and residing in rural areas were additional significant predictors of HIV-related knowledge.ConclusionHIV-related knowledge in this sample is generally low among women, those with low literacy levels, the poor, the unemployed, those residing in rural areas, those with traditional religious beliefs and those living in states with the highest wealth inequality ratios. The identification of these risk groups for low HIV-related knowledge facilitates the implementation of future evidence-based interventions among these groups in order to potentially reduce HIV transmission.

Knowledge Gaps of STIs in Africa; Systematic review

“…Fifty one included studies assessed the awareness of 1,235,811 Africans in regard to HIV in total of 35 countries, eleven studies were conducted in Nigeria [14,16,83,17,18,23,38,48,60,63,81] , nine in South Africa [24,27,29,34,37,42,46,82,84] , five in each of Ghana [19,31,65,66,68] and Ethiopia [21,73,77,78,80] , four in Uganda [13,55,72,75] , three in Mozambique [22,26,30] , two in each of Namibia [45,76] and Cameroon [59,67] , one in each of Congo [25] , Sudan [33] , Senegal [39] , Morocco [47] , Gambia [50] , Tanzania [53] , Madagascar [71] and Egypt [74] while a study provided awareness prevalence in 33 countries [8] . The conduction of the studies ranged from 2010 to 2017.…”

“…Eleven included studies in regard to HIV were conducted among Nigerians representing a total population of 98,279 participants; three studies were conducted in Oyo State [14,16,63] and one in each of Osun State [17] , Ekiti State [18] , Enugu State [23] , Kano State [48] , Sokoto State [81] and Ogun State [60] . Two studies were nationally representative and participants were from different States [38,83] . The oldest among the study included were conducted in 2010 while the newest were conducted in 2013 (Table S3).…”

“…Two studies indicated a statistically significant difference in the HIV/AIDS knowledge scores and the marital/ relationship status [38,65] . Nevertheless, another study indicated that no relation exists.…”

“…In spite of the study populations’ differences, five studies reported a significant association between knowledge of STIs and the level of education [30,38,68,81,82] . Considering age as a factor affecting the level of awareness; several studies reported it to be significantly true [38,50,65,81] , while other studies reported it is not [26,59] . Moreover, living in an urban area was found to be significantly associated with awareness level in several studies [38,68,83] .…”

“…Considering age as a factor affecting the level of awareness; several studies reported it to be significantly true [38,50,65,81] , while other studies reported it is not [26,59] . Moreover, living in an urban area was found to be significantly associated with awareness level in several studies [38,68,83] .…”