HIV/AIDS related knowledge and stigma in the Rustenburg area of North West Province : a representative cross-sectional survey.

Abstract

In response to the HIV epidemics since its onset in 1981, several preventive measures have been applied or employed to combat the epidemics. Up to date, the epidemics have reported limited success and/or increased incidence inspite of various interventions. It is widely known that stigma constitute a major setback to preventive interventions of this disease. This informed, amongst others, information, education and communication (IEC) interventions directed at combating HIV stigma through the enhancement and creation of awareness on HIV knowledge. However, lack of adequate and correct knowledge on HIV and AIDS is believed to be a main pre-cursor to HIV stigma. This cross sectional study therefore investigates and reports findings on the associations between HIV stigma and other relevant variables such as HIV related knowledge, exposure to mass media and some socio-demographic characteristics among representatives of the ethnic groups aged between 18 and 49 in the broader Rustenburg community (N = 351). The study utilized some data collected by the Aurum Institute of Health Research in partnership with the International AIDS Vaccine Initiative (IAVI) and the European Union. Data was analyzed using descriptive statistical methods and presented in figures and tables. Independent sample T-tests and ANOVA were employed to compare means while the Pearson’s product moment was used to find the association between variables. A standard multiple regression analysis was applied to assess the predictors of HIV/AIDS stigma. Findings from the study showed an adequate knowledge of HIV/AIDS as 72.8% scored more than 17 out of the 24 basic questions on HIV/AIDS correctly. The respondents’ overall mean HIV/AIDS knowledge score was 18.22±3.80 out of 24 points. However there was a deficit in knowledge on the preventive role of male circumcision in HIV transmission (27.6%) and the high chance of getting HIV infection from sexual intercourse with a recently HIV infected individual (48.4%). Misconceptions existed among the respondents about the association between ritual cleansing of widows and HIV transmission (43.0%) and the stopping of ART at will due to side effects (54.1%). With respect to knowledge acquisition, the leading source of information is the electronic media (52.9% for radio, 75.8% for TV and 81.4% for cell phone) while newspapers (17.2%) are a minor source. Regarding HIV stigma, the findings revealed that HIV stigma is intertwined with other contextual stigmas of gender and sexual immorality. There was a high prevalence in the attribution of blame on female prostitution and promiscuity for the cause of HIV infection in this study. Furthermore, the findings in this study showed very pronounced negative stigmatising attitudes towards HIV infected women in the community especially in relation to child bearing. Levels of HIV/AIDS knowledge and AIDS stigma were influenced by education, perceived socio-economic status, living standard, media exposure, racial differences and employment status (p<0.05). The study revealed that there was a significant main effect of age group (18-24, 25-35, 36-49), specifically with knowledge regarding HIV transmission and the physiological impact of HIV; social distance towards PLWHA and stigmatising attitude towards HIV infected women.This study underscore the importance of developing and implementing stigma reduction interventions in the community to address attitudinal biases towards PLWHA especially regarding the females by encouraging social cohesion and support, HIV disclosure and involvement of role models, more greater awareness regarding PMTCT. Education on the importance of male circumcision and the long life usage of ART are also of utmost importance. To lend support to the current intervention measures on HIV/AIDS messages via a telephone helpline, there is need of sending text messages as a means of increasing HIV/AIDS knowledge should be encouraged. Finally, there is need for further explorative studies in acceptability, perceptions and barriers to male circumcision; the perceptions of ART and HIV infection and the relevance of ART in HIV stigma as well as AIDS stigma regarding childbearing and HIV infected women. Findings from this study have implications for the reduction of HIV related stigma and prevention. It is hoped that these findings and recommendations will greatly inspire, influence and inform policy makers, communities, stakeholders, empower PLWHA to cope with stigma as well as reduce stigma prevalence in the study area in particular and South Africa. Areas of further research that require urgent attention are also highlighted.