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Background: Patients with HIV consult traditional healers (THs). These THs can both delay care for people living with HIV (PLHIV) and transmit HIV through poor infection control practices. The main objective of this study was to evaluate knowledge and practices of THs regarding HIV in Bukavu. Methods: A cross-sectional study using quantitative approach was carried out among 71 THs in Bukavu City. The collected data included the following topics: personal and socio-demographic characteristics, HIV knowledge, and infection control practices. Descriptive statistics, independent-samples T-test or F-test, and multiple linear regression were used to analyze the data with a p-value < 0.05. Results: The THs' mean age was 49.2 ± 11.2 years, and the majority were aged 40 to < 60 years. Males constituted 88.7% of THs with a male-to-female ratio of 7.9. In general, 47.9% of study participants had poor knowledge about HIV/AIDS infection, 45.1% of them had fair knowledge, and only 7.0% had good knowledge. Overall, 43.7% of THs had poor infection control practices, 52.1% of THs had fair practices, and only 4.2% of participants had good practices. Results of multiple linear regression analysis revealed that none of the personal and demographic variables studied were significant predictors of their knowledge about HIV/AIDS (p > 0.05). In terms of practices, two variables were significant predictors of infection control practices: living in Ibanda and receiving training in taking care of HIV/AIDS. Conclusion and recommendations: : The study revealed that THs' knowledge about HIV infection was insufficient and that they had poor infection control practices. Formal standardized training on HIV infection should be organized for all THs so that they can always refer their patients to modern, reliable antiretroviral therapy (ART) clinics and reduce the risk of occupational exposure in their practices. Although PPE's assistance for THs is required in terms of protective measures, the province health authority must also oversee infection control procedures at THs' offices. [ABSTRACT FROM AUTHOR]

Globally and in Malaysia, there are increasing rates of HIV infection among older adults but a corresponding decline in other younger age groups. We aimed to investigate the HIV-related knowledge, perceived risks, attitudes, and risk behaviours among multi-ethnic urban-dwelling older adults in Malaysia. A cross-sectional, questionnaire-based study was conducted among 320 adults aged 50 years and above residing in urban Klang Valley, Malaysia. Participants were recruited via convenience sampling in the community and in the outpatient clinics and pharmacy of University Malaya Medical Centre, Malaysia, from April 2021 to January 2022. The median (IQR) age of participants was 58 (55–64) and 42.5% were males. The median (IQR) knowledge score was 10 (8–12) out of 14. Significant knowledge gaps were noted and ethnic Chinese, higher education levels and better HIV-related attitudes were associated with better scores. The median (IQR) attitude score was 49 (41–55) out of 65. Ethnic Chinese and Indian, knowing people living with HIV (PLHIV), and better HIV-related knowledge were associated with better attitude scores. Many (43.8%) older adults were sexually active however rates of consistent condom use was low (19%) and the majority (89.9%) of participants had low self-perceived risk of HIV. These findings highlight underlying drivers for HIV transmission and delayed treatment among older adults in Malaysia and indicate a need for targeted HIV prevention programs for this population. [ABSTRACT FROM AUTHOR]

Introduction: Disability and HIV are intricately linked, as people with disabilities are at higher risk of contracting HIV, and living with HIV can lead to impairments and disability. Despite this well‐established relationship, there remains limited internationally comparable evidence on HIV knowledge and access to testing for people with disabilities. Methods: We used cross‐sectional data from 37 Multiple Indicator Cluster Surveys. Surveys were from six UNICEF regions, including East Asia and Pacific (n = 6), East and Central Asia (n = 7), Latin America and the Caribbean (n = 6), Middle East and North Africa (n = 4), South Asia (n = 2) and sub‐Saharan Africa (n = 12). A total of 513,252 people were eligible for inclusion, including 24,695 (4.8%) people with disabilities. We examined risk ratios and 95% confidence intervals for key indicators on HIV knowledge and access to testing for people with disabilities by sex and country. We also conducted a meta‐analysis to get a pooled estimate for each sex and indicator. Results: Men and women with disabilities were less likely to have comprehensive knowledge about HIV prevention (aRR: 0.74 [0.67, 0.81] and 0.75 [0.69, 0.83], respectively) and to know of a place to be tested for HIV (aRR: 0.95 [0.92, 0.99] and 0.94 [0.92, 0.97], respectively) compared to men and women without disabilities. Women with disabilities were also less likely to know how to prevent mother‐to‐child transmission (aRR: 0.87 [0.81, 0.93]) and ever have been tested for HIV (aRR: 0.90 [0.85, 0.94]). Conclusions: Men and women with disabilities have lower overall HIV knowledge and in particular women with disabilities also indicate lower testing rates. Governments must include people with disabilities in HIV programmes by improving disability‐inclusion and accessibility to HIV‐related information, education and healthcare services. [ABSTRACT FROM AUTHOR]

Introduction: Although strong scientific evidence of the efficacy and effectiveness of treatment‐as‐prevention (TasP) is available, full endorsement of the "Undetectable = Untransmittable" (U = U) and "zero‐risk" messages could be improved. Increasing knowledge about HIV transmission, prevention and treatment is a critical component of care efforts. The study assessed knowledge of HIV transmission and prevention strategies, and the perceived accuracy of the slogan U = U among sexual and gender minorities (SGM) in Brazil. Methods: Cross‐sectional web‐based survey targeting adult SGM living in Brazil (2021−2022) recruited on social media and dating apps. We used the 12‐item HIV Knowledge Assessment (HIV‐KA) questionnaire to assess HIV knowledge, three items of which address pre‐exposure prophylaxis (PrEP), post‐exposure prophylaxis and TasP. Perceived accuracy of the U = U slogan was assessed with the question: "With regards to HIV‐positive individuals transmitting HIV through sexual contact, how accurate do you believe the slogan U = U is?". We a priori grouped the study population into three mutually exclusive groups: people living with HIV (PLHIV), HIV negative and HIV unknown. We used logistic regression models to assess factors associated with high HIV knowledge and perception of the U = U as completely accurate. Results: Of 50,222 individuals accessing the questionnaire, 23,981 were included: 5071 (21.0%) PLHIV, 17,257 (71.5%) HIV negative and 1653 (6.9%) HIV unknown. The proportion of participants with high knowledge was significantly higher for PLHIV and HIV negative (48.1% and 45.5%, respectively) compared to 26.1% of HIV unknown. More PLHIV perceived U = U as completely accurate (80.4%), compared to 60.0% of HIV negative and 42.9% of HIV unknown. HIV knowledge correlates with perceived accuracy of the U = U slogan across all groups. Higher HIV knowledge was associated with higher income and education regardless of HIV status. Among HIV‐negative participants, PrEP awareness and use were associated with higher knowledge and accurate perception of the U = U slogan. Conclusions: Our findings show that HIV knowledge and perceived accuracy of U = U are strongly correlated, that knowledge differs according to HIV status, and that poor socio‐economic is linked to poor knowledge among SGM from Brazil. Educational strategies regarding TasP, U = U and zero risk targeting socio‐economically vulnerable populations are urgent in Brazil. [ABSTRACT FROM AUTHOR]

