Social intolerance, risky sexual behaviors and their association with HIV knowledge among Ugandan adults: results from a national survey

ABSTRACT

Understanding the link between HIV knowledge, risky sexual behaviors, and social intolerance such as stigma and discrimination is important for HIV prevention and treatment program planning. We investigated whether intolerant attitudes and practices among Ugandan adults were associated with HIV-transmission knowledge.

We analyzed data from a nationally representative population-based household survey, the 2011 Uganda AIDS Indicator Survey. A total of 15,526 participants who responded to questions on HIV knowledge, social intolerance and risky sexual behavior were included in this analysis.

Results show that 34.8% of respondents reported having fear of casual contact with people living with HIV (PLWA), 21% blame PLWAs for their disease, 62% would not want HIV infection in their family disclosed, while 25% reported engaging in risky sexual behaviors. After adjusting for age, sex, residence, and level of education, people with low HIV-transmission knowledge had almost three-fold higher odds of fear of casual contact with a PLWA (aOR = 2.70, 95%CI = 2.33–3.13), and had 30% higher odds of HIV-related stigmatizing attitudes (aOR = 1.29, 95%CI = 1.07–1.54). Further, they had 47% higher odds of having sex under the influence of alcohol (aOR = 1.47, 95%CI = 1.25–1.73) and 40% higher odds of having unprotected sex with any of their last three sex partners (aOR = 1.39, 95%CI = 1.06–1.89).

Our findings show that intolerant attitudes such as stigma still persist, particularly among people with low HIV-transmission knowledge. Improving knowledge about HIV/AIDS can foster positive attitudes and building safe practices among populations, and is critical for improving prevention and treatment programs.

KEYWORDS:

• Social intolerance attitudes
• risky sexual behaviors
• HIV knowledge

Acknowledgments

We acknowledge Jennifer Galbraith, Ph.D, of the Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda, for providing useful comments during preparation of this paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approvals

We conducted secondary data analysis using the Uganda AIDS Indicator Survey de-identified data that is publicly available and requires no ethical approvals. However, permission to use these data was obtained from the Demographic and Health Surveys division at ICF International, from where the data was downloaded. The Ministry of Health of Uganda carried out data collection for the 2011 UAIS.

ORCID

Damazo T. Kadengye http://orcid.org/0000-0001-7586-4928