Role of comprehensive HIV knowledge as a mediator between receiving HIV information during antenatal care visits and positive attitudes toward people living with HIV among reproductive-age women in Bangladesh

Objective

Comprehensive knowledge of HIV transmission and positive attitudes toward people with HIV (PWH) are key to HIV prevention and care. This study assessed the potential mediational role of comprehensive HIV knowledge between receiving HIV information during antenatal care (ANC) visits and positive attitudes toward PWH among reproductive-age women in Bangladesh.

Methods

We analyzed the 2019 Multiple Indicator Cluster Survey data (N = 5118). Comprehensive HIV knowledge scale (9-item; Cronbach's alpha = 0.706) and Attitudes toward PWH scale (2-item; Cronbach's alpha = 0.84) were constructed. Receiving HIV information was a dichotomous variable (yes/no). A multivariable structural equation model was controlled for age, ethnicity, education, rural/urban residence, media exposure, marital status, wealth index, and division. All analyses were performed using Stata 18.0.

Results

After adjusting for sociodemographic characteristics, receiving HIV transmission knowledge during ANC was not associated with positive attitudes toward PWH (B = 0.06, p = 0.101). Receiving HIV information was positively associated with comprehensive HIV knowledge (B = 0.39; p < 0.0.001), and comprehensive HIV knowledge was positively associated with positive attitudes toward PWH (B = 0.13; p < 0.001). The indirect effect of comprehensive HIV knowledge on the relationship between receiving HIV information during ANC and positive attitudes toward PWH was statistically significant (B = 0.05, p < 0.001).

Conclusion

Given the mediational role of comprehensive HIV knowledge between receiving HIV information and positive attitudes toward PWH, providing HIV information during ANC should be a routine practice to capture the teachable moments to prevent HIV transmission.