Association between mass media exposure and endorsement of HIV-infected female teachers’ teaching: insight from 2014 Ghana Demographic and Health Survey | BMC Women’s Health

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Studies on HIV-related stigma/discrimination have established that stigma tends to be higher among individuals with low media exposure than among those with high media exposure [21]. In light of this, the present study investigated the association between mass media exposure and whether HIV-infected female teachers should be allowed to teach or otherwise in Ghana. The principal finding of the study was that those who had access to mass media were more probable to endorse that female teachers infected with HIV should be allowed to continue teaching in school compared to those without access to mass media. Our findings coincide with various studies conducted in other parts of sub-Saharan Africa and Asia where it was revealed that media use was generally associated with low levels of HIV-related stigma and lessened the gap between individuals with high and low educational levels [21, 27, 28]. Similarly, in the Greater Accra, Ashanti, and Upper East regions, it was suggested that mass media channels can effectively address HIV-related stigma on a national scale [29]. Arguably, adequate knowledge and awareness of disease are the key prerequisites for its prevention and control, given that adequate knowledge is a basis for adopting the appropriate attitudes and practices [30,31,32]. This lays credence to the fact that employing television, radio, newspapers, and other forms of mass media to carry out HIV-related stigma/discrimination-related socio-behavioural education is needful. At least, exposing communities to HIV-related stigma-related information could significantly enhance community knowledge and understanding of the disease.

Another interesting finding was that those who had completed secondary or higher education had higher odds to affirm that female teachers infected with HIV should be allowed to continue teaching in a school as opposed to those with no formal education. The positive effects of formal education on HIV knowledge have been supported by many other studies. For instance, in Nigeria and Kenya, it was known that those with higher levels of education and with a higher wealth index are more sympathetic toward people living with HIV (PLHIV) [33, 34]. The association between formal education and knowledge of health-protective behaviour is often explained by the fact that education increases cognitive abilities, numeracy, and decision-making abilities and therefore improves abilities to engage in health-protective behaviours [35]. Specifically, formal education influence HIV and AIDS knowledge by providing people with the requisite information to protect themselves from infection.

It was found that those in rural areas were less likely to proclaim that female teachers infected with HIV be allowed to continue teaching in a school compared with urban residents. Previously conducted studies have consistently indicated that mass media was found to be stronger among urbanites rather than among rural residents which could lead to a widening gap between the two groups in the endorsement of HIV-related stigma [21, 33, 36]. The results imply that the social location in which this attitude prevails might be visualized at the intersection of other multiple identities. Similarly, the fact that stigma is high among people from rural communities is an indication that PLHIV in such communities could experience high levels of stigma. The foregoing study also revealed that, comparatively, those cohabiting had lesser odds to endorse that female teachers infected with HIV should be allowed to continue teaching in a school compared with the married. This could be attributable to pre-marital preparation and counselling organized for couples before marriage. Before marriage is contracted, couples go through HIV/AIDS voluntary testing and counselling which raise their understanding of HIV/AIDS.

In agreement with previous studies [37, 38], the current study revealed that traditionalists were least probable to support that female teachers infected with HIV should be allowed to continue teaching in a school as compared to Christian. A Ghanaian-based study also indicated that women who identified themselves as Christians were more knowledgeable about modes of HIV transmission than women who followed African traditional religion or were not religiously affiliated [37]. This is suggestive that a probable relationship exists between religious affiliation and levels of knowledge about HIV/AIDS. This finding is in line with a study conducted in Tanzania, where religious beliefs played a major role in shaping people’s perspectives on HIV and PLHIV [38]. Nevertheless, a study in Mozambique found protestant women to have more comprehensive HIV and AIDS knowledge than their Catholic counterparts [39]. Such a finding suggests that policymakers need to pay more attention to the non-Christian groups in their HIV/AIDS campaigns as well as consider the differences existing among Christian groups.

The rich had a higher propensity to endorse that female teachers infected with HIV should be allowed to continue teaching in a school as compared to the poor. The result is in line with a study in Nigeria and Kenya which found that those in the higher wealth index are more sympathetic toward PLHIV [33, 34]. Probably, those with higher wealth status might own and have access to varied mass media platforms, hence, exposing them to various HIV/AIDS information. Our finding is similar to a previous study in Bangladesh in which the authors found that rich women had a higher likelihood of exposure to media and HIV/AIDS information [36]. Similarly, those whose partners had completed secondary or higher education were most probable to support that female teachers infected with HIV should be allowed to continue teaching in a school compared with those whose partners had no education. This could be due to cascading effect of partner’s knowledge on the couple as it is known that there is higher awareness among the educated and wealthy ones on the prognosis of PLHIV and the availability of antiretroviral treatments [34].

Finally, those at parity four or more were least inclined to endorse that female teachers infected with HIV should be allowed to continue teaching in a school as compared with those at parity zero just as among the Grusi as compared to the Akan. This could be due to diverse beliefs, perceptions, and practices held by various ethnic groups. However, evidence suggests that eliminating stigma and discrimination will result in higher acceptance of PLHIV by community members [40]. Therefore, promoting positive and acceptable attitudes toward PLHIV among diverse ethnic groupings and mothers of varying parity in Ghana is needful. Admittedly, the current study failed to provide probable reasons for the observed variations. Therefore, a study, preferably, qualitative study is needed to understand the phenomenon.

Strengths and weaknesses of the study

This study investigated the association between mass media and HIV-related stigma in Ghana and it is the first of its kind to have done that. Also, the study depended on survey data from the former principal ten administrative regions in Ghana, hence representing the views of women in Ghana. The probability sampling approach employed in the survey aided to reduce sampling biases. The study further employed rigorous analytical procedures thereby enhancing the robustness of the results. However, a causal relationship cannot be established due to the cross-sectional nature of the survey. Also, issues surrounding HIV/AIDS, especially stigma and discrimination are delicate, respondents might be biased in their responses due to social desirability bias. The study also focused on females only and the findings and conclusions are based on views of females excluding males.

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