Background characteristics
A total of 20,770 individuals (59.5%, n= 12,358 women’s and 40.5%, n=8,412 men’s) who have heard about HIV/AIDS were included in the study. The background information of the sample population can be seen in Table 1. Overall, The highest proportion of respondents (59.3%) were between age 15-29, 63.3% of respondents were rural residents. In terms of educational level, forty-eight percent of them had primary education, whereas 36.6 % had no education. Nearly 32% were in the poor economic category, and 61.5% of respondents were Tigray, Amhara, Oromia, SNNP, and Dire-Dawa residents.
Table 1 Reproductive age (15–49) men and women who heard about HIV/AIDS by background Characteristics in Ethiopia, 2016 EDHS.
Variables
|
Women
|
Men
|
Total
|
Frequency
|
%
|
Frequency
|
%
|
Frequency
|
%
|
Age
|
|
|
|
|
|
|
15-19
|
2814
|
22.8
|
1809
|
21.5
|
4623
|
22.2
|
20-24
|
2397
|
19.4
|
1533
|
18.2
|
3930
|
18.9
|
25-29
|
2230
|
18.0
|
1560
|
18.4
|
3790
|
18.2
|
30-34
|
1760
|
14.2
|
1135
|
13.5
|
2895
|
13.9
|
35-39
|
1451
|
11.7
|
969
|
11.5
|
2420
|
11.6
|
40-44
|
993
|
8.0
|
828
|
9.8
|
1761
|
8.4
|
45-49
|
713
|
5.8
|
578
|
6.9
|
1291
|
6.2
|
Residence
|
|
|
|
|
|
|
Urban
|
4736
|
38.3
|
2866
|
34.1
|
7602
|
36.7
|
Rural
|
7622
|
61.7
|
5546
|
65.9
|
13,168
|
63.3
|
Education
|
|
|
|
|
|
|
No education
|
4727
|
38.3
|
1609
|
19.1
|
7602
|
36.6
|
Primary
|
4417
|
35.7
|
3627
|
43.1
|
9963
|
47.9
|
Higher
|
3214
|
26.0
|
3176
|
37.8
|
6390
|
|
Wealth index
|
|
|
|
Poorest
|
2452
|
19.8
|
1529
|
18.2
|
3981
|
19.2
|
Poorer
|
1518
|
12.3
|
1145
|
13.6
|
2663
|
12.8
|
Middle
|
1591
|
12.9
|
1162
|
13.8
|
2753
|
7.6
|
Richer
|
1668
|
13.5
|
1315
|
15.6
|
2983
|
14.4
|
Richest
|
5129
|
41.5
|
3261
|
38.8
|
8390
|
40.4
|
Region
|
|
|
|
|
|
|
Tigray
|
1443
|
11.7
|
992
|
11.8
|
2435
|
11.7
|
Afar
|
876
|
7.1
|
487
|
5.8
|
1363
|
6.5
|
Amhara
|
1388
|
11.2
|
1103
|
13.1
|
2491
|
11.9
|
Oromia
|
1468
|
11.9
|
1129
|
13.4
|
2597
|
12.5
|
Somali
|
601
|
4.9
|
399
|
4.7
|
1000
|
4.8
|
Benishangul
|
875
|
7.1
|
557
|
6.6
|
1432
|
6.9
|
SNNP
|
1570
|
12.7
|
1127
|
13.4
|
2697
|
12.9
|
Gambela
|
804
|
6.5
|
629
|
7.5
|
1433
|
6.8
|
Harari
|
770
|
6.2
|
490
|
5.8
|
1260
|
6.0
|
Dire-Dawa
|
1683
|
13.6
|
919
|
10.9
|
2602
|
12.5
|
Addis Ababa
|
880
|
7.1
|
580
|
6.9
|
1460
|
7.0
|
The proportion of discriminatory attitudes among women and men
As Figure 1 shows, 44.3% of women and 37.7% of men respondents said they would not buy vegetables from an HIV-infected vendor, and 38.8% of women and 29.7% of men would not be willing to allow an HIV infected child to attend school.
