Central African Journal of Public Health

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Association of Education and Knowledge of HIV with HIV Stigma in Thirteen Selected African Countries

Received: 21 February 2018    Accepted: 21 March 2018    Published: 02 May 2018
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Abstract

Majority of African countries have high stigma index(HSI) and are mostly populated by rural dwellers with high levels of illiteracy/ignorance. Therefore, poor education and knowledge of human immune deficiency virus(HIV) infection might be key drivers of stigmatization. Eight countries with a stigma index(STI) >40%(Niger, Guinea, Ghana, Sierra Leone, Liberia, Mali, Togo, and Democratic Republic of Congo) of 32 African countries with listed STI by UNAIDS, and three (Rwanda, Zambia, and Namibia), with a low stigma index (LSI) of 20%, were descriptively analyzed. Four knowledge classes(≤25%-class one;>25%≤50%-class two; >50%≤75% class three; >75%-class four), and categories of stigmatisation score (< 0.5-class one; 0.5< 1.0-class two; 1.0< 1.5-class three and >1.5-class four - signifying little, medium, high and very high tendency to stigmatize, respectively), were created based on respondents 'answers to twelve questions assessing knowledge of HIV, and four questions assessing stigmatisation of HIV-positive people, respectively. Data were characterized and evaluated by frequency tables using IBM SPSS Software. Respondents in knowledge classes three and four, mainly comprised urban dwellers in both LSI (98.0%urban vs 96.5%rural), and HSI (80.3%urban vs 64.5%rural) countries. Females had higher educational attainment than males in countries with LSI (98.35%females vs 97.6%males) than his (79.8% females vs 81.6% males). However, males expressed positive views (< 0.5-class one) about having an HIV-positive teacher, continuing to teach (i.e. least tendency for social stigmatization), and would buy vegetables from an HIV-positive vendor (i.e. least tendency for physical stigmatization), than females. Meanwhile, 48% of respondents would not buy vegetables from an infected vendor, yet they knew that HIV will not be transmitted by sharing food with an infected person. Impact factors of positive attitudes towards HIV are urbanization, educational attainment, and knowledge about HIV. LSI countries are distinguished from HSI countries by higher female educational attainment and knowledge about HIV than male, which may impact HIV stigmatization, and could be of socio-cultural significance. Lesser tendency to stigmatize among males than females may suggest that socio-cultural factors which enable stigmatization may be gender-related. The greater tendency towards physical than social stigmatization may reflect respondents' perception that physical contact enables HIV transmission. The contradiction between knowledge and belief was evident hence almost half of those who knew the mode of transmission of HIV, had a negative attitude towards an infected vendor.

DOI 10.11648/j.cajph.20180402.13
Published in Central African Journal of Public Health (Volume 4, Issue 2, April 2018)
Page(s) 48-58
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Level of Education, Knowledge of HIV Infection, HIV-Stigma, African Countries

