scholarly journals Stigma among tuberculosis patients and associated factors in urban slum populations in Uganda

2021 ◽  
Vol 21 (4) ◽  
pp. 1640-50
Author(s):  
Clare Ashaba ◽  
David Musoke ◽  
Solomon Tsebeni Wafula ◽  
Joseph Konde-Lule
Keyword(s):  
Urban Population ◽  
Associated Factors ◽  
Urban Setting ◽  
Outcome Variable ◽  
Urban Populations ◽  
Major Barrier ◽  
Tb Treatment ◽  
Stigma Score ◽  
Related Stigma ◽  
Hiv Aids

Background: Stigma continues to be a major barrier to tuberculosis (TB) control particularly in urban populations. Stigma can influence health seeking behaviour and affect adherence to TB treatment, yet few studies have examined TB related stigma and associated factors in Uganda. This study was therefore conducted to determine the level of stigma and associated factors among TB patients in an urban setting in Kampala, Uganda. Methods: A cross-sectional study was conducted in Makindye division, Kampala among 204 patients with TB aged 18 years and above. Data were collected on socio-demographic, individual patient and HIV/AIDS related factors using an intervieweradministered questionnaire. The outcome variable (stigma) was assessed on a four-point Likert scale from the participants’ perspective. Stigma scores ranged from 0 to 36 which were summed up and a median stigma score calculated. Individuals with a stigma score equal or greater than the median were categorized as having high stigma. A multivariable logistic regression analysis was performed to determine factors associated with TB stigma. Results: Over half (52%) of the participants were found to have high TB stigma. Knowing someone who had died of TBAOR = 4.42, 95% CI (1.69 - 11.50) and believing that TB and HIV symptoms were similarAOR = 3.05, 95% CI (1.29 - 7.22) were positively associated with high TB stigma. The odds of having high stigma were 79% lower among individuals who had been previously treated for TBAOR = 0.21, 95% CI (0.09 - 0.52). Conclusions: Stigma towards TB was high in this urban population and mainly associated with knowing a person who had died of TB, perception that symptoms of TB are similar to those of HIV/AIDS, and previous TB treatment. Interventions to mitigate TB stigma are needed in urban populations and should also address HIV/AIDS related stigma. Key terms: Stigma; tuberculosis; health facility; urban population; Uganda.

scholarly journals Prevalence of Diabetes Mellitus and Associated Factors in Southern Ethiopia: A Community Based Study

1970 ◽  
Vol 28 (4) ◽  
Author(s):  
Alemayehu Zekewos ◽  
Eskindir Loha ◽  
Tariku Egeno ◽  
Kindie Wubshet ◽  
Zelalem Merga
Keyword(s):  
Risk Factors ◽  
Associated Factors ◽  
Addis Ababa ◽  
Urban Setting ◽  
Diabetes Prevalence ◽  
Rural Setting ◽  
Outcome Variable ◽  
Southern Ethiopia ◽  
Community Based ◽  
Independent Variables

BACKGROUND: Like in all populations of the world, recently, diabetes became serious health problem in Ethiopian population, as indicated by few community- and institution-based studies. As high as 6.5% diabetes prevalence was reported in Addis Ababa while 5.1% in urban setting and 2.1% in rural setting of Northwest Ethiopia have been reported. This study aimed to provide additional data on the magnitude of diabetes and associated risk factors. The study aimed to determine the prevalence of diabetes in Bona District and identify contributing risk factors.METHODS AND MATERIALS: A cross-sectional community based survey for diabetes and associated factors was done from February-June, 2016 on a total of 2670 participants in the age range of 15-110 years. Participants were recruited to the study by using a two-stage simple random sampling technique. Data were collected by using structured questionnaire from consented participants. Data were entered, checked for quality and analyzed using SPSS for Windows version 20.0. Since the outcome variable was ordered categorical, we used ordinal regression model to identify associated factors. There was no multicollinearity among the independent variables included in the model. All the independent variables with p<0.25 during bivariate analysis wereincluded in the multivariate model. The level of significance wasset at P value < 0.05.RESULTS: The overall prevalence of diabetes (1.9%) from our survey was so high in rural setting that prevention and control mechanisms should be designed. The risk factors include advanced age (β=1.04(0.57-1.50)), systolic hypertension (β=0.59(0.01-1.18)), high waist circumference (β=0.86(0.34-1.39)) and postsecondary education (β=0.87(0.03-1.71)).KEYWORD: Diabetes, prevalence, risk factors