South Africa is the epicentre of the HIV pandemic. Although there have been health promotion education campaigns to reduce HIV incidence, these have not achieved the desired outcomes. When exploring the effectiveness of these campaigns, it is useful not only to examine HIV knowledge, but also to explore the relationship between that knowledge and health-related behaviour. This study aimed to determine the (1) level of knowledge of HIV prevention, (2) relationship between the level of knowledge and the adoption of these behaviours and (3) barriers to sexual behaviour change of vulnerable women in Durban's city centre, KwaZulu-Natal, South Africa. A mixed methods approach was used to collect information from a marginalised population of women (n = 109) attending a non-governmental organisation, which provides for the needs of people from low socio-economic strata. Data were collected during September 2018 at a wellness day programme at the centre. A total of 109 women, over the age of 18 years answered the questionnaire. Knowledge of HIV transmission was high, with majority of participants correctly identifying modes of transmission. Almost all the participants (91.2%) had been tested for HIV, with 68.8% tested a minimum of three times. Despite this, sexual risk behaviour was high. Despite the high level of knowledge of HIV transmission, there was no relationship between HIV knowledge and adoption of behaviours for the prevention of HIV transmission (p =.457). However, bivariate analysis showed an association between transactional sex and living in informal housing (OR = 31.94, 95% CI: 5.65–180.63, p <.001). Living in informal housing was also associated with having multiple current sexual partners (OR = 6.30, 95% CI: 1.39–28.42, p =.02). Multivariate analysis, after adjusting for all other factors, indicated that the odds of having transactional sex was increased by 23 times in those who did not have formal housing (OR = 23.306, 95% CI: 3.97–144.59, p =.001). Qualitative responses showed that women perceived poverty as the overarching factor determining the lifestyle choices which impacted their health. They indicated a need for employment opportunities and provision of housing to alleviate both poverty as well as transactional sex. Although, participants from this study understood the benefits of the protective behaviours to prevent HIV transmission, economic and social factors do not afford this vulnerable group the opportunity nor the motivation to adopt such behaviours. In the current climate of increasing unemployment and escalating GBV, urgent interventions are needed in terms of employment opportunities and empowerment drives to prevent an increase in HIV transmission. [ABSTRACT FROM AUTHOR]

Community-based organizations (CBOs) are well-positioned to address the negative effects of HIV stigma, which is prevalent in the U.S. South. This article describes a Gilead COMPASS-funded small grants and capacity-building program for CBOs to address stigma and describes the broad reach and positive outcomes associated with program implementation. [ABSTRACT FROM AUTHOR]

Background: This study responds to the increasing rate of HIV/AIDS and unplanned pregnancies among Chinese college students from a sociocultural perspective, and investigates the influences of sociocultural factors in shaping sex-related beliefs and acts among Chinese college students. Methods: An online survey was conducted on a purposive sample of 1286 female college students in four cities in east and west China. Results: Significant east–west disparities have emerged in the rate of sexual intercourse experience, rate of safer sex, conservative sexual values, authority sex education, unofficial sex knowledge access and HIV knowledge. A higher rate of sexual activity, but lower rate of safer sex, were found among the students in the west relative to those in the east. Conclusions: This study demonstrates that in a large country, such as China, regional disparities in economy, social development and sexual norms are salient to affect individuals' sexual behaviours. A total of 1286 female college students in China was surveyed to investigate their sexual behaviours. The results show that between those students in the east (Shanghai and Nanjing) and those in the west (Chongqing and Chengdu), their rate of sexual intercourse experience, rate of safer sex, conservative sexual values, authority sex education, unofficial sex knowledge access and HIV knowledge level were different. Compared with the eastern students, western students have a higher rate of sexual activity, but lower rate of safer sex. The regional disparities in economy, social development and culture affect individuals' sexual behaviours saliently. [ABSTRACT FROM AUTHOR]

Aim: To estimate the pooled prevalence of HIV testing service utilization and its association with HIV-related knowledge among students in higher education institutions in Ethiopia. Subjects and methods: The MEDLINE, EMBASE, Web of Science, and Cochrane Library databases were systematically reviewed for published articles on HIV testing or voluntary counseling and testing (VCT) service utilization among students in higher education institutions in Ethiopia. The Higgins I2 test was used to assess the heterogeneity between the studies. A random-effects model was applied to determine the pooled prevalence of VCT service utilization. Result: After reviewing 348 studies, 14 studies fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled magnitude of VCT service utilization among students in higher education institutions in Ethiopia was 46.0% (95% confidence interval [CI]: 35.1, 56.9). The odds of VCT service utilization were 2.6 times as high among students who had good HIV-related knowledge as those who had poor HIV-related knowledge (adjusted odds ratio = 2.64; 95% CI: 1.31–5.31). Conclusion: In general, it was found that VCT service utilization among students at higher education institutions in Ethiopia was low. More than half (54.0%) of students did not know their HIV status. Good HIV-related knowledge was positively associated with VCT service utilization. Therefore, to encourage HIV testing utilization, the HIV education program should be strengthened through institutional capacity-building (training) and improving supply chain systems (AIDS leaflets, stickers, newspapers, and billboards). [ABSTRACT FROM AUTHOR]

Background: Long-distance truck drivers (LDTDs) have a higher rate of HIV infection compared to the general population. This is due to their living and working conditions which predispose them to riskier sexual behaviours. Inadequate knowledge of HIV and AIDS, coupled with risky sexual behaviours such as unprotected sex with commercial sex workers (CSWs), predisposes LDTDs to contract and propagate HIV. This study aims to determine the factors associated with buying sex and the knowledge that condoms prevent HIV transmission among long-distance truck drivers at Kazungula weighbridge terminal in the Chobe District of Botswana. Methods: A cross-sectional descriptive survey was employed and 399 LDTDs participated. A questionnaire was used to collect sociodemographic data and information on knowledge of HIV and AIDS and the sexual behaviours of the LDTDs. Results: The results reveal that more than half of the LDTDs (56.9%; n = 227) had paid for sex with CSWs at some point in their travels, and 27.1% (n = 108) reported having had unprotected sex with CSWs. The LDTDs who preferred to have sex with CSWs without a condom had about five times the odds of buying sex with CSWs than those who preferred to use a condom (AOR 4.9; 95% CI 2.85–8.46). Disliking condom use was a factor contributing to less knowledge of condom use preventing HIV among the LDTDs (AOR 0.4; CI 0.17–0.97). Conclusion: It can be concluded from the results of this study that the LDTDs engage in considerable risky sexual behaviours, and associated factors were found to be multidimensional. This population remains of concern in HIV acquisition and transmission. Therefore, there is a need for a robust public health response to deal with the problem of both new infection and re-infection with HIV in this population. [ABSTRACT FROM AUTHOR]