References
[1] UNAIDS, 2016 http://www.unaids. org/sites/ default/files/media_asset/ UNAIDS_FactSheet_en.pdf
[2] (UNAIDS, 2016 http://www.unaids.org/en/ regionscountries/countries/
[3] Amuche NJ, Emmanuel EI, Innocent NE. HIV/AIDS in sub-Saharan Africa: Current status, challenges and prospects. Asian Pacific Journal of Tropical Disease. 2017; 7(4): 239-256. https://doi.org/10.12980/apjtd.7.2017D6-366
[4] Food and Agricultural Organisation of the United Nations. AIDS - a threat to rural Africa. http://www.fao.org/FOCUS/E/aids/aids1-e.htm Accessed on 18/07/2017.
[5] Apanga PA. HIV/AIDS-related stigma and discrimination in sub-Saharan Africa: a review. J Nat Sci Res 2014; 4(21): 41-8.
[6] Obeng-Odoom F. The State of African Cities 2008: A framework for addressing urban challenges in Africa, edited by Alioune Badiane. Nairobi: UN-Habitat, 206 pp. ISBN 978 9 21132 015 2. Afr Aff (Lond) (2010) 109 (435): 340-341. DOI: https://doi.org/10.1093/afraf/adq012
[7] Ramin B. Slums, climate change and human health in sub-Saharan Africa. Bulletin of the World Health Organization. 2009 Dec;87(12):886-A.
[8] Colclough C, Rose P, Tembon M. Gender inequalities in primary schooling: The roles of poverty and adverse cultural International Journal of Educational Development. 2000 Jan 31; 20(1):5-27.
[9] Saleh, Adam Gambo and Lasisi, Fatima Ibrahim (2011). Information needs and information seeking behavior of rural women in Borno state, Nigeria. Library Philosophy and Practice (e-journal), accessed July 18, 2017, from http://www.webpages.uidaho.edu/~mbolin/saleh-lasisi2.htm
[10] Ogunsola LA. Health information literacy: a road map for poverty alleviation in the developing countries. Journal of Hospital Librarianship. 2009 Jan 16;9(1):59-72.
[11] Mufune P. Poverty and HIV/AIDS in Africa: specifying the connections. Soc Theory Health 2015; 13(1): 1-29.
[12] Ucha C. Poverty in Nigeria: Some dimensions and contributing factors. Global Majority E-Journal. 2010 Jun;1(1):46-56.
[13] De-Graft Aikins A, Marks DF. Health, disease and healthcare in Africa. Journal of Health Psychology. 2007 May;12(3):387-402.
[14] Chaudhury N, Hammer J, Kremer M, Muralidharan K, Rogers FH. Missing in action: teacher and health worker absence in developing countries. The Journal of Economic Perspectives. 2006 Mar 1; 20(1):91-116.
[15] Ibeneme S, Eni G, Ezuma A, Fortwengel G. Roads to Health in developing countries–Understanding the intersection of culture and healing. Current Therapeutic Research. 2017 Mar 4.
[16] Mall S, Middelkoop K, Mark D, Wood R, Bekker LG. Changing patterns in HIV/AIDS stigma and uptake of voluntary counselling and testing services: the results of two consecutive community surveys conducted in the Western Cape, South Africa. AIDS Care 2013; 25(2): 194-201.
[17] Tsai AC, Hatcher AM, Bukusi EA, Weke E, Hufstedler LL, Dworkin SL, Kodish S, Cohen CR, Weiser SD. A livelihood intervention to reduce the stigma of HIV in rural Kenya: longitudinal qualitative study. AIDS and Behavior. 2017 Jan 1;21(1):248-60.
[18] Smith EA, Miller JA, Newsome V, Sofolahan YA, Airhihenbuwa CO. Measuring HIV/AIDS-related stigma across South Africa: a versatile and multidimensional scale. Health Educ Behav 2014; 41(4): 387-91.
[19] Thai Network of People Living with HIV/AIDS (TNP+) Index of stigma and discrimination against people living with HIV/AIDS in Thailand. 2009. [cited 2013 Jul 8]. Available from:http://www.aidsdatahub.org/dmdocuments/Stigma_Index_Thailand.pdf
[20] The DHS Program User Forum: HIV/AIDS » Stigma and Discrimination. The new questions suggested as well as the minor adaptation of Q932 in the HIV module, are used to construct indicators measuring stigma.userforum.dhsprogram.com/index.php?t=msg&goto=1831&S....
[21] Greeff M, Uys LR, Wantland D, Makoae L, Chirwa M, Dlamini P, Kohi TW, Mullan J, Naidoo JR, Cuca Y, Holzemer WL. Perceived HIV stigma and life satisfaction among persons living with HIV infection in five African countries: a longitudinal study. International journal of nursing studies. 2010 Apr 30; 47(4):475-86.
[22] Mall S, Middelkoop K, Mark D, Wood R, Bekker LG. Changing patterns in HIV/AIDS stigma and uptake of voluntary counselling and testing services: the results of two consecutive community surveys conducted in the Western Cape, South Africa. AIDS Care 2013; 25(2): 194-201.
[23] Apanga PA. HIV/AIDS-related stigma and discrimination in sub-Saharan Africa: a review. J Nat Sci Res 2014; 4(21): 41-8.
[24] Gilbert L, Walker L. ‘My biggest fear was that people would reject me once they knew my status…’: stigma as experienced by patients in an HIV/AIDS clinic in Johannesburg, South Africa. Health & social care in the community. 2010 Mar 1;18(2):139-46.
[25] Shisana O, Simbayi LC, editors. Nelson Mandela/HSRC study of HIV/AIDS: South African national HIV prevalence, behavioural risks and mass media: household survey 2002. HSRC Press; 2002.
[26] Sahn DE, Stifel DC. Urban–rural inequality in living standards in Africa. Journal of African Economies. 2003 Dec 1;12(4):564-97.
[27] Morrell R, Jewkes R, Lindegger G. Hegemonic masculinity/masculinities in South Africa: Culture, power, and gender politics. Men and Masculinities. 2012 Apr; 15(1):11-30.
[28] Jacobs JA. Gender inequality and higher education. Annual review of sociology. 1996 Aug;22(1):153-85.
[29] Kabeer N. Gender equality and women's empowerment: A critical analysis of the third millennium development goal 1. Gender & Development. 2005 Mar 1; 13(1):13-24.
[30] Mayoux L. Questioning virtuous spirals: micro-finance and women's empowerment in Africa. Journal of international development. 1999 Nov 1; 11(7):957.
[31] Katulushi C. Teaching Traditional African Religions and Gender Issues in Religious Education in Zambia. British Journal of Religious Education. 1999 Mar 1; 21(2):101-11.
[32] Afisi OT. Power and womanhood in Africa: An introductory evaluation. The Journal of Pan-African Studies. 2010 Mar 1;3(6):229-38.
Author Information
  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Rehabilitation; University of Nigeria, Enugu, Nigeria

