Hotspots and determinants of women’s discriminatory attitude towards people living with HIV; evidence from ethiopian demographic and health survey data

Abstract

Background Human Immunodeficiency Virus (HIV) is the major public health concern in Ethiopia with more profound effect on women. Discriminatory attitude towards people living with HIV (PLWH) impose a significant impact on patient outcomes and related issues. Hence, this study aimed to investigate the hotspot areas and determinant factors of women’s discriminatory attitude towards people living with HIV. Methods An in-depth secondary data analysis was conducted based on Ethiopian demographic and health survey (EDHS) 2016. A total of weighed 13,822 reproductive-age women were included in the analysis. The non-spatial analysis was conducted using Stata 16. A mixed effect multi-level logistic regression model was fitted to identify determinant factors of discriminatory attitude towards PLWH. A p-value < 0.2 and 0.05 were used as a cut-off point to declare statistical significance for the bi- and multi-variable regression models, respectively. Four separate models i.e. the null, individual, community level model, and a fourth combined model were fitted. Model comparison was done using deviance. Random effect parameters such as correlation coefficient, median odds ratio, and proportional change in variance were used to explain the variation between and within clusters. Global and local level spatial analyses were conducted using Global Moran’s index, GetisOrd Gi* statistics, and Spatial scan statistics were conducted. Results The magnitude of women’s discriminatory attitude towards PLWH was 62.66% (95%CI: 60.12, 65.10). The discriminatory attitude of women towards PLWH was spatially clustered (Moran’s index = 0.41, P < 0.01). The hotspots of discriminatory attitude towards PLWH were detected in most parts of the Tigray region; Northern, and southeast borders of the Amhara region; Addis Ababa city; Central, Southern, and western Oromiya region; and East, south, and northeastern parts of South Nations, Nationalities and Peoples Region (SNNPR). Being rural resident, and having no media exposure were positively associated while better educational statuses, better wealth index, unmarried, having comprehensive HIV knowledge, Orthodox religion fellow, and ever being tested for HIV were negatively associated with women’s discriminatory attitude towards people living with HIV. Conclusion Discriminatory attitude of women towards PLWH was high in Ethiopia. Hotspots were detected in Amhara, Oromiya, SNNPR, Tigray regions, and Addis Ababa city. Socio-demographic, socio-economic, and HIV knowledge-related factors determine the women’s discriminatory attitude towards PLWH.

Discrimination against HIV/AIDS patients and associated factors among women in East African countries: using the most recent DHS data (2015–2022)

“…Women from low socioeconomic/wealth status households were more likely to harbor a prejudiced attitude toward those living with HIV/AIDS. This is consistent with research done elsewhere [ 23 , 33 , 36 , 39 ]. This may be the result of better and more relevant knowledge, higher levels of education, better access to media, and greater awareness of health issues among people from higher socioeconomic backgrounds [ 40 ].…”

“…Independent variables: Various maternal-related factors were included. All these variables were included after reviewing previous literatures based on their proximity to the outcome variable [ 23 , 33 – 35 ]. This included maternal age (15–24, 25–34, and 35–49 years old), educational status (not educated, primary, and secondary/higher), types of places of residence (urban, rural), marital status (not married, married), household wealth index (poorest, poorer, middle, richer, and richest), current employment status (no, yes), mass media exposure (no, yes0, ANC follow-up (no, yes), place of delivery (health facility, home), number of health visits (once, more than once), visited by field workers in the past 12 months (no, yes), contraceptive utilization methods (no utilized, traditional, and modern methods), distance to the health facility (not perceived as a big problem, big problem), comprehensive knowledge of HIV/AIDS (poor, good), sex of the household head (male, female0, and breastfeeding status (no, yes) were included.…”

Behavioral response for condom use messages to prevent human immunodeficiency virus/acquired immune deficiency syndrome among Bahir Dar City High School students, North West Ethiopia, 2022: Application of the extended parallel process model

“…[19][20][21] One of the most common serious consequences of HIV/ AIDS is the loss of young adults in their most productive years, and Ethiopia is one of the most affected countries in East Africa (11) The majority of the victims HIV/AIDS primarily affects are aged 15-24 years. 20,22 The majority of HIV/AIDS awareness campaigns are grounded in behavioral theories, such as the theory of reasoned action, theory of planned behavior, social learning/ cognitive theory, Bruner's theory of discovery learning, theory of classical conditioning, the health belief model (HBM), and extended parallel process model (EPPM). [23][24][25] Models and theories can help us understand and explain why certain health interventions work and others do not.…”

“…According to the EDHS 2016, there are 0.9% HIV cases nationwide, and the Amhara region had the highest rate of new HIV infections (26% on average) over the same year. 19–21…”

“…One of the most common serious consequences of HIV/AIDS is the loss of young adults in their most productive years, and Ethiopia is one of the most affected countries in East Africa (11) The majority of the victims HIV/AIDS primarily affects are aged 15–24 years. 20,22…”