Factors association of discriminatory attitudes toward people living with HIV/AIDS among adult citizens in Myanmar : an analysis of 2015-2016 Myanmar demographic and health survey

Abstract

Myanmar, a developing nation, is still among the countries with the highest prevalence of HIV infection. Misconceptions, stigmatisation, and discrimination towards people living with HIV/AIDS (PLHIV) are significant factors that contribute to the prevention, transmission, and treatment of HIV. So, PLHIV-related stigma and discrimination are pervasive issues that significantly undermine public health efforts to prevent the spread of HIV and provide support for those living with the PLHIV. Despite its importance, the stigma and discrimination issues are often overlooked in national responses to PLHIV. In Myanmar, there are limited studies on discrimination against people living with HIV/AIDS, and it requires understanding the situation and proposing the implications. This study aims to assess the knowledge level and discriminatory attitudes toward people living with HIV/AIDS among Myanmar adult citizens and identify factors that influence discriminatory attitudes. The research methodology involved a secondary data analysis of the cross-sectional Myanmar Demographic and Health Survey (MDHS) carried out in 2015-2016. The study population comprised men and women aged 15-49 who had heard of AIDS and expressed accepting or discriminatory attitudes toward people living with HIV/AIDS. The study employed multiple logistic regression to determine the factors associated with the dependent variable, with a significant value of <0.05. The study involved 13978 participants, with a weighted distribution of 70% females and 30% males. The mean age of the participants was 31.77 years (SD ±9.77). Of the participants, 79% exhibited discriminatory attitudes towards PLHIV. This study revealed that age, marital status, education level, media exposure, geographical location, and HIV/AIDS knowledge significantly influenced discriminatory attitudes. Specifically, older age groups (AOR 0.72; 95% CI 0.56-0.91, p=0.006), those with higher education levels groups (AOR 0.41; 95% CI 0.27-0.60, p=<0.001), those with the wealthiest economic group groups (AOR 0.65; 95% CI 0.50-0.85, p=0.002) and individuals with moderate to high HIV/AIDS knowledge groups (AOR 0.26; 95% CI 0.19-0.35, p<0.001) exhibited lower discriminatory attitudes. Top 3 reasons for discriminatory attitudes are 1) low level of knowledge, 2) low education level, and 3) low economic status. Our study reveals a high prevalence (80%) of discriminatory attitudes towards individuals living with HIV/AIDS among adult citizens in Myanmar, highlighting the critical need for targeted interventions. Our findings emphasise the importance of sociodemographic factors and HIV/AIDS knowledge in forming these attitudes. To solve this issue, the study proposes an integrated strategy consisting of comprehensive educational programmes and a public health policy to reduce the stigma associated with PLHIV. In addition, effective media engagement is required to alter societal perspectives of PLHIV. These initiatives are essential for nurturing a more inclusive societal response, thereby enhancing the quality of life for HIV/AIDS patients in Myanmar.