Zegeye Betregiorgis, Adjei Nicholas Kofi, Ahinkorah Bright Opoku, Ameyaw Edward Kwabena, Budu Eugene, Seidu Abdul-Aziz, Yaya Sanni
HaSET Maternal and Child Health Research Program, Shewarobit Field Office Shewarobit Ethiopia.
Department of Public Health and Policy University of Liverpool Liverpool UK.
Health Sci Rep. 2021 Oct 27;4(4):e430. doi: 10.1002/hsr2.430. eCollection 2021 Dec.
Discriminatory attitude towards people living with human immunodeficiency virus (HIV) remains a major problem in the prevention and treatment of HIV in sub-Sahara Africa (SSA). Understanding the multiple factors linked to discriminatory attitude towards people living with HIV/AIDS (PLWHA) in SSA is necessary for developing appropriate interventions. This study aimed at investigating the individual, household, and community-level factors associated with pregnant married women's discriminatory attitude towards people living with HIV/AIDS.
We used data from the Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2015 and 2019. Data on 17 065 pregnant married women were analyzed. Bivariate (chi-squared test) and multivariable multilevel logistic regression analyses were applied to investigate the factors associated with discriminatory attitude towards PLWHA. The results were reported as adjusted odds ratio (aOR) at 95% confidence interval (CI).
The mean age of participants was 31.2 ± 8.5. The prevalence of discriminatory attitude towards PLWHA was 36.2% (95% CI: 33.4%-39.1%). Individual/household-level factors associated with discriminatory attitude towards PLWHA were women's educational level (secondary school-aOR = 0.49, 95% CI: 0.26-0.93), husband's educational level (higher education-aOR = 0.35, 95% CI: 0.16-0.76), decision-making power (yes-aOR = 0.51, 95% CI: 0.38-0.69), wife-beating attitude (disagreement with wife beating-aOR = 0.58, 95% CI: 0.43-0.79), and religion (Muslim-aOR = 1.92, 95% CI: 1.22-3.04). Community socioeconomic status (medium-aOR = 0.61, 95% CI: 0.41-0.93) was the only community-level factor associated with discriminatory attitude towards PLWHA.
More than one-third of pregnant married women in SSA had discriminatory attitude towards PLWHA. Women's educational level, husband's educational level, decision-making power, wife-beating attitude, religion, and community socio-economic status were associated with discriminatory attitude towards PLWHA. To lessen the prevalence of discriminatory attitude towards PLWHA, considering these significant factors is needed. Therefore, governments and other stakeholders in the respective countries need to increase education coverage. Moreover, empowering women through education and economy is crucial. Finally, working with religious leaders to increase awareness about HIV and discriminatory attitude towards PLWHA should also be a priority in SSA.
在撒哈拉以南非洲地区（SSA），对人类免疫缺陷病毒（HIV）感染者的歧视态度仍是HIV预防和治疗中的一个主要问题。了解与SSA地区对HIV/AIDS感染者（PLWHA）的歧视态度相关的多种因素，对于制定适当的干预措施是必要的。本研究旨在调查与已婚孕妇对HIV/AIDS感染者的歧视态度相关的个人、家庭和社区层面的因素。
我们使用了2015年至2019年期间在12个撒哈拉以南非洲国家进行的人口与健康调查的数据。对17065名已婚孕妇的数据进行了分析。采用双变量（卡方检验）和多变量多水平逻辑回归分析来调查与对PLWHA的歧视态度相关的因素。结果以95%置信区间（CI）的调整优势比（aOR）报告。
参与者的平均年龄为31.2±8.5岁。对PLWHA的歧视态度患病率为36.2%（95%CI：33.4%-39.1%）。与对PLWHA的歧视态度相关的个人/家庭层面因素包括女性的教育水平（中学-aOR=0.49，95%CI：0.26-0.93）、丈夫的教育水平（高等教育-aOR=0.35，95%CI：0.16-0.76）、决策权（是-aOR=0.51，95%CI：0.38-0.69）、反对殴打妻子的态度（不同意殴打妻子-aOR=0.58，95%CI：0.43-0.79）以及宗教信仰（穆斯林-aOR=1.92，95%CI：1.22-3.04）。社区社会经济地位（中等-aOR=0.61，95%CI：0.41-0.93）是与对PLWHA的歧视态度相关的唯一社区层面因素。
SSA地区超过三分之一的已婚孕妇对PLWHA持有歧视态度。女性的教育水平、丈夫的教育水平、决策权、反对殴打妻子的态度、宗教信仰以及社区社会经济地位与对PLWHA的歧视态度相关。为了降低对PLWHA的歧视态度患病率，需要考虑这些重要因素。因此，各国政府和其他利益相关者需要扩大教育覆盖范围。此外，通过教育和经济手段增强妇女权能至关重要。最后，与宗教领袖合作以提高对HIV和对PLWHA的歧视态度的认识，也应该是SSA地区的一个优先事项。
