Sexual behaviour, HIV/AIDS knowledge, stigma and economic consequences of HIV/AIDS in Tanzania
| dc.contributor.author | Silas, Joel | |
| dc.date.accessioned | 2020-05-15T20:28:16Z | |
| dc.date.available | 2020-05-15T20:28:16Z | |
| dc.date.issued | 2013 | |
| dc.description | Available in printed form, East Africana Collection, Dr. Wilbert Chagula Library | en_US |
| dc.description.abstract | This thesis investigates the influence of demographic and socio-economic factors on sexual behaviours, HIV/AIDS knowledge, and stigma and assesses the consequences of HIV/AIDS on households and firms in Tanzania. It consists of three self-contained papers that are somewhat related to each other. Two papers use secondary data, and the last paper, which is the case specific study, assesses the socio-economic consequences of HIV/AIDS at household level and firm level using primary data collected in the Iringa and Dar es Salaam regions. The thesis contains also chapter one which acts as an introduction and chapter five which contains a conclusion and areas for further research. Chapter two presents an analysis of sexual behaviours in Tanzania. It contains two major components: The first component focuses on how demographic and socio-economic factors are associated with abstinence, faithfulness and condom use (ABC strategy) among individuals as preventive measures. Analysis under this component is conducted using Tanzania HIV/AIDS and Malaria Indicator Survey 2007/2008. The second component of this chapter focuses on an analysis of risky sexual behaviour, based on evidence from Tanzania. An attempt is made to investigate the association between socio-economic status, demographic factors and risky sexual behaviours in Tanzania. Based on 2010 DHS data, analysis is conducted using two different data sets to compare and contrast how sexual behaviours among individuals change over time. Univariate analysis, bivariate analysis and multivariate logistic regressions are used to analyze models for generating the odds ratios and confidence intervals (C.I.) for each predictor. Results from the first component (Abstinence, faithfulness and condom use) show that poorest individuals are less likely to use condoms, less likely to abstain and are more likely to pay for sex compared to richest individuals. Men and women aged 15-24 years are less likely to start sexual activities at 18 years or above. Also, men and women aged 15-24 years and 25- 34 years are less likely to abstain and are less likely to be faithful compared to older men and women. Women living in urban areas are less likely to abstain for more than 12 months without having sex. This indicates that their likelihood to abstain from sexual activities is lower. level of education is strongly associated with condom use among men and women, as those with no education are less likely to use condoms. Results also indicate that the likelihood of condom use among men living in regions with a lower prevalence rate of HIV is lower compared to their counterparts living in regions with a higher prevalence rate of HIV. Surprisingly, women living in regions with a lower prevalence rate are more likely to have more than two sexual partners. This implies that sexually active women from regions with a lower prevalence rate of HIV infections are less likely to be faithful. Non-mobile men and women are more likely to be faithful compared to mobile men and women. Men who are not employed are less likely to use condoms and are less likely to be engaged in transactional sex (pay for sex) compared to employed men. Findings also indicate that unemployed men and women are more likely to abstain compared to their employed counterparts. Results from the second component of chapter two indicate that poverty and media exposure are highly associated with higher risk sex behaviour for both men and women. In terms of condom use at last higher risk sex, the poorest and the poor individuals are less likely to use condoms compared to their rich counterparts. Findings indicate that there is a significant association between level of education and condom use at last higher risk sex, as both men and women with no education are less likely to use condoms at last higher risk sex compared to educated men and women. Number of sexual partners for both men and women is not significantly associated with wealth and education. However, results show that the number of sexual partners among men and women is highly associated with earlier sexual debut. Results also show that poorer men are more likely to pay for sex compared to richer men. In brief, poverty, lack of education, mobility and earlier sexual debut stand out as the major predictors that are significantly associated with risky sexual behaviours. Therefore, when focusing on these results, more emphasis should be given to research on distribution networks of condoms and education on condom use in protecting