Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2022 Feb 4;17(2):e0261978. doi: 10.1371/journal.pone.0261978. eCollection 2022.
BACKGROUND: Discrimination of people living with HIV/AIDS is one of the reported obstacles to the achievement of universal access to HIV/AIDS prevention, treatment, care, and support programs. Many international agencies have made combating HIV/AIDS stigma and discrimination a top priority. However, previous evidence in different parts of Africa revealed that the magnitude of HIV/AIDS-related discriminatory attitude is significantly high. OBJECTIVE: To assess discriminatory attitude towards people living with HIV/AIDS and its associated factors among the adult population in 15 sub-Saharan African nations. METHODS: We have used the 15 Demographic and Health Survey data that were conducted in sub-Saharan Africa (SSA) from 2015 to 2019/20. Each country's data was appended and a total weighted sample of 318,186 (unweighted sample = 315,448) adults who had ever heard of AIDS was used for the final analysis. The two discriminatory attitude questions were used to get the outcome variable and those who answered "Yes" or "don't know" for both questions were counted as if they had no discriminatory attitude towards people living with HIV/AIDS. To assess the factors associated with discriminatory attitude towards people living with HIV/AIDS, we have fitted a multilevel binary logistic regression model. Bivariable analysis was done to select eligible variables for the multivariable analysis. Finally, variables with p<0.05, in the multivariable analysis, were considered as significant predictors of discriminatory attitude towards people living with HIV/AIDS. RESULTS: The prevalence of discriminatory attitude towards HIV/AIDS in the 15 sub-Saharan African nations was 47.08% (95% CI: 47.08, 47.42), which ranges from 17.64% (95% CI: 17.22, 18.07) in Malawi to 79.75% (95% CI: 79.02, 80.45) in Guinea. In the multivariable analysis, both individual level and community level variables were significantly associated with discriminatory attitude towards people living with HIV/AIDS. Being younger age, no formal education, never married, low socioeconomic status, male-headed household, non-contraceptive use, no mass media exposure, and incorrect comprehensive knowledge towards HIV/AIDS were among the individual-level factors that were associated with higher odds of discriminatory attitude towards people living with HIV/AIDS. While being from urban residence and the western SSA region were among the community-level factors that were significantly associated with higher odds discriminatory attitude towards people living with HIV/AIDS. CONCLUSION: The prevalence of discriminatory attitude towards people living with HIV/AIDS in 15 sub-Saharan African nations was high. Both individual and community-level factors were associated with discriminatory attitude towards people living with HIV/AIDS. Therefore, special attention should be given to those who are poor, uneducated, and younger adults. In addition, it is better to strengthen the accessibilities of different media for adult populations to create an appropriate attitude towards people with HIV/AIDS.
背景:对艾滋病毒/艾滋病感染者的歧视是实现艾滋病毒/艾滋病预防、治疗、护理和支持方案普及的报告障碍之一。许多国际机构都将消除艾滋病毒/艾滋病污名和歧视作为当务之急。然而,非洲不同地区以往的证据表明,与艾滋病毒/艾滋病相关的歧视态度的幅度非常高。
目的:评估撒哈拉以南非洲 15 个国家成年人对艾滋病毒/艾滋病感染者的歧视态度及其相关因素。
方法:我们使用了 2015 年至 2019/20 年在撒哈拉以南非洲(SSA)进行的 15 项人口与健康调查数据。每个国家的数据都进行了附加处理,共有 318186 名(未加权样本=315448 名)曾听说过艾滋病的成年人加权样本用于最终分析。使用两个歧视性态度问题来获得因变量,对两个问题都回答“是”或“不知道”的人被算作对艾滋病毒/艾滋病感染者没有歧视态度。为了评估与对艾滋病毒/艾滋病感染者的歧视态度相关的因素,我们拟合了一个多水平二项逻辑回归模型。进行单变量分析以选择多变量分析的合格变量。最后,在多变量分析中,p 值<0.05 的变量被认为是对艾滋病毒/艾滋病感染者的歧视态度的显著预测因子。
结果:在撒哈拉以南非洲的 15 个国家,对艾滋病毒/艾滋病的歧视态度的流行率为 47.08%(95%CI:47.08,47.42),范围从马拉维的 17.64%(95%CI:17.22,18.07)到几内亚的 79.75%(95%CI:79.02,80.45)。在多变量分析中,个体水平和社区水平的变量都与对艾滋病毒/艾滋病感染者的歧视态度显著相关。年龄较小、没有正规教育、未婚、社会经济地位较低、男性为户主、不使用避孕药具、没有大众媒体接触以及对艾滋病毒/艾滋病的综合知识不正确,这些都是与对艾滋病毒/艾滋病感染者的歧视态度呈正相关的个体因素。而来自城市居住地和撒哈拉以南非洲西部地区是与对艾滋病毒/艾滋病感染者的歧视态度呈正相关的社区因素。
结论:撒哈拉以南非洲 15 个国家对艾滋病毒/艾滋病感染者的歧视态度流行率较高。个体和社区层面的因素都与对艾滋病毒/艾滋病感染者的歧视态度有关。因此,应特别关注贫困、受教育程度低和年轻成年人。此外,应加强为成年人口提供的各种媒体的可及性,以树立对艾滋病患者的正确态度。
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