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Background: Ascribed traditional gender role has rarely been examined in the topical area of protected sex. Objective: The purpose of this study was to examine the relationship between HIV knowledge, ascribed cultural gender roles of machismo and marianismo, acculturation, attitudes toward risky sexual behaviors and sexual self-efficacy on protected sex, and the mediating effect of sexual self-efficacy between these predictors and protected sex. Methods: Part of a larger study, Hispanic college students from a Hispanic-serving institution in a U.S. southern border city were recruited. Results and Conclusion: Sexual self-efficacy was found a significant mitigating factor against sexual risks associated with machismo as well as a positive reinforcing element on attitudes toward protected sex. Study findings have implications toward the development of culturally sensitive evidence-based interventions that promote sexual self-efficacy skills among Hispanic males who strongly identify with culturally ascribed gender roles. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to understand how the association between internalized homonegativity (IH) and sexual risk behavior differed in Spain (N = 3,336) and Turkey (N = 550). Methods: We used multigroup structural equation modeling. Results: HIV and pre-exposure prophylaxis (PrEP) knowledge mediated the relationship between IH and sexual risk behavior among MSM in Spain, but not among men in Turkey. Higher HIV/PrEP knowledge was associated with higher sexual risk behavior among MSM in Spain, while among MSM in Turkey the association was in the opposite direction. Conclusions: The meaning of safe-sex may differ across contexts, and this should be taken into consideration when tailoring HIV prevention programs. [ABSTRACT FROM AUTHOR]

A better understanding of the complex relationships between HIV knowledge, self-efficacy, perception of peer condom use, and condom-use intention is needed for improving HIV prevention among adolescents. The study analyzed survey data collected from high school students (N = 1970) in the Bahamas. Mediation and moderated mediation modeling analyses were used for data analysis. Results showed that self-efficacy mediated the association between HIV knowledge and condom-use intention. Perception of peer condom use moderated the mediation model by modifying the HIV knowledge-self-efficacy and self-efficacy-condom-use intention associations among males, but not for females. Findings of the study suggest the significant impact of perception of peer condom use in competition with HIV knowledge and self-efficacy in promoting condom use. Effective intervention program may consider targeting the modification of adolescents' perception of peer condom use to promote condom use among adolescents. [ABSTRACT FROM AUTHOR]

The global trend of poorer outcomes across the HIV treatment cascade for men has drawn attention to the importance of engaging men in prevention and treatment services. The South African construction industry is one of the economic sectors most adversely affected by HIV/AIDS. Previous research on HIV testing behaviour among workers in the industry has revealed that male workers are less likely to be tested than female workers. Given this gender differential, this study employed a field-administered survey to gather data from 450 site-based, male construction workers in Western Cape, South Africa. An integrated model comprising demographic, cognitive, and behavioural factors was then hypothesised to explain HIV testing behaviour. Bivariate analysis and structural equation modelling were then used to test the model. Findings indicate that HIV knowledge, having previously had an STI, and possessing a positive attitude towards HIV testing are terminal predictors of testing behaviour. As a strategy for positively influencing testing behaviour, employers should ensure that effective communication about HIV testing is established with workers across all levels of education and ethnic groups. Interventions relating to risky sexual behaviour need particular attention, and where possible HIV testing should be coupled with general STI screening. [ABSTRACT FROM AUTHOR]

In a sample of men who have sex with men (MSM) (N = 3436) in Spain who bear intrinsic HIV risk, we investigated how internalised homonegativity (IH) is associated with the number of non-steady male partners with condomless intercourse (as a proxy of sexual risk behaviour). Using structural equation modelling (SEM), we examined the relationship between IH and sexual risk behaviour, and mediating effects of HIV/PrEP knowledge and substance use during sex on this relationship. We found no direct association between IH and sexual risk behaviour, nor did IH influence substance use during sex. In line with our hypothesis, association between IH and sexual risk behaviour was significant when mediated by HIV/PrEP knowledge. We found that as IH increased, sexual risk behaviour decreased, because higher IH was associated with lower HIV/PrEP knowledge while higher HIV/PrEP knowledge was associated with increased non-condom use with non-steady partners. Substance use during sex was significantly associated with sexual risk behaviour. Our results emphasize the continuing importance of prevention strategies focused on behavioural changes and community level interventions, especially targeting substance use. [ABSTRACT FROM AUTHOR]

Background: Impulsive personality traits (IPTs) are key predictors of individuals' engagement in sexual risk behaviours. This study investigated the associations between IPTs and HIV-related knowledge, beliefs and behaviours among Chinese college students.Methods: A sample of 1062 freshmen (first year) and sophomore (second year) students was obtained through stratified random sampling from 11 universities and colleges in Chengdu, China. The sociodemographic information, and HIV-related knowledge, beliefs and behaviours were investigated. A 20-item Short UPPS-P Impulsive Behaviour Scale (S-UPPS-P) was employed to estimate IPTs. Contingency table analyses (χ 2 ) and adjusted logistic regression were used to analyse the association between IPTs and HIV-related knowledge, beliefs and behaviours.Results: The S-UPPS-P scale measure of IPTs yielded scores among college students ranging from 26 to 70. Students with a greater level of IPTs were more likely to have a high level of HIV stigma (aOR=1.46, 95% CI: 1.13-1.89), and a low level of HIV knowledge (aOR=1.41, 95% CI: 1.11-1.80) and HIV prevention beliefs (aOR=1.40, 95% CI: 1.09-1.80). All variables of HIV-related behaviours were not significantly associated with IPTs (all P >0.05).Conclusions: Future campus health education should provide HIV education without neglect of early identification of students' IPTs. [ABSTRACT FROM AUTHOR]

South Africa implemented Universal Test & Treat (UTT) guidelines in September 2016. We examine HIV/ART knowledge among newly diagnosed from a prospective study enrolling newly diagnosed HIV-positive adults, under same-day ART policy, at four primary health clinics in Johannesburg, South Africa. We describe factors associated with high HIV/ART related knowledge score among newly diagnosed patients using Poisson regression. We included 652 HIV positive adults (64.1% female; median age 33 years (IQR: 28–39). Overall, 539 (82.7%) patients were classified as having high HIV/ART knowledge, 14.7% medium knowledge and 2.6% had low knowledge. HIV/ART knowledge was mainly associated to high English literacy (aRR 0.9 Medium vs High, 95% CI: 0.8–0.9; aRR 0.7 for Low vs High: 95% CI: 0.6–0.9). However, patients who did not disclose their intentions for HIV test (aRR 0.9, not disclosed intentions vs having disclosed intentions to test, 95% CI: 0.8–0.9), participants who indicated concerns with ART (aRR 0.9 moderate to high vs low concerns, 95% CI: 0.8–0.9) were less likely to have high knowledge. Our results highlight a correlation between English literacy and good knowledge. There is a need to make information more accessible in a non-English language. Addressing this gap is critical in achieving the WHO targets. [ABSTRACT FROM AUTHOR]

Objective: The Buffalo, New York region is one of the leading refugee resettlement areas in the country, settling 94% of African refugees in 2014. However, little is known about their health beliefs, particularly regarding sexual health and HIV. This study's purpose was to describe HIV attitudes and beliefs in a sample of African refugee women, a population that is increasingly present in the country, yet seldom represented in the literature. Design: A convenience sample of 101 African refugee women were recruited via snowball technique in Buffalo, New York. Data were collected from July 2017–July 2018, via paper-pen survey, and were analyzed using descriptive statistics. Results: Participants had low levels of education, but high HIV screening rates. Inconsistencies between knowledge of HIV acquisition and behaviors relating to HIV positive individuals may indicate HIV stigma among the population. Conclusion: Novel strategies geared towards educational levels and societal norms to educate African refugee women about HIV are urgently needed. [ABSTRACT FROM AUTHOR]