individuals from STIs and HIV infections. Sensitizations programmes and campaigns on raising awareness of how abstinence reduces an individual's risk of contracting STIs and HIV/AIDS should be emphasised in both urban and rural areas. Emphasis should also be given to the risks of having multiple sexual partners. More efforts in assessing the impact of poverty reduction, investments on education, and access to media are required to determine if they can help to reduce the vulnerability of poor people in contracting HIV/AIDS. Chapter three presents a study on HIV/AIDS knowledge and stigma in Tanzania. Lack of HIV/AIDS knowledge and stigma against people with HIV/AIDS remain the major challenges in efforts to reduce the spread of new HIV/AIDS infections. Stigma is one of the key factors that is evidently catalyzing the spread of new HIV infections in Tanzania. Much has been done to improve the situation, but people living with HIV/AIDS are still stigmatized in both the socio¬economic arena and in the labor market. This and other issues highlight the need to identify the factors that are associated with HIV/AIDS knowledge and stigma at individual level. The study used Tanzania HIV/AIDS and Malaria Indicator Survey data (THIMS 2007/2008) while descriptive statistics and multivariate logistic regressions analyses were employed as tools of analysis. Results show that age is significantly associated with general HIV/AIDS knowledge and stigma for men and women. However, this predictor is not associated with specific HIV/AIDS knowledge. Type of place of residence is highly associated with specific HIV/AIDS knowledge and stigma for both men and women but is not associated with general HIV/AIDS knowledge. Level of education is highly associated with general HIV/AIDS knowledge, specific HIV/AIDS knowledge and stigma for both men and women in both urban and rural areas. In terms of wealth status, the poorest individuals are less likely to be knowledgeable and more likely to stigmatize and discriminate against people with HIV/AIDS. Marital status is shown to be significantly associated with HIV/AIDS knowledge and not associated with stigma for both men and women. Individuals who lack media exposure are less likely to be knowledgeable on specific HIV/AIDS issues and are more likely to stigmatize and discriminate people with HIV/AIDS. Furthermore gender balance, Tuberculosis knowledge and HIV testing are significantly associated with specific HIV/AIDS knowledge. Men and women living in regions with a lower prevalence rate of HIV/AIDS are more likely to be knowledgeable on HIV/AIDS issues and less likely to stigmatize and discriminate people with HIV/AIDS compared to individuals living in regions with a higher prevalence rate of HIV/AIDS. This analysis demonstrates the importance of improving access to information and education about HIV/AIDS in Tanzania, especially among young men and women in urban and rural areas. Further initiatives should aim to increase the coverage of centres that provide VCT services particularly in rural areas. In addition, special programmes in local languages should be established and be easily accessed especially in rural areas. Chapter four presents a study on the socio-economic consequences of the HIV/AIDS epidemic across households and firms. HIV/AIDS has broad and serious impacts on individuals and on different socio-economic sectors. The epidemic has also serious consequences for firms. In view of the above facts, this study specifically assesses the socio-economic consequences of HIV/AIDS at household level by comparing households affected by the epidemic and households that have not been recently affected by HIV/AIDS (control group). The study goes further by investigating the impact of HIV/AIDS on firms, focusing on productivity, training and investment capacity. It should be noted that this study is a case-specific study that is not intended to cover the whole country because of a limited time framework, resources constraints and the unavailability of nation-wide surveys on the consequences of HIV/AIDS across households and firms. The study used primary data collected in the Iringa region (household related data) and Dar es Salaam region (firm related data). Analysis between households affected with HIV and unaffected households is carried out and presented in the form of frequencies and percentages. Cross tabulations are also conducted to establish links between the variables. Regressions analysis using Ordinary Least Square methods is undertaken to examine how HIV/AIDS related indicators influence household number of meals and household average income. Results show that most of the heads of affected households are females with no education compared to the heads of unaffected households. Affected households own less assets compared to unaffected households. Also, the majority of the affected households do not own land for