Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Department of Development Economics and Centre for Modern Indian Studies (CeMIS), University of Göttingen, Waldweg Göttingen, Germany.
PLoS One. 2023 Oct 25;18(10):e0292378. doi: 10.1371/journal.pone.0292378. eCollection 2023.
Starting in late 2019, the coronavirus "SARS-CoV-2", which causes the disease Covid-19, spread rapidly and extensively. Although many have speculated that prior experience with infectious diseases like HIV/AIDS, Ebola, or SARS would better prepare populations in sub-Saharan Africa for COVID-19, this has not been formally tested, primarily due to data limitations.
We use longitudinal panel data from the Malawi Longitudinal Study of Families and Health (MLSFH, waves 2006, 2008, and 2020) to examine the association between exposure to the HIV/AIDS epidemic and perceptions of, and behavioral response to, the COVID-19 pandemic. We measured exposure to HIV infection through perceived prevalence of HIV/AIDS in the community, worry about HIV infection, perceived likelihood of HIV infection, and actual HIV status; and the experience of HIV/AIDS-related mortality through self-reports of knowing members of the community and extended family who died from AIDS (measured in 2006 or 2008). Our outcome measures were perceptions of COVID-19 presence in the community, perceptions of individual vulnerability to COVID-19, and prevention strategies to avoid COVID-19 collected through phone-interviews in 2020.
Based on our data analysis using multivariable regression models, we found that the experience of HIV-related mortality was positively associated with perceptions of COVID-19 prevalence in the community and preventive behaviors for COVID-19. However, perceived vulnerability to HIV-AIDS infection and actual HIV positive status 10-years prior to the COVID-19 pandemic are generally not associated with COVID-19 perceptions and behaviors.
Our results suggest that COVID-19-related behaviors are impacted more by experience of AIDS mortality instead of HIV/AIDS risk perceptions, and that individuals may be correctly viewing HIV/AIDS and COVID-19 transmission as distinct disease processes.
自 2019 年末以来，导致 COVID-19 疾病的冠状病毒“SARS-CoV-2”迅速广泛传播。尽管许多人推测，先前对艾滋病毒/艾滋病、埃博拉或 SARS 等传染病的经验会使撒哈拉以南非洲的人群更好地为 COVID-19 做好准备，但这尚未得到正式检验，主要是因为数据有限。
我们使用来自马拉维家庭与健康纵向研究（MLSFH，2006 年、2008 年和 2020 年波次）的纵向面板数据，来检验艾滋病毒/艾滋病流行的暴露情况与对 COVID-19 大流行的看法和行为反应之间的关联。我们通过社区中艾滋病毒/艾滋病的感知流行率、对艾滋病毒感染的担忧、感知感染艾滋病毒的可能性以及实际的艾滋病毒状况来衡量对艾滋病毒感染的暴露情况；通过自我报告认识死于艾滋病的社区成员和大家庭成员（在 2006 年或 2008 年进行测量）来衡量与艾滋病毒/艾滋病相关的死亡率的经验。我们的结局测量指标是通过 2020 年的电话访谈收集的对社区中 COVID-19 存在的看法、对个人易感染 COVID-19 的看法以及避免 COVID-19 的预防策略。
根据我们使用多变量回归模型进行的数据分析，我们发现与艾滋病毒相关的死亡率经历与对社区中 COVID-19 流行的看法以及针对 COVID-19 的预防行为呈正相关。然而，在 COVID-19 大流行之前 10 年对艾滋病毒/艾滋病感染的感知易感性和实际的艾滋病毒阳性状态通常与 COVID-19 的认知和行为无关。
我们的结果表明，与 COVID-19 相关的行为更多地受到艾滋病死亡率的影响，而不是艾滋病毒/艾滋病风险感知的影响，并且个体可能正确地将艾滋病毒/艾滋病和 COVID-19 传播视为不同的疾病过程。