Background: Ascribed traditional gender role has rarely been examined in the topical area of protected sex. Objective: The purpose of this study was to examine the relationship between HIV knowledge, ascribed cultural gender roles of machismo and marianismo, acculturation, attitudes toward risky sexual behaviors and sexual self-efficacy on protected sex, and the mediating effect of sexual self-efficacy between these predictors and protected sex. Methods: Part of a larger study, Hispanic college students from a Hispanic-serving institution in a U.S. southern border city were recruited. Results and Conclusion: Sexual self-efficacy was found a significant mitigating factor against sexual risks associated with machismo as well as a positive reinforcing element on attitudes toward protected sex. Study findings have implications toward the development of culturally sensitive evidence-based interventions that promote sexual self-efficacy skills among Hispanic males who strongly identify with culturally ascribed gender roles. [ABSTRACT FROM AUTHOR]

Black and Latina women are disproportionately impacted by HIV/AIDS. Despite existing research linking social networks and HIV risk among men who have sex with men (MSM) and other high-risk populations, little research has examined how ethnic/racial minority women's social networks shape HIV prevention and intervention targets. Using interviews with a sample of 165 predominantly Black and Latina-identifying women from a small city in the Western U.S., this research examines the relationship between egocentric network characteristics and HIV knowledge, attitudes, and testing history. Results reveal that network characteristics play a significant role in shaping HIV-related knowledge, prejudice, and testing intention but not HIV testing history. Individual-level factors like homelessness and perceptions of testing barriers are more salient for explaining testing behaviors than network characteristics. Intervention efforts to improve knowledge and reduce prejudice among Black and Latina women may benefit from mobilizing network ties. [ABSTRACT FROM AUTHOR]

Background: Healthy sexual behavior is critical for controlling the HIV/AIDS epidemic among university students, particularly in regions with increasing infection rates among university students in China.Methods: This study investigated the prevalence of unhealthy sexual behavior in the past 6 months and the associated demographic and psychosocial factors among sexually active Chinese university students. Self-identified sexually active Chinese university students were recruited for the study.Results: The study found that most students used condoms inconsistently during sexual intercourse (54.8%), and logistic regression showed that condomless sex was associated with being raised by a single parent (AOR = 1.934, 95% CI 1.234-3.031) or by grandparents or others (AOR = 1.583, 95% CI 1.003-2.50) and with sometimes using dating apps (AOR = 1.496, 95% CI 1.106-2.024). The independent protective factors for condomless sex were HIV knowledge scores between 15 and 18 compared to scores of 0 to 4 (AOR = 0.434, 95% CI 0.244-0.771). Among sexually active university students, 15.5% reported that they had multiple sexual partners; having multiple sexual partners was associated with sometimes (AOR = 2.543, 95% CI 1.553-4.167) or always (AOR =4.048, 95% CI 2.177-7.527) using dating apps. Being female (AOR = 0.402, 95% CI 0.231-0.699) and in a relationship (AOR = 0.236, 95% CI 0.154-0.363) were protective factors against having multiple sexual partners.Conclusions: There is an urgent need to promote HIV prevention and to implement psychosocial interventions by providing comprehensive sex education and access to condoms and health care on campuses to decrease the potential factors related to unhealthy sexual behaviors among university students. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to implement a HIV stigma reduction/health literacy educational program to investigate HIV stigma reduction and HIV knowledge and health literacy expansion within a cross-generational African American faith center on the west side of Chicago. Subject and methods: The study included a community-based mixed method design, enveloped with elements of "stigma reduction, intergroup contact and religious social capital" theories, analyzed a sample size of fourteen (N = 14) faith center participants' pre- and post-assessment scores and their direct quotes gathered from focused observations. Results: The study presented significant difference found in HIV knowledge (p =.007), and (HIV) health literacy (p =.041). Additionally, significant difference was found in four out of fifteen HIV stereotypes subscales scores on the Stereotype About AIDS Questionnaire. Conclusion: The study suggests that HIV stigma has potentiality to reduce within the African American faith center population contrary to previous studies where HIV stigma reduction was not evident. The intervention model provided a protocol for partnership development between this faith center and the local community hospital infectious disease program to address HIV stigma, HIV knowledge and health literacy (HIV health literacy). [ABSTRACT FROM AUTHOR]

Background: The Liangshan Yi Autonomous Prefecture has one of the most serious human immunodeficiency virus (HIV) epidemics in China. Evidence shows HIV-related stigma toward people living with HIV (PLWH) among nurses impedes HIV prevention and treatment. However, only limited research about HIV-related stigma toward PLWH from the perspective of nurses in Liangshan has been conducted. Objective: This study aimed to assess HIV-related stigma toward PLWH among nurses and determine factors associated with it in Liangshan, China. Design: We conducted a cross-sectional survey using a stratified, random cluster sampling method. Participants: Registered nurses (N = 1,248; primary hospitals = 102, secondary hospitals = 592, tertiary hospitals = 554) who were aged 18 or older, worked in the selected hospitals for at least 6 months, and consented to participate were recruited. Methods: All participants completed an anonymous online survey measuring sociodemographic characteristics, HIV-related stigma and HIV knowledge. We used multiple stepwise regression analysis to examine factors associated with HIV-related stigma toward PLWH among these nurses. Results: The mean score of HIV-related stigma among nurses was 50.7 (SD = 8.3; range 25–78). Nurses who were more experienced, had higher levels of education, and were working in tertiary hospitals reported higher level of HIV-related stigma. Those who had better HIV knowledge, reported a willingness to receive HIV-related training, were working in areas that had a high prevalence of HIV, had prior experience working in AIDS specialized hospitals, and worked in hospitals that had policies to protect PLWH showed a lower level of HIV-related stigma toward PLWH. Conclusions: Our findings suggested that providing culturally congruent education and training about HIV and care, and having hospitals that promoted policies protecting PLWH, may reduce HIV-related stigma toward PLWH among nurses in China. [ABSTRACT FROM AUTHOR]

Background Eleven percent of people living with HIV in Australia remain unaware of their diagnosis, and there are missed opportunities for HIV testing in priority settings in New South Wales. HIV testing remains low outside of sexual health clinics with the exception of antenatal settings where HIV testing is routine. To understand why HIV testing rates are low, we sought to identify health worker-related barriers to HIV testing.Methods: We conducted an anonymous online survey to health workers in Western Sydney Local Health District (WSLHD) in September 2019. Tick-box, Likert scale responses were analysed using Chi-square and Kruskal-Wallis statistical tests, and free text responses were analysed with thematic analysis.Results: Three percent (n = 420) of WSLHD's estimated 14 000 health workers responded. These included 317 clinicians (171 nurses, 65 doctors, 56 allied health professionals (AHPs), 25 midwives, and 103 health workers in non-clinical roles). Health workers were from a variety of in-patient/out-patient settings. Many health workers (291/420, 69%; 95%CI = 64.9-73.7%) were unaware that HIV testing is offered in their areas; doctors (82%) and midwives (80%) were more aware than nurses (23%) and AHPs (11%) (P < 0.0001). Doctors (Likert score = 3.62; 3.45/5) and midwives (2.84; 2.76) were significantly more comfortable discussing and confidently offering HIV testing than nurses (2.42; 1.81) or AHPs (1.83; 0.91) (P < 0.0001 for both). The top five barriers to HIV testing were (1) procedural knowledge, (2) identification of at-risk patients, (3) HIV knowledge, (4) positive result management, and (5) privacy concerns. Free text responses highlighted perceived stigma, testing/result responsibilities and resource challenges as barriers to HIV testing.Conclusions: Clinicians working in priority settings and with priority populations require more education and support to increase targeted HIV testing. [ABSTRACT FROM AUTHOR]

