HIV/AIDS-related knowledge, behaviors, stigmatizing attitude and discrimination among refugees, migrants, and the general population in Jordan (Preprint)

Abstract

BACKGROUND A better understanding of knowledge, attitude, practices (KAP) in the community and other issues related to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) can help in implementing evidence-driven activities to control HIV/AIDS in Jordan. With a prevalence rate of 0.02% among the overall population and a prevalence rate of roughly 0.05% among important populations, Jordan is recognized as a country with a low HIV pandemic. The absence of cases could be attributed to underreporting, inaccurate information, and a dearth of efficient organizations to reach the most vulnerable and at-risk group. No systematic HIV surveillance studies have been carried out among the general population or particular most-at-risk populations, with the exception of a few small-scale studies among particular subgroups of the Jordanian population. OBJECTIVE This study aimed to assess HIV/AIDS-related knowledge, attitude, and behaviors among refugees, migrants, and the general population, as well as assess their stigmatizing and discrimination attitudes toward HIV/AIDS patients, their social behavior towards HIV/AIDS, and their healthcare-seeking behaviors. METHODS A cross-sectional study was conducted among Jordanians, Syrian refugees (both urban and camp refugees), and migrants living in four governorates including Amman, Zarqa, Mafraq, and Irbid during the study period June-September 2021. A structured questionnaire was developed and used to collect the data via face-to-face interviews. RESULTS A total of 2276 persons (674 Jordanians, 591 urban refugees, 500 camp refugees, and 511 migrants) participated in this study. The majority of participants (70.8% of Jordanians, 75.2% of urban refugees, 51.3% of the camp refugees, and 65.0% of migrants) had a low level of HIV/AIDS-related knowledge. More than half of the Jordanian, urban refugees and migrants had a positive attitude toward HIV/AIDS and patients with HIV/AIDS, while only 39.5% of camp refugees had a positive attitude. HIV/AIDs stigma levels varied significantly among migrants, Jordanians, urban and camp refugees. Almost 52.1% of Jordanians, 55.9% of urban refugees, 58.1% of camp refugees, and 50.9% of migrants had moderate to high stigma levels. Almost 57.4% of Jordanians, 62.2% of urban refugees, 57.1% of camp refugees, and 66.1% of migrants had moderate to high discrimination levels. About 30.9% of Jordanians, 26.7% of urban refugees, 35.6% of camp refugees, and 37.3% of migrants stated that they feel compassion and desire to help people with HIV/AIDS. Almost one-third of participants reported that the community mostly supports and helps patients with HIV/AIDS. CONCLUSIONS The study populations had significant gaps in HIV/AIDS-related knowledge. Moderate to a high level of stigmatizing attitude was reported by a considerable proportion of the study participants. The poor knowledge of HIV/AIDS, negative attitude, and high level of stigmatizing attitude varied between the studied groups, level of education, and employment status. It is of paramount importance to implement public health education programs to increase the community’s awareness of HIV/AIDS and address HIV/AIDS-related stigma.