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

  • Department of Medical Information Management, University of Applied Sciences and Arts, Hannover, Germany

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  • APA Style

    Gerhard Fortwengel, Sam Ibeneme, Jacqueline Behnsen, Lars Heinrich, Stephanie Ilenseer, et al. (2018). Association of Education and Knowledge of HIV with HIV Stigma in Thirteen Selected African Countries. Central African Journal of Public Health, 4(2), 48-58. https://doi.org/10.11648/j.cajph.20180402.13

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    ACS Style

    Gerhard Fortwengel; Sam Ibeneme; Jacqueline Behnsen; Lars Heinrich; Stephanie Ilenseer, et al. Association of Education and Knowledge of HIV with HIV Stigma in Thirteen Selected African Countries. Cent. Afr. J. Public Health 2018, 4(2), 48-58. doi: 10.11648/j.cajph.20180402.13

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    AMA Style

    Gerhard Fortwengel, Sam Ibeneme, Jacqueline Behnsen, Lars Heinrich, Stephanie Ilenseer, et al. Association of Education and Knowledge of HIV with HIV Stigma in Thirteen Selected African Countries. Cent Afr J Public Health. 2018;4(2):48-58. doi: 10.11648/j.cajph.20180402.13

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  • @article{10.11648/j.cajph.20180402.13,
      author = {Gerhard Fortwengel and Sam Ibeneme and Jacqueline Behnsen and Lars Heinrich and Stephanie Ilenseer and Susanna Kirchner and Ya-Jui Liang and Marie Lindemann and Jana-Elena Michaelis and Melanie Müller and Kira Schütze and Christina Valtin},
      title = {Association of Education and Knowledge of HIV with HIV Stigma in Thirteen Selected African Countries},
      journal = {Central African Journal of Public Health},
      volume = {4},
      number = {2},
      pages = {48-58},
      doi = {10.11648/j.cajph.20180402.13},
      url = {https://doi.org/10.11648/j.cajph.20180402.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cajph.20180402.13},
      abstract = {Majority of African countries have high stigma index(HSI) and are mostly populated by rural dwellers with high levels of illiteracy/ignorance. Therefore, poor education and knowledge of human immune deficiency virus(HIV) infection might be key drivers of stigmatization. Eight countries with a stigma index(STI) >40%(Niger, Guinea, Ghana, Sierra Leone, Liberia, Mali, Togo, and Democratic Republic of Congo) of 32 African countries with listed STI by UNAIDS, and three (Rwanda, Zambia, and Namibia), with a low stigma index (LSI) of 20%, were descriptively analyzed. Four knowledge classes(≤25%-class one;>25%≤50%-class two; >50%≤75% class three; >75%-class four), and categories of stigmatisation score (1.5-class four - signifying little, medium, high and very high tendency to stigmatize, respectively), were created based on respondents 'answers to twelve questions assessing knowledge of HIV, and four questions assessing stigmatisation of HIV-positive people, respectively. Data were characterized and evaluated by frequency tables using IBM SPSS Software. Respondents in knowledge classes three and four, mainly comprised urban dwellers in both LSI (98.0%urban vs 96.5%rural), and HSI (80.3%urban vs 64.5%rural) countries. Females had higher educational attainment than males in countries with LSI (98.35%females vs 97.6%males) than his (79.8% females vs 81.6% males). However, males expressed positive views (< 0.5-class one) about having an HIV-positive teacher, continuing to teach (i.e. least tendency for social stigmatization), and would buy vegetables from an HIV-positive vendor (i.e. least tendency for physical stigmatization), than females. Meanwhile, 48% of respondents would not buy vegetables from an infected vendor, yet they knew that HIV will not be transmitted by sharing food with an infected person. Impact factors of positive attitudes towards HIV are urbanization, educational attainment, and knowledge about HIV. LSI countries are distinguished from HSI countries by higher female educational attainment and knowledge about HIV than male, which may impact HIV stigmatization, and could be of socio-cultural significance. Lesser tendency to stigmatize among males than females may suggest that socio-cultural factors which enable stigmatization may be gender-related. The greater tendency towards physical than social stigmatization may reflect respondents' perception that physical contact enables HIV transmission. The contradiction between knowledge and belief was evident hence almost half of those who knew the mode of transmission of HIV, had a negative attitude towards an infected vendor.},
     year = {2018}
    }
    