HIV disproportionately affect adolescent girls and young women in sub-Saharan Africa. In Uganda, the HIV prevalence is four times higher in adolescent girls compared to boys. This study examined gender, HIV general and clinical knowledge, and prevention attitudes among adolescents living with HIV in Uganda. Data from a cluster randomized clinical trial were analyzed. A total of 702 adolescents (average age of 12.4) were randomized to either a control arm receiving bolstered standard of care or the treatment arm receiving bolstered standard of care plus a family economic empowerment intervention to support medication adherence. Ordinary Least Squares models that adjust for clustering of adolescents within health clinics were conducted. No gender differences were observed in HIV knowledge and prevention attitudes at baseline. However, at 12-months follow-up, boys were more likely than girls to report correct HIV general knowledge (d = 0.21), clinical knowledge (d = 0.48), and favorable prevention attitudes (d = 0.27). The intervention was not associated with any of the outcomes. Given the high HIV prevalence among adolescents, specifically girls, there is need to develop and/or tailor existing programs and interventions that equip adolescent girls with comprehensive knowledge and prevention attitudes, that are culturally appropriate, to reduce HIV transmission and reinfection within this population. [ABSTRACT FROM AUTHOR]

Over the past decade, incidence of human immunodeficiency virus (HIV) has increased significantly in Tajikistan, with female adolescents and emerging adults (i.e., 15–24 years old) particularly vulnerable for acquiring HIV. This study sought to examine whether HIV knowledge and HIV testing among female youth in Tajikistan have increased between 2012 and 2017 using national data from the Demographic and Health Surveys (DHS). In addition, predictors of HIV knowledge and testing were examined. Results suggest that between 2012 and 2017, self-reported HIV testing prevalence increased from 10% to 15% among female adolescents and emerging adults. In addition, HIV knowledge increased significantly among female youth from 2012 to 2017; however, many respondents still displayed limited knowledge about the modes of HIV transmission and effective prevention methods. In order to reduce incidence of HIV among youth in Tajikistan, greater efforts are needed to engage women in education and prevention efforts, as well as to understand the unique vulnerabilities that place some subgroups at increased risk for infection. [ABSTRACT FROM AUTHOR]

Background Elimination of HIV is a public health priority in China, but there has been reports of an upsurge in HIV among young people. A nationwide cross-sectional survey was conducted to assess the awareness of HIV knowledge, attitudes towards homosexuality and practice of sexual behaviours among Chinese aged 15-24 years.Methods: The face-to-face survey was conducted from June to August 2017, collecting data on sociodemographic characteristics, HIV-related knowledge, attitudes towards homosexuality and practice of sexual behaviours among Chinese senior high school and university students. A generalised linear model (GLM) was used to assess the different levels of HIV knowledge between groups, and identify the key contributors to HIV knowledge scores.Results: The survey was completed by 73.6% (1355/1840) of the students approached. The overall level of HIV-related knowledge was low (58.9%, 10.6/18); 48.0% (650/1355) supported same-sex marriage; and 6.9% (93/1355) self-identified as homosexual or bisexual. The major factors associated with higher scores [mean ± standard deviation (s.d.)] in HIV knowledge among students included: having received school-based HIV education (11.47 ± 3.51 vs 9.02 ± 4.14, P < 0.05); support for same-sex marriage (11.69 ± 3.33 vs 9.49 ± 4.29, P < 0.05) and older age (11.61 ± 2.78 vs 9.87 ± 4.17, P < 0.05). Compared with females, males were significantly more likely (all P < 0.05) to report masturbation (60.7% vs 7.6%), pornography experiences (77.4% vs 35.3%), sexual encounters (24.6% vs 12.3%), casual sex (37.0% vs 18.1%) and sex under the influence of alcohol (29.5% vs 12.8%).Conclusions: There is is still much room for improvement in terms of HIV/AIDS prevention and health education for Chinese young people, and more comprehensive and diverse models of education for HIV prevention are urgently needed. [ABSTRACT FROM AUTHOR]

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Introduction: the neighboring Republics of Chad and Cameroon have respectively one of the lowest and highest HIV prevalence rates in central Africa at 1.3% and 4.5%, respectively. We conducted a comparative description of social behaviors and HIV risk factors among heterosexual men and explored the baseline of the first UNAIDS target (by 2020, 90% of people living with HIV will know their status) in the two countries. Methods: this was a retrospective cross-sectional study using Demographic and Health Survey data. We fitted a separate multilevel logistic model for each country. In total, 5248 men were interviewed in Chad and 7191 men in Cameroon. Results: Cameroonian men have a higher level of education, higher HIV testing rate, and are more knowledgeable about HIV than Chadian men. However, Chadian men have a lower number of lifetime sexual partners (2 interquartile range (IQR), 1-4) compared to Cameroonian men (6 IQR 3-15) and 86.96% of Chadian versus 57.30% of Cameroonian men reported fidelity to their domestic partners in the last twelve months. Conclusion: there is a crucial need to encourage HIV screening and testing among Chadian men, especially in rural areas. Testing also needs to be increased in Cameroon to meet the first UNAIDS target. Government and partners in Cameroon could support more research and campaigns that aim at reducing multiple sexual partnerships among the communities in Cameroon. [ABSTRACT FROM AUTHOR]

Background: Karo District is one of the districts in North Sumatera province where from 2016 to 2018 the number of HIV sufferers increased dramatically to 384 people and then it increased to 775 people up to September 2020. The aim of this study was to explore the experiences of people with HIV/AIDS and the experiences of the church members regarding people living with HIV/AIDS (PLWHA). Design and Methods: Qualitative research design with descriptive phenomenology approach. Data collection was carried out by interviewing 34 participants in Karo District. The data analysis in this study used the Collaizi technique. Results: Five themes were obtained from the results of the study, namely the responses of the participants diagnosed with HIV/AIDS, health problems faced by PLWHA, stigma and discrimination, the support of family and church members given to PWLHA, and family/church members' expectations toward PLWHA. Conclusions: Based on the findings of the themes, the role of the National AIDS Commission of Moderamen Karo Batak Protestant Church (GBKP) in responding to HIV and AIDS cannot be optimally implemented because of some obstacles namely, localization which is a determinant of the spread of cases, the unavailability of service and ARV in all health centers, lack of sectoral cross-cooperation, very insufficient financial support from the government, the role of nurses played only in the hospitals and the stigmatism to those people with HIV/AIDS due to lack of knowledge of HIV and AIDS. [ABSTRACT FROM AUTHOR]

