Effect of mass media on comprehensive knowledge of HIV/AIDS and its spatial distribution among reproductive-age women in Ethiopia: a spatial and multilevel analysis

Abstract

Background Globally, HIV/AIDS remains a significant public health issue particularly in Sub-Saharan Africa. Media exposure plays a significant role in raising community knowledge about HIV. Therefore, this study aimed to investigate the effect of media on comprehensive knowledge of HIV and its spatial distribution among reproductive-age women in Ethiopia. Methods A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total weighted sample of 15,683 reproductive-age women was included for analysis. For the spatial analysis, ArcGIS version 10.3 and SaTScan version 9.6 software were employed to explore the spatial distribution of comprehensive knowledge of HIV/AIDS and for identifying significant hotspot areas. For associated factors, the mixed-effect logistic regression model was fitted. Deviance and ICC were used for model comparison. In the multivariable analysis, Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was reported to declare significantly associated factors of comprehensive knowledge of HIV/AIDS. Results The spatial analysis revealed that the spatial distribution of comprehensive knowledge of HIV/AIDS among reproductive-age women was significantly varied across the country. The SaTScan analysis identified significant clusters in the entire Somali region, the eastern part of Dire Dawa and Harari regions. Being rural (AOR = 1.52,95% CI:1.21–1.91), maternal age 25–34 years (AOR = 1.26,95% CI:1.14–1.40), aged ≥35 years (AOR = 1.20,95%CI:1.07–1.35), being Muslim (AOR = 0.68,95% CI:0.60–0.78), being protestant (AOR = 0.83,95% CI:0.71–0.96), poorer wealth (AOR = 1.26,95%CI:1.06–1.51), middle wealth (AOR = 1.34,95%CI:1.11–1.60), richer wealth (AOR = 1.36,95% CI:1.12–1.63), richest wealth (AOR = 1.72,95% CI:1.37–2.15), reading newspaper (AOR = 1.20,95%CI: 1.06–1.37), listening radio (AOR = 1.24,95% CI:1.10, 1.41), covered by health insurance (AOR = 1.23,95%CI:1.01–1.51), having primary education (AOR = 1.77,95% CI:1.57–1.99), having secondary education (AOR = 2.45,95%CI:2.10–2.86) and having higher education (AOR = 3.04,95%CI:2.52–3.65) were significantly associated with comprehensive knowledge of HIV/AIDS. Conclusion Spatial distribution of comprehensive knowledge of HIV/AIDS among reproductive-age women was significantly varied across the country with significant hotspot areas with poor comprehensive knowledge of HIV/AIDS identified in the Somali region, the eastern part of Dire Dawa and Harari Regions. media exposure was a significant predictor of comprehensive knowledge of HIV/AIDS among reproductive-age women in Ethiopia. Therefore, the government should scale up public health programs in the hot spot areas and provide health information using different media.

Knowledge and determinants of women’s knowledge on vertical transmission of HIV and AIDS in South Africa

“…At the contextual level, wealth status (poorest, poorer, middle, Richer, Richest), Region (Western Cape, Eastern Cape, Northern Cape, Free State, KwaZulu-Natal, Northwest, Gauteng, Mpumalanga, Limpopo), type of residence (urban, rural) was considered. These variables were not just considered arbitrarily, but based on previous studies in sub-Saharan Africa [18][19][20] including South Africa [21][22][23].…”

Knowledge and Determinants of Women’s Knowledge on Vertical Transmission of HIV and AIDS in South Africa

“…For example, educated women might be able to easily comprehend the health education they receive compared to uneducated women (27). Also, previous studies have espoused that higher socio-economic status is associated with easy access to healthcare including health information (26,28-30) Furthermore, women who have attained higher education are more likely to secure jobs with high wages and are able to afford various means to access health information (26) Similar to previous studies, (17,19,27,31), place of residence and regional variations were observed in the knowledge of women on MTCT of HIV and AIDS.…”

“…Women in urban areas are more likely to have knowledge compared to those in rural areas. This perhaps is due to the inter-regional and rural-urban differentials in access to education and resources including HIV and AIDS education (17,19,27). Liyeh et al (2020) also noted that women in urban centres there is easy accessibility and availability of nearby health services and greater media exposure compared with rural areas.…”

“…This corroborates several previous studies (18,27,32,33). Mass media, especially, radio is a useful tool to convey health education messages in different languages to the intended audience (19). This can, therefore, be a valuable channel to tackle those with a low level of education (18,27).…”

“…Based on previous studies (17)(18)(19) eleven independent variables were considered in the study. These were age (15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49), employment (not working, managerial, clerical, Agriculture, Home, Services, manual), marital status (Never married, married, Cohabiting, Widowed/Divorced/Separated), education (no education, primary, secondary, Higher), wealth (poorest, poorer, middle, Richer, Richest), and parity (0,1,2,3,4+).…”