Association of discriminatory attitudes towards PLHIV with HIV related knowledge’s among men and women
In the analysis, discriminatory attitudes were significantly associated with Comprehensive knowledge about HIV, knowledge about mother-to-child transmission Ever tested for HIV (p<0.01). From knowledgeable respondents, A higher proportion of men than women had a more discriminatory attitude toward PLHIV. From respondents who had tested for HIV before the survey, above two-thirds of them had a favorable attitude ( Table 2).
Table 2 Relationship between discriminatory attitudes towards PLHIV with HIV-related knowledge’s among reproductive age (15–49) men and women.
Variables
|
Attitude towards PLHIV
|
Total frequency
|
P-value
|
Negative n(%)
|
Positive n(%)
|
Women
|
Comprehensive knowledge about HIV
|
|
Knowledgeable
|
1476(22.9)
|
2676(45.3)
|
4152(33.6)
|
0.000
|
Not-knowledgeable
|
4979(77.1)
|
3227(54.7)
|
8206(66.4)
|
|
knowledge about mother-to-child transmission
|
|
Knowledgeable
|
4516(69.9)
|
4352(73.3)
|
8868(71.8)
|
0.000
|
Not-knowledgeable
|
1939(30.0)
|
1551(26.3)
|
3490(28.2)
|
|
Knowledge of HIV status
|
|
Know status
|
2781(43.1)
|
4068(68.9)
|
6849(55.4)
|
0.000
|
Don’t know the status
|
3674(56.9)
|
1835(31.1)
|
5509(44.6)
|
|
Men
|
Comprehensive knowledge about HIV
|
|
Knowledgeable
|
1360(35.6)
|
2571(55.9)
|
3931(46.7)
|
0.000
|
Not-knowledgeable
|
2459(64.4)
|
2022(44.0)
|
4481(53.3)
|
|
knowledge about mother-to-child transmission
|
|
Knowledgeable
|
2299(60.2)
|
2961(64.5)
|
5260(62.5)
|
0.000
|
Not-knowledgeable
|
1520(39.8)
|
1632(35.5)
|
3152(37.5)
|
|
Knowledge of HIV status
|
|
Know status
|
1713(44.8)
|
2881(62.7)
|
4594(54.6)
|
0.000
|
Don’t know status
|
2016(55.2)
|
1712(34.3)
|
3818(45.4)
|
|
Association of discriminatory attitudes towards PLHIV with Socioeconomic and demographic factors
Table 3 shows that the discriminatory attitude was significantly associated with age, residence, education, wealth, and region (p<0.001). The level of discriminatory attitudes was lower in urban areas and respondents in higher educational status.
Table 3 Association between sociodemographic factors and discriminatory attitude among reproductive age (15–49) men and women.
Variables
|
Women
|
|
Men
|
|
Negative n(%)
|
Positive n(%)
|
p-value
|
Negative n(%)
|
Positive n(%)
|
p-value
|
Age(in years )
|
|
|
15-19
|
1354(20.9)
|
1460(24.7)
|
0.000
|
823(21.5)
|
986(21.5)
|
0.000
|
20-24
|
1140(17.7)
|
1257(21.9)
|
|
654(17.1)
|
879(19.1)
|
|
25-29
|
1169(18.1)
|
1061(17.9)
|
|
644(16.9)
|
916(19.9)
|
|
30-34
|
967(14.9)
|
793(13.43)
|
|
533(13.9)
|
602(13.1)
|
|
35-39
|
815(12.6)
|
636(10.7)
|
|
472(12.4)
|
497(10.8)
|
|
40-44
|
579(8.9)
|
414(7.0)
|
|
395(10.3)
|
433(9.4)
|
|
45-49
|
431(6.7)
|
282(4.8)
|
|
298(7.8)
|
280(6.1)
|
|
Residence
|
|
|
|
|
Urban
|
1188(18.4)
|
3548(60.1)
|
0.000
|
677(17.7)
|
2189(47.7)
|
0.000
|
Rural
|
5267(81.6)
|
2355(39.9)
|
|
3142(82.3)
|
2404(52.3)
|
|
Highest Education attainment
|
|
|
|
|
No education
|
3501(54.2)
|
1226(20.8)
|
0.000
|
1085(28.4)
|
524(11.4)
|
0.000
|
Primary
|
2288(35.5)
|
2129(36.1)
|
|
1893(49.6)
|
1734(37.8)