Background: Studies have demonstrated that health care students and practitioners are not immune to stigma towards people living with HIV (PLHIV). This attitude could lead to poor quality of care if it remains uncorrected. However, little is known about dietetic students' acceptance of PLHIV despite their substantial role in treatment. This study aimed to measure the extent of knowledge and stigma towards PLHIV among dietetic students and to determine the associated factors using the attribution theory.Methods: Students from three dietetics schools in Indonesia (n = 516) were recruited to participate in this cross-sectional study. Survey questions covered demographic information, interaction with PLHIV, access to information sources, cultural values, and beliefs as predictor variables. The outcome variables were comprehensive knowledge of HIV, HIV and nutrition-specific knowledge, and attitudes. Analyses with linear regression and the stepwise selection were performed to determine factors related to the outcome.Results: The levels of HIV comprehensive knowledge and HIV-nutrition specific knowledge among dietetic students were low, as indicated by the average score of 19.9 ± 0.19 (maximum score = 35) and 8.0 ± 0.11 (maximum score = 15), respectively. The level of negative attitudes towards PLHIV was high, with 99.6% of participants reported having a high stigma score. Types of university affiliation (public or private), beliefs and values, exposure to HIV discourse, access to printed media, and years of study were significantly related to HIV comprehensive knowledge (p < 0.05). Nutrition-specific knowledge was also correlated with university affiliation, beliefs and values, participation in HIV discussion, and years of study (p < 0.05). HIV comprehensive knowledge, university affiliation, discussion participation, and ethnicities were associated with attitudes (p < 0.05).Conclusions: Awareness and acceptance of PLHIV must be further improved throughout dietetic training to ensure patients' quality of care since students represent future dietary care providers. Considering the consistent findings that affiliation to education institution correlates with HIV knowledge and attitude, some examinations concerning the curriculum and teaching conduct might be necessary. [ABSTRACT FROM AUTHOR]

The current body of literature on the HIV knowledge related to young adult Middle Eastern and North African (MENA) individuals residing in the United States is substantially underdeveloped. As the number of MENA individuals residing in the US continues to rise, there remains a need for research investigating the levels of general HIV knowledge for this unique group. An exploratory cross-sectional design was used for an anonymous online survey of MENA adults ages 18–35 (n = 198) residing in the United States concerning their levels of HIV knowledge. Results showed that less than fifty percent (46.40%) of the sample reported adequate knowledge of HIV transmission and prevention methods. Multiple regression analyses indicate that prior sexual health education, prior HIV testing, a four-year college degree and identification as a Muslim predicted higher HIV knowledge. These findings may assist with the development of MENA specific HIV prevention and education programs. [ABSTRACT FROM AUTHOR]

Access to antiretroviral treatment (ART) in South Africa is suboptimal and erratic. For those on treatment, compliance remains a significant challenge. Interruptions to ART have negative implications for the individual and the epidemic. ART is therefore not a sustainable solution and there is an urgent need for a cure. As HIV cure research expands globally, the need to engage community members about cure is becoming a priority. It is vital that potential trial participants understand basic HIV cure research concepts. An online interactive educational tool was co-created with HIV stakeholders to engage and inform HIV research trial participants. The study was conducted with patients at the FAMCRU HIV clinic at Tygerberg Hospital in Cape Town, South Africa. The educational tool comprises two modules that provide information on HIV prevention, treatment and cure research. Participants completed a questionnaire before and after interacting with the programme. There was a significant increase in knowledge scores of participants demonstrated after using the tool. The interactive tool was successful in increasing participants' knowledge of HIV prevention, treatment and cure research. [ABSTRACT FROM AUTHOR]

Background: Transmission of HIV in South Africa continues to be high due to a large proportion of individuals living with undiagnosed HIV. Uptake of HIV testing is influenced by a multitude of factors including the patient's knowledge and beliefs about HIV.Methods: This study sought to quantify the impact of knowledge and attitudes on HIV testing acceptance in an emergency department by co-administering a validated HIV knowledge and attitudes survey to patients who were subsequently offered HIV testing.Results: During the study period 223 patients were interviewed and offered HIV testing. Individuals reporting more negative overall attitudes (p = 0.006), higher levels of stigma to HIV testing (p < 0.001), and individuals who believed their test was confidential (p < 0.001) were more likely to accept an HIV test.Conclusions: Interventions focused on improving patient perceptions around testing confidentiality will likely have the greatest impact on testing acceptance in the emergency department. [ABSTRACT FROM AUTHOR]

Human immunodeficiency virus (HIV) testing is important for controlling the epidemic in low- and middle-income countries such as the Dominican Republic (DR) – a country in the Caribbean. This study aimed to examine factors associated with HIV testing in the DR. The study used HIV test data in the 2013 DR Demographic and Health Survey. HIV data were collected from 18,614 individuals aged 15–59 years. Wealth status, HIV-related stigma, and knowledge scales were constructed using factor analysis. Survey-weighted logistic regression was used to identify correlates of HIV testing in the DR. Results show that almost two-thirds (62.4%) of the participants reported ever having an HIV test. In the multivariable analysis, older age, higher education, female gender, richest wealth status, health insurance, married, higher HIV-knowledge, and lower HIV-related stigma increased the likelihood of getting an HIV test in the DR. People living in Norte/Cibao, which had a higher HIV prevalence, had a lower chance of having an HIV test than people living in the Este/Sureste region. Although HIV testing has increased in recent times, it is not yet satisfactory in the DR. Specific interventions building HIV awareness targeting specific sub-populations and regions will increase knowledge on HIV and reduce HIV-related stigma, and may increase HIV testing. [ABSTRACT FROM AUTHOR]

Background Valid and reliable instruments for measuring knowledge about human immuno-deficiency virus (HIV) among people living with the virus are necessary to identify knowledge gaps and evaluate effectiveness or outcomes of education programmes. However such instruments are scarce, particularly in developing countries. Objective This study aimed to develop and validate a self-administered instrument for measuring HIV-related knowledge among people living with HIV in Nigeria. Setting This study was conducted in the HIV/AIDS clinic of the University of Uyo Teaching Hospital, Akwa Ibom State, Nigeria. Methods The Patient's HIV Knowledge Questionnaire (PHKQ) items, designed with response choices of 'yes', 'no' and 'don't know', were developed based on relevant literature and similar published studies. Face and content validity were established. Evidence of construct validity was established by factor analysis and group differences. Factor analysis was done using principal components and varimax rotation with Kaiser Normalization. Estimates of reliability were evaluated using internal consistency approach (with Cronbach's alpha coefficient) as well as the test-retest method for estimating the stability of the PHKQ scores over time (with Pearson's r). Main outcome measure Validity/reliability of the Patient's HIV Knowledge Questionnaire. Result Response rate in this study was 95.0%. Item analysis of the 20-item instrument resulted in the deletion of 5 items; thus the final instrument consists of 15 items. Cronbach's alpha coefficient for the scale was 0.77, while test-retest reliability was 0.80 (p < 0.001). Factor analysis resulted in 3 components-Transmission and Misconceptions, Causes and Treatment Outcomes, and Diet and Immunity-with Cronbach's alpha of 0.70, 0.56 and 0.46 respectively. The Patient's HIV Knowledge Questionnaire differentiated between newly diagnosed (≤ 1 year) individuals and those with at least 10 years since HIV diagnosis, and also between those with only primary education and those who had had up to tertiary education (p < 0.001). Conclusion The Patient's HIV Knowledge Questionnaire appears to be a valid and reliable tool for assessing HIV-related knowledge among people living with HIV in Nigeria. Further studies are needed to explore the instrument's responsiveness to change, and to evaluate its psychometrics in different settings. [ABSTRACT FROM AUTHOR]