The Effects of HIV-Related Stigma on HIV Counselling and Testing in Nigeria: A Mediation Analysis

2020 ◽  
pp. 002190962096015
Author(s):  
Felix Oluyemi Adekunjo ◽  
Rajah Rasiah ◽  
Maznah Dahlui ◽  
Chiu Wan Ng
Keyword(s):  
Mediation Analysis ◽  
Structural Equation ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Perceived Seriousness ◽  
Related Stigma ◽  
Hiv Counselling And Testing ◽  
Hiv Aids

Human immunodeficiency viruses (HIV) counselling and testing (HCT) plays a major role in the continuum of HIV programmes in Nigeria. However, HIV-related stigma (STGM) poses a serious threat to its success. Consequently, a cross-sectional study was carried out to examine whether STGM mediates the relationships between the explanatory variables (HIV-related knowledge, HIV transmission misconception (MSHIV), and perceived seriousness of HIV/acquired immune deficiency syndrome (AIDS)), and the outcome variable (HCT service utilization). The mediation analysis was undertaken using data from 768 individuals collected through convenience sampling in the Local Government Areas of Alimosho, Ikorodu, and Surulere of Lagos state, and deploying partial least squares–structural equation modelling. The results show that STGM played a mediating role in the relationship between MSHIV, perceived seriousness of HIV/AIDS, and HCT utilization. These findings offer wide ramifications for the intensification and enforcement of Nigeria’s HIV/AIDS Anti-Discrimination Act 2014 to eradicate stigma, which is important to enhance uptake of HCT to achieve the United Nations’ 90-90-90 HIV targets by 2020.

scholarly journals Assessment of HIV-related stigma and determinants among people living with HIV/AIDS in Abeokuta, Nigeria: A cross-sectional study

2019 ◽  
Vol 7 ◽  
pp. 205031211986910
Author(s):  
Olaide Olutoyin Oke ◽  
Adeolu Oladayo Akinboro ◽  
Fatai Olatunde Olanrewaju ◽  
Olatunbosun Ayokunle Oke ◽  
Ayanfe Samuel Omololu
Keyword(s):  
Hiv Stigma ◽  
People Living With Hiv ◽  
Perceived Stigma ◽  
Cross Sectional ◽  
Stigma Score ◽  
Low Education ◽  
Related Stigma ◽  
Enacted Stigma ◽  
Living With Hiv ◽  
Hiv Aids

Introduction: HIV/AIDS-related stigma remains an essential barrier to the formulated care delivery and improved quality of life of people living with HIV/AIDS in sub-Saharan Africa. Only a few studies have evaluated stigma and its determinants as concerns people living with HIV/AIDS in Nigeria. Methods: A cross-sectional design study recruited 386 people living with HIV/AIDS attending the government clinic, Federal Medical Centre, Abeokuta, Nigeria, for the assessment of stigma using Berger’s HIV stigma scale and United States Agency International Development-recommended indicators and questions on HIV-related stigma among people living with HIV/AIDS. Data were analyzed using SPSS 21. Results: Of the 386 people living with HIV/AIDS, 322 (83.4%) were females and 64 (16.6%) were males, and 96.9% had disclosed their HIV status. Overall, mean perceived stigma score was moderately high at 95.74 (standard deviation = ±16.04). Majority (77.2%) of the participants experienced moderately perceived stigma. Among the subscales, disclosure concerns contributed the most to stigma score at 68.9%. Enacted stigma in the last 12 months was documented in 35.8% (138). There was no association observed between age, gender, marital status and HIV-related stigma. However, low education was associated with higher negative self-image perception (31.83 ± 5.81 vs 29.76 ± 5.74, p < 0.001). Furthermore, higher perceived stigma score was associated with abandonment by spouses (p < 0.001), isolation from household members (p < 0.001) and social exclusion (p < 0.001). We demonstrated a correlation between the domains of enacted stigma and Berger HIV stigma scales except for the loss of resources. Conclusion: Perceived HIV-related stigma is moderately high among people living with HIV/AIDS. Low education, disclosure concerns, spousal or household abandonment and social exclusion are the significant contributors. HIV-related stigma preventive interventions at different levels of care are advocated.

scholarly journals Quality of Life and its Associated Factors among People Living with HIV/AIDS in Southeast of Iran (2018-2019)