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    T1  - Association of Education and Knowledge of HIV with HIV Stigma in Thirteen Selected African Countries
    AU  - Gerhard Fortwengel
    AU  - Sam Ibeneme
    AU  - Jacqueline Behnsen
    AU  - Lars Heinrich
    AU  - Stephanie Ilenseer
    AU  - Susanna Kirchner
    AU  - Ya-Jui Liang
    AU  - Marie Lindemann
    AU  - Jana-Elena Michaelis
    AU  - Melanie Müller
    AU  - Kira Schütze
    AU  - Christina Valtin
    Y1  - 2018/05/02
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    N1  - https://doi.org/10.11648/j.cajph.20180402.13
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    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
    SP  - 48
    EP  - 58
    PB  - Science Publishing Group
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    AB  - Majority of African countries have high stigma index(HSI) and are mostly populated by rural dwellers with high levels of illiteracy/ignorance. Therefore, poor education and knowledge of human immune deficiency virus(HIV) infection might be key drivers of stigmatization. Eight countries with a stigma index(STI) >40%(Niger, Guinea, Ghana, Sierra Leone, Liberia, Mali, Togo, and Democratic Republic of Congo) of 32 African countries with listed STI by UNAIDS, and three (Rwanda, Zambia, and Namibia), with a low stigma index (LSI) of 20%, were descriptively analyzed. Four knowledge classes(≤25%-class one;>25%≤50%-class two; >50%≤75% class three; >75%-class four), and categories of stigmatisation score (1.5-class four - signifying little, medium, high and very high tendency to stigmatize, respectively), were created based on respondents 'answers to twelve questions assessing knowledge of HIV, and four questions assessing stigmatisation of HIV-positive people, respectively. Data were characterized and evaluated by frequency tables using IBM SPSS Software. Respondents in knowledge classes three and four, mainly comprised urban dwellers in both LSI (98.0%urban vs 96.5%rural), and HSI (80.3%urban vs 64.5%rural) countries. Females had higher educational attainment than males in countries with LSI (98.35%females vs 97.6%males) than his (79.8% females vs 81.6% males). However, males expressed positive views (< 0.5-class one) about having an HIV-positive teacher, continuing to teach (i.e. least tendency for social stigmatization), and would buy vegetables from an HIV-positive vendor (i.e. least tendency for physical stigmatization), than females. Meanwhile, 48% of respondents would not buy vegetables from an infected vendor, yet they knew that HIV will not be transmitted by sharing food with an infected person. Impact factors of positive attitudes towards HIV are urbanization, educational attainment, and knowledge about HIV. LSI countries are distinguished from HSI countries by higher female educational attainment and knowledge about HIV than male, which may impact HIV stigmatization, and could be of socio-cultural significance. Lesser tendency to stigmatize among males than females may suggest that socio-cultural factors which enable stigmatization may be gender-related. The greater tendency towards physical than social stigmatization may reflect respondents' perception that physical contact enables HIV transmission. The contradiction between knowledge and belief was evident hence almost half of those who knew the mode of transmission of HIV, had a negative attitude towards an infected vendor.
    VL  - 4
    IS  - 2
    ER  - 

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