Background: Aspects of sexual identity development, including integration into gay community, have been found to be associated with sexual risk behavior among men who have sex with men (MSM), but not in the Middle East. Method: Drawing on the minority stress model and integrated theory of health behavior, we examined the relationships between measures of sexual identity development and HIV protective behaviors (condomless anal sex and HIV testing) and the mediating roles of HIV knowledge, peer judgmentalism, and discrimination, in a sample of 226 young MSM in Beirut, Lebanon. A cross-sectional, mediation analysis was conducted using a bootstrapping approach and logistic regression models. Results: Fifteen percent of the sample reported recent condomless anal sex with partners whose HIV status was positive or unknown, and 82.3% had ever been tested for HIV. Multivariate logistic regression analysis showed that greater integration into the gay community was significantly associated with having recent condomless anal sex with positive/unknown HIV status partners and having any history of HIV testing, after controlling for covariates. Knowledge of HIV risk was associated with gay integration as well as both condomless anal sex with positive or unknown HIV status partners and any history of HIV testing, but it only served as a (partial) mediator of HIV testing. Peer judgmental communication about sex and sexuality-related discrimination were related in bivariate analysis to gay integration and condomless anal sex, but they too did not prove to be significant mediators of the relationship between these two constructs. Conclusion: These findings highlight the potential sexual health benefits and vulnerabilities associated with increased integration into the gay community for young MSM in Beirut and the need to better understand how to increase HIV knowledge while limiting its potential to increase sexual risk behavior. [ABSTRACT FROM AUTHOR]

Using data from the 2012 and 2017 Tajikistan Demographic and Health Surveys (DHS), this research explores the trends and determinants of HIV/AIDS awareness and knowledge among women of reproductive age in Tajikistan across two time periods and identifies areas for improvement. The results of this research indicate that nearly four in ten women had not heard of HIV/AIDS before participating in the DHS. Moreover, between 2012 and 2017, the level of HIV/AIDS awareness among women decreased from 63% to 57%. Although the level of HIV knowledge increased from 21% in 2012–33% in 2017, many women still lack knowledge about the modes of HIV transmission and effective prevention methods. Considering that the HIV epidemic is currently increasing in Tajikistan, HIV/AIDS prevention interventions are urgently needed that include outreach efforts targeting younger women and those from rural areas and lower socioeconomic groups. [ABSTRACT FROM AUTHOR]

Research on female orphans rarely explores their comprehensive HIV knowledge, which is a proximate factor for HIV vulnerability. Access to information generally is associated with higher HIV knowledge. Although emerging, but still limited, is research that accounts for broader community-level factors, such as the spatial distribution of HIV prevalence and orphanhood. This study explores if there is a relationship between individual orphanhood status and access to information and HIV knowledge among females aged 15–17 years in Malawi using 2015/6 Demographic and Health Survey data. The study also investigates whether there are orphan/non-orphan differences in HIV knowledge with increasing community-level HIV prevalence. Logistic regression analyses indicate that being an orphan is significantly associated with having less access to information through school and mass media (OR: 0.6, p < 0.05), whereas higher community orphanhood prevalence is associated with comprehensive HIV knowledge (OR: 1.1, p < 0.05). The analyses revealed a small disadvantage among orphans in terms of their comprehensive HIV knowledge in areas with higher HIV prevalence. School attendance and age-appropriate progression are positively associated with HIV knowledge. To improve current levels of HIV knowledge (40%), strategies that focus on increasing access to school, particularly among orphans, are needed. [ABSTRACT FROM AUTHOR]

Men's relatively low rates of HIV testing has been termed the 'HIV blind spot' and recently declared by UNAIDS as a top priority. This study uses data from five nationally representative Demographic and Health Surveys in Kenya, Malawi, Mozambique, Zambia, and Zimbabwe to explore factors associated with men's lifetime HIV testing. Between 29.3% and 34.9% of men ages 15–49 in these countries had never tested for HIV and men who held accepting attitudes towards gender-based violence, who lacked HIV knowledge, and who held stigmatising views of HIV were more likely to report never testing for HIV. Findings are interpreted, including a discussion of the possible unintended consequences of current 90-90-90 targets on men's relatively low testing rates. The results point to possible intervention opportunities to increase HIV testing among men in high-HIV prevalence settings in Eastern and Southern Africa and emphasise the importance of changing men's perceptions related to stigma and gender norms. [ABSTRACT FROM AUTHOR]

Background: HIV testing and counselling (HTC) has been a viable tool in controlling the spread of HIV/AIDS, and serves as the entry point in the HIV care and treatment cascade. In Africa, HIV-related morbidity and mortality are high with thousands still unaware of their HIV status. This study assessed the effect of on-site multiple HIV control interventions on the uptake of HTC services, knowledge and sexual behaviour among residents of two military cantonments [barracks] in south-east Nigeria. Methods: A quasi-experimental study was conducted among residents of cantonments in two states in Nigeria. A multistage sampling technique was used to select 350 respondents each at intervention and control sites. A pre-tested interviewer-administered questionnaire was used to collect information. On-site HTC services were established, with the training of HTC counsellors and peer educators. HIV awareness carnivals, with information, education and communication activities were conducted. Data were analysed with SPSS software and statistical tests carried out at 5% level of significance. Results: There was a statistically significant increase in the uptake of HTC services from 41.1% pre-intervention to 81.1% post-intervention (χ2 = 113.8, p < 0.001). Also, knowledge about HIV improved significantly from 35.4% to 98.8% (p < 0.001) in the intervention group, together with avoidance of risky sexual behaviour. Conclusion: The study demonstrated the effectiveness of multiple on-site intervention models in improving HIV knowledge, uptake of HTC services, and sexual behaviour among diverse cantonment residents. Establishing on-site HTC services and a constellation of awareness events will contribute significantly towards HIV prevention and control among high-risk populations. [ABSTRACT FROM AUTHOR]

Adolescents of color in urban communities are at high risk for contracting HIV, unlikely to have access to HIV testing services, or any other form of screening services. Using latent class analysis among a sample of African American/Black (48.1%) and Hispanic/Latina(o) (42%) youth (N = 668; Mage = 16.30; 51% female), this study examined the association cluster group membership, based on sexual negotiation skills and risk behavior, had on HIV knowledge, perception of risk, and the number of sexual partners. Five distinct cluster groups emerged, with significant heterogeneity observed between cluster groups on select dependent variables. A larger proportion of the study participants were in cluster groups that identified higher levels of sexual negotiation skills; however, variation was present based on risk behaviors. Results provide useful recommendations for research on HIV/AIDS and risk behaviors, as well prevention-intervention programing among urban youth of color. [ABSTRACT FROM AUTHOR]

Theater-based approaches have been implemented globally as a health education and behavior change strategy for decades. Studies have shown that live theater performances can engage an audience and influence the knowledge, attitudes, and behaviors of audience members. Moreover, literature has shown that adolescents find theater-based interventions to be more acceptable and memorable than traditional didactic teaching methods. Few studies, however, have compared the effect of different intervention delivery modes on adolescents' sexual health knowledge, attitudes, and beliefs. The present study aims to fill this gap in the literature and to evaluate the efficacy of two delivery modes (live and virtual) of a theater-based sexual health intervention for promoting sexual health strategies among adolescents. A total of 300 high school students were included in this study. Participants in both the live and virtual modes reported increased HIV knowledge and improved safe sex self-efficacy, suggesting that the live and virtual modes have comparable impact. Given the low cost and resource demands, these findings support the utilization of a virtual program as a promising practice for disseminating a sexual health intervention targeting adolescents on a large scale. [ABSTRACT FROM AUTHOR]