2020 ◽  
Author(s):  
Neda Malekmohammadi ◽  
Ali Ahmad Rafiee Rad ◽  
Abedin Iranpour ◽  
Nima Ghalekhani ◽  
Mehdi Shafie ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Associated Factors ◽  
People Living With Hiv ◽  
Infected People ◽  
Stigma Score ◽  
Multivariable Regression ◽  
Living With Hiv ◽  
Correlated Factors ◽  
Hiv Aids

Abstract Aim: This study aimed to evaluate the quality of life (QoL) and its associated factors among people living with HIV referring to two referral centers for HIV infected people in the southeast of Iran.Methods: Using a convenience sampling, 104 HIV-infected people were recruited. Data were collected using the HIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument with 42 items divided into 9 fields: overall activity, sexual activity, disclosure worries, health worries, financial worries, HIV mastery, life satisfaction, and medication concerns and provider trust. The higher score indicated the higher QoL. Bivariable and multivariable linear regressions were performed to analysis the data.Results: The average QoL score was 52.5 (standard deviation [SD] 13.9) (range 0 to 100). In the multivariable regression model, those who experienced higher external stigma score (B= -1.9; 95% CI-2.6; -1.1) and higher internal stigma score (B=-1.1; 95%CI=-1.5; -0.6) and those who were emplyed (B=-5.9; 95% CI=-9.7; -2.1) reported lesser QoL. However, divorced or widowed people versus single people (B=6.9; 95% CI=0.7; 13.1) reported a higher QoL.Conclusions: Studying the QoL among HIV infected patients and its correlated factors and trying to improve that could reduce the problems of HIV infected patients. This study showed, QoL among this population is a multidimensional and several factors (internal and external stigma, job and marital status) could affect it.

Healthcare Utilization, Unmet Service Needs, and Medication Adherence Among People Living with HIV/AIDS

2020 ◽  
Vol 18 (6) ◽  
pp. 436-442
Author(s):  
Xiangjun Zhang ◽  
Roy F. Oman ◽  
Trudy A. Larson ◽  
Elizabeth J. Christiansen ◽  
Michelle L. Granner ◽  
...  
Keyword(s):  
Health Promotion ◽  
Service Utilization ◽  
Medical Service ◽  
Outcome Variable ◽  
People Living With Hiv ◽  
Service Needs ◽  
Art Adherence ◽  
Living With Hiv ◽  
Adherence Group ◽  
Hiv Aids

Background: Comorbidity rates and service needs are high among people living with HIV/AIDS (PLWHA). The effects of service utilization and unmet service needs on antiretroviral therapy (ART) adherence are not well understood. The purpose of this study was to investigate associations among PLWHA’s service utilization, unmet service needs, and ART adherence. Methods: PLWHA (N=162) 18 years or older were recruited from a Nevada statewide needs assessment project in 2016. Participants completed a self-administered questionnaire on paper or online. The independent variables were service utilization and unmet service needs. The outcome variable was ART adherence. Multivariable logistic regression analyses were conducted to examine associations between the amount of utilized services and unmet service needs with ART adherence. Results: Only 12 (7.5%) participants reported they received all needed services. The ART non-adherence group showed significantly higher unmet medical service needs compared to the ART adherence group (p=0.007). Unmet medical service needs (Adjusted Odds Ratio (AOR) 0.69, CI 0.53-0.90) and unmet support service needs (AOR 0.68, CI 0.48-0.97) were negatively associated with ART adherence. However, utilizing medical services (AOR 1.06, CI 0.87-1.30) and support services (AOR 0.88, CI 0.74-1.04) in the current year were not significantly associated with ART adherence. Conclusion: The results of this study indicate that health promotion programming should focus not only on introducing new services at the community level, but also work to optimize the availability and awareness of current services. Furthermore, health promotion programs should focus on filling service coverage gaps and improving the facilitation of services.

scholarly journals The long term effect of pulmonary tuberculosis on income and employment in a low income, urban setting

Thorax ◽  
2020 ◽  
pp. thoraxjnl-2020-215338
Author(s):  
Jamilah Meghji ◽  
Stefanie Gregorius ◽  
Jason Madan ◽  
Fatima Chitimbe ◽  
Rachael Thomson ◽  
...  
Keyword(s):  
Low Income ◽  
Disease Onset ◽  
Treatment Completion ◽  
Well Being ◽  
Urban Setting ◽  
Financial Strain ◽  
First Episode ◽  
Health Seeking ◽  
Tb Treatment