|
|
Higher
|
666(10.2)
|
2548(43.2)
|
|
841(22.0)
|
2335(50.8)
|
|
Household Wealth index
|
|
|
|
Poorest
|
1905(29.5)
|
547(9.3)
|
0.000
|
998(26.1)
|
531(11.6)
|
0.000
|
Poorer
|
1094(16.9)
|
424(7.1)
|
|
687(18)
|
458(10)
|
|
Middle
|
1078(16.7)
|
513(8.7)
|
|
644(16.8)
|
518(11.3)
|
|
Richer
|
1011(15.7)
|
657(11.1)
|
|
648(17)
|
667(14.5)
|
|
Richest
|
1367(21.2)
|
3762(63.7)
|
|
842(22.1)
|
2419(52.7)
|
|
Region
|
|
|
|
|
Tigray
|
807(12.5)
|
636(10.8)
|
0.000
|
455(11.9)
|
537(11.7)
|
0.000
|
Afar
|
598(9.3)
|
278(4.7)
|
|
240(6.3)
|
247(5.4)
|
|
Amhara
|
776(12.0)
|
612(10.4)
|
|
479(12.5)
|
624(13.6)
|
|
Oromia
|
1014(15.7)
|
454(7.7)
|
|
614(16.1)
|
515(11.2)
|
|
Somali
|
476(7.4)
|
125(2.1)
|
|
250(6.6)
|
149(3.2)
|
|
Benishangul
|
472(7.3)
|
403(6.8)
|
|
309(8.1)
|
248(5.4)
|
|
SNNP
|
1095(16.9)
|
475(8.1)
|
|
666(17.4)
|
461(10)
|
|
Gambela
|
345(5.3)
|
459(7.8)
|
|
317(8.3)
|
312(6.8)
|
|
Harari
|
300(4.7)
|
470(7.9)
|
|
187(4.9)
|
303(6.6)
|
|
Addis Ababa
|
285(4.4)
|
1398(23.7)
|
|
157(4.1)
|
762(16.6)
|
|
Dire-Dawa
|
287(4.5)
|
593(10.5)
|
|
145(3.8)
|
435(9.5)
|
|
Factors associated with discriminatory attitudes towards PLHIV
Table 4 shows the factor associated with respondent attitudes towards PLHIV. In multivariate analysis, women and men respondents who reside in a rural area were about 1.61 and 1.64 times greater odds of having discriminatory attitudes respectively compared with urban residents. Likewise, when uneducated women and men compared with educated respondents, respondents who had no formal education had 1.79 times greater odds of having a negative attitude towards PLHIV respectively compared with higher educated levels. Respondents who are in richest category were 57% (AOR women =0.43, 95% CI: 0.35-0.52) and 42% (AOR men =0.58, 95% CI: 0.47-0.71) less likely to had discriminatory attitudes as compared with poorest ones.
In terms of region of residence, The odds of discriminatory attitudes among women and men in Oromia, Somali, and SNNP regions were higher compared to the Tigray region. However, the odds of discriminatory attitudes at Amhara, Benishangul, Gambella, and Dire Dawa regions were lower as compared to Tigray. Afar had not significantly different in the prevalence of the discriminatory attitude among men and women as compared to the reference region Tigray.
For HIV/AIDS-related knowledge, the negative attitude of respondents decreased by 47% among women's and 45% among men's respondents who have comprehensive knowledge about HIV transmission methods compared to the attitude of respondents who are not knowledgeable. In addition, previous experience of respondents to HIV test has shown a significant impact on attitude towards PLHIV, discriminatory attitudes towards HIV decreased by 36% (AOR women =0.64, 95% CI: 0.58-0.70) and 24% (AOR men =0.76, 95% CI: 0.68-084) among respondents who have tested for HIV compared to the attitude of respondents who did not take HIV test ever. Furthermore, there was a 17% decreases in negative attitude among males who are knowledgeable about mother-to-child HIV transmission methods compared to their counterparts.