Introduction: people with disabilities have been identified as a key risk population for HIV. The aim of this study was to investigate HIV status, knowledge, attitudes, behaviours and its correlates in persons with and without disabilities in South Africa. Methods: cross-sectional data of 26404 participants 15 years and older from the "2012 South African national HIV prevalence, incidence and behaviour survey" were analysed. Results: 1348(5.3%) had a disability. Persons with a disability were older (median age 52 years, IQR=24; versus 36 years, IQR=29), more often men, had a lower education and lower income and more likely living in a rural area than persons without disability. The prevalence of HIV infection was 16.7% in persons with disability, 23.0% in persons with visual/hearing or speech disability, 31.6% in persons with hearing disability and 16.2% in persons without disability. Antiretroviral (ARV) exposure in the HIV positive population was 41.3% among persons with disability and 30% in persons without disability. In multivariable logistic regression analysis, persons with disability had a lower odds to know an HIV testing site (Odds Ratio=OR: 0.46, Confidence Interval=CI: 0.22, 0.98) and a higher odds to have had two or more sexual partners in the past 12 months (OR 2.74, CI: 1.44, 5.21), had casual or transactional sex (OR: 6.25, CI: 2.57, 15.21) and psychological distress (OR: 2.10, CI: 1.50, 2.95) than persons without disability. In multivariable logistic regression analysis in both groups (with and without disability), psychological distress (OR: 2.90, CI: 1.53, 5.47, and OR: 1.90, CI: 1.20, 3.01, respectively) and high HIV stigma (OR: 0.31, CI: 0.25, 0.67, and OR: 0.57, CI: 0.34, 0.96, respectively) were associated with increased prevalence of HIV infection. Conclusion: the study found a high prevalence of HIV infection in persons with disabilities, in particular in those with hearing impairment. In some areas, persons with disability showed lower knowledge and higher risk behaviours than persons without disabilities. There is a need to strengthen HIV information and communication strategies geared towards targeting people with all types of disabilities. [ABSTRACT FROM AUTHOR]

In Botswana, an estimated 350 000 people live with HIV/AIDS. HIV/AIDS testing rates are low, suggesting that many other people remain undiagnosed. Stigma related to HIV/AIDS is prevalent and contributes to low testing rates and under-diagnosis of the virus. Identifying factors that contribute to stigma, such as insufficient or inaccurate knowledge of HIV/AIDS, may be critical in increasing early identification and treatment. This cross-sectional study used nationally representative data from the 2013 Botswana AIDS Impact Survey (BAIS) IV to examine the relationship between HIV/AIDS knowledge and stigmatising attitudes toward people living with HIV/AIDS (PLWHA). The mean (standard error) for stigma towards PLWHA score and HIV/AIDS knowledge score were 0.99 (0.02) and 5.90 (0.03) respectively. HIV/AIDS knowledge score and stigma towards PLWHA score were strongly positively correlated r (4,4045) = 0.415, p < 0.001). After adjusting for potential confounders, HIV/AIDS knowledge score significantly predicted stigma towards PLWHA score [coefficient β (95% CI)] [−0.25 (−0.29, −0.20), p < 0.001]. These findings imply that programmes and interventions that increase HIV/AIDS knowledge may reduce the pervasive apprehension, blame, and stigmatising attitude held towards PLWHA in Botswana. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Rural incarcerated women have an increased risk of acquiring the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV) due to prevalent engagement in drug use and sexual behaviors. Limited research has investigated HIV and HCV knowledge in this high-risk population. Furthermore, the interplay of sociodemographic factors (i.e., education, age, income, and sexual orientation) and risky behavior is understudied in this population. The present study evaluated a sample of adult, predominately White women from rural Kentucky (n = 387) who were recruited from local jails. The sample had high HIV and HCV knowledge but also reported extensive risk behaviors including 44% engaging in sex work and 75.5% reporting a history of drug injection. The results of multiple regression analysis for risky sexual behavior indicated that sexual minority women and those with less HIV knowledge were more likely to engage in high-risk sexual behaviors. The regression model identifying the significant correlates of risky drug behavior indicated that HIV knowledge, age, and income were negative correlates and that sexual minority women were more likely to engage in high-risk drug use. When HCV knowledge was added to the regression models already including HIV knowledge, the interaction was significant for drug risk. Interventions for rural imprisoned women should consider the varied impact of sociodemographic background and prioritize HIV education to more effectively deter risky sexual and drug behaviors. [ABSTRACT FROM AUTHOR]

While older African American women (e.g., aged 50 years and older) comprise only 11% of the female population in the United States, they account for 50% of HIV diagnoses among women in this age group. Unique sociocultural factors, including a lack of HIV knowledge and stigma, contribute to HIV risk among older African American women. The goal of this qualitative study was to obtain a nuanced perspective from older African American women about HIV knowledge and experiences with HIV using the framework of intersectionality theory. Focus groups were conducted with 35 African American women who were 50 years and older, nonpartnered, and heterosexual. Women were asked what they knew about HIV and if they thought older women were at risk for HIV. A thematic analysis using NVivo 11 yielded two central themes and three subthemes: HIV knowledge, including experiential knowledge, superficial knowledge, and no knowledge, and stigma around HIV in the Black church. Implications for developing HIV prevention programs and testing messages are discussed. [ABSTRACT FROM AUTHOR]

Objective: HIV-related stigma is one of the strongest barriers to prevention and treatment. HIV prevalence in U.S. college students is estimated around 0.02%, but is thought to be drastically underreported. We examined the influence of HIV knowledge on the relationship between HIV testing history and stigma in college students. Participants: A random sample of 2343 students, over the age of 18, attending a large university in the southeastern United States completed the survey in January 2016. Methods: A mediation model was constructed in regression framework to explore the relationship between HIV testing history, knowledge, and stigma. Results: HIV testing history was associated with higher knowledge scores (a path: B = 4.08, p <.001) and higher knowledge scores were associated with lower stigma (b path: B =.01, p <.001). These results suggest that HIV knowledge partially mediates the relation between HIV testing history and stigma in college students. Conclusions: HIV testing history may decrease stigma by increasing knowledge. Results can be used to inform college health promotion practice on developing programs and services. [ABSTRACT FROM AUTHOR]

Objective: College students are a high-risk population for new human immunodeficiency viruses (HIV) diagnoses. Although condom use self-efficacy and HIV knowledge can protect against risky sexual behavior (RSB), these same protective factors have been shown to exacerbate RSB. The influence of alcohol use can further complicate these protective factors to influence RSB. Participants: 689 African American/Black and non-Hispanic White college students attending a public university in the Southeast United States. Method: This study sought to examine the relations between condom use self-efficacy and HIV knowledge with RSB and the moderating effect of alcohol use. Results: Findings showed positive associations between RSB and HIV knowledge and alcohol use. Unexpectedly, low frequency drinkers with high condom use self-efficacy were at increased risk for RSB compared to high frequency drinking counterparts. Conclusions: Findings point to the need to target prevention services for low-risk drinkers in college settings. [ABSTRACT FROM AUTHOR]