BackgroundMitigating the socioeconomic impact of tuberculosis (TB) is key to the WHO End TB Strategy. However, little known about socioeconomic well-being beyond TB-treatment completion. In this mixed-methods study, we describe socioeconomic outcomes after TB-disease in urban Blantyre, Malawi, and explore pathways and barriers to financial recovery.MethodsAdults ≥15 years successfully completing treatment for a first episode of pulmonary TB under the National TB Control Programme were prospectively followed up for 12 months. Socioeconomic, income, occupation, health seeking and cost data were collected. Determinants and impacts of ongoing financial hardship were explored through illness narrative interviews with purposively selected participants.Results405 participants were recruited from February 2016 to April 2017. Median age was 35 years (IQR: 28–41), 67.9% (275/405) were male, and 60.6% (244/405) were HIV-positive. Employment and incomes were lowest at TB-treatment completion, with limited recovery in the following year: fewer people were in paid work (63.0% (232/368) vs 72.4% (293/405), p=0.006), median incomes were lower (US$44.13 (IQR: US$0–US$106.15) vs US$72.20 (IQR: US$26.71–US$173.29), p<0.001), and more patients were living in poverty (earning <US$1.90/day: 57.7% (211/366) vs 41.6% (166/399), p<0.001) 1 year after TB-treatment completion compared with before TB-disease onset. Half of the participants (50.5%, 184/368) reported ongoing dissaving (use of savings, selling assets, borrowing money) and 9.5% (35/368) reported school interruptions in the year after TB-treatment completion. Twenty-one participants completed in-depth interviews. Reported barriers to economic recovery included financial insecurity, challenges rebuilding business relationships, residual physical morbidity and stigma.ConclusionsTB-affected households remain economically vulnerable even after TB-treatment completion, with limited recovery in income and employment, persistent financial strain requiring dissaving, and ongoing school interruptions. Measures of the economic impact of TB disease should include the post-TB period. Interventions to protect the long-term health and livelihoods of TB survivors must be explored.

scholarly journals The role of unintended pregnancy in internalized stigma among women living with HIV in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Chace Dwyer ◽  
Aparna Jain ◽  
Wilson Liambila ◽  
Charlotte E. Warren
Keyword(s):  
Unintended Pregnancy ◽  
Hiv Treatment ◽  
Outcome Variable ◽  
Internalized Stigma ◽  
Health Seeking ◽  
Logistic Regression Models ◽  
Stigma And Discrimination ◽  
Women Living With Hiv ◽  
Related Stigma ◽  
Living With Hiv

Abstract Background Kenya has successfully expanded HIV treatment, but HIV-related stigma and discrimination, and unintended pregnancy remain issues for many Kenyan women living with HIV. While HIV-related stigma can influence the health seeking behaviors of those living with HIV, less is known about how reproductive health outcomes influence internalized stigma among women living with HIV. Methods Baseline data only were used in this analysis and came from an implementation science study conducted in Kenya from 2015 to 2017. The analytic sample was limited to 1116 women who are living with HIV, between 18 to 44 years old, and have ever experienced a pregnancy. The outcome variable was constructed from 7 internalized stigma statements and agreement with at least 3 statements was categorized as medium/high levels of internalized stigma. Unintended pregnancy, categorized as unintended if the last pregnancy was mistimed or unwanted, was the key independent variable. Univariate and multivariate logistic regression models were used to assess the association between unintended pregnancy and internalized stigma. Associations between internalized stigma and HIV-related discrimination and violence/abuse were also explored. Results About 48% agreed with at least one internalized stigma statement and 19% agreed with at least three. Over half of women reported that their last pregnancy was unintended (59%). Within the year preceding the survey, 52% reported experiencing discrimination and 41% reported experiencing violence or abuse due to their HIV status. Women whose last pregnancy was unintended were 1.6 times (95% CI 1.2–2.3) more likely to have medium/high levels of internalized stigma compared to those whose pregnancy was wanted at the time, adjusting for respondents’ characteristics, experiences of discrimination, and experiences of violence and abuse. Women who experienced HIV-related discrimination in the past 12 months were 1.8 times (95% CI 1.3–2.6) more likely to have medium/high levels of internalized stigma compared to those who experienced no discrimination. Conclusions Results suggest that unintended pregnancy is associated with internalized stigma. Integrated HIV and FP programs in Kenya should continue to address stigma and discrimination while increasing access to comprehensive voluntary family planning services for women living with HIV.

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