Furthermore, respondents who have exposure to mass media shows favorable attitudes towards PLHIV, respondents who don't read newspapers before the survey were about 1.55 (women) among and 1.34 (men) times more likely to have discriminatory attitudes to PLHIV compared to the attitude of respondents who read newspapers once a week. Similarly, the discriminatory attitudes of women respondents towards PLHIV increased by 26% among women who never watched television before (AOR =1.26, 95% CI: 1.11-1.42) compared to women respondents who watch television at least once a week.
Table 4 Factors associated with discriminatory attitudes towards PLHIV among reproductive age (15–49) men and women by selected characteristics
|
Women
|
|
Men
|
|
Variables
|
AOR (95% CI)
|
p-value
|
AOR (95% CI)
|
p-value
|
Residence
|
|
|
|
|
Urban
|
1
|
|
1
|
|
Rural
|
1.61[1.36-1.90]
|
0.000
|
1.64[1.35-1.99]
|
0.000
|
Education
|
|
|
|
|
No education
|
1.79[1.61-2.01]
|
0.000
|
1.79[1.55-2.06]
|
0.000
|
Primary
|
4.34[3.79-4.98]
|
0.000
|
3.42[2.91-4.02]
|
0.000
|
Higher
|
1
|
|
1
|
|
Wealth index
|
|
|
|
|
Poorest
|
1
|
|
1
|
|
Poorer
|
0.83[0.70-0.97]
|
0.022
|
0.84[0.70-0.99]
|
0.047
|
Middle
|
0.71[0.60-0.83]
|
0.000
|
0.73[0.61-0.87]
|
0.000
|
Richer
|
0.59[0.50-0.69]
|
0.000
|
0.60[0.51-0.72]
|
0.000
|
Richest
|
0.43[0.35-0.52]
|
0.000
|
0.58[0.47-0.71]
|
0.000
|
Region
|
|
|
|
|
Tigray
|
1
|
|
1
|
|
Afar
|
0.86[0.69-1.05]
|
0.152
|
0.85[0.67-1.09]
|
0.212
|
Amhara
|
0.81[0.68-0.96]
|
0.015
|
0.82[0.68-0.99]
|
0.037
|
Oromia
|
1.54[1.30-1.84]
|
0.000
|
1.50[1.23-1.79]
|
0.000
|
Somali
|
2.45[1.93-3.20]
|
0.000
|
2.21[1.70-2.91]
|
0.000
|
Benishangul
|
0.63[0.52-0.77]
|
0.000
|
1.57[1.25-1.98]
|
0.000
|
SNNP
|
1.50[1.26-1.78]
|
0.000
|
1.83[1.51-2.20]
|
0.000
|
Gambela
|
0.63[0.51-0.77]
|
0.000
|
1.70[1.36-2.11]
|
0.000
|
Harari
|
0.84[0.68-1.04]
|
0.107
|
1.11[0.86-1.43]
|
0.392
|
Addis Ababa
|
0.65[0.53-0.79]
|
0.000
|
0.77[0.61-0.99]
|
0.050
|
Dire-Dawa
|
0.75[0.61-0.92]
|
0.007
|
0.72[0.56-0.93]
|
0.011
|
Comprehensive knowledge about HIV
|
|
|
|
Knowledgeable
|
0.53[0.48-0.58]
|
0.000
|
0.55[0.49-0.60]
|
0.000
|
Not-Knowledgeable
|
1
|
|
1
|
|
knowledge about mother-to-child transmission
|
|
|
Knowledgeable
|
0.94[0.85-1.0]
|
0.181
|
0.83[0.75-0.91]
|
0.000
|
Not-Knowledgeable
|
1
|
|
1
|
|
Ever tested for HIV
|
|
|
|
|
Yes
|
0.64[0.58-0.70]
|
0.000
|
0.76[0.68-0.84]
|
0.000
|
NO
|
1
|
|
1
|
|
Watching television
|
|
|
|
No watch at all
|
1.26[1.11-1.42]
|
0.000
|
1.05[0.93-1.18]
|
0.430
|
Watch once a week
|
1
|
|
1
|
|
Reading news paper
|
|
|
|
Doesn’t read before
|
1.55[1.35-1.76]
|
0.000
|
1.34[1.20-1.51]
|
0.000
|
Read once a week
|
1
|
|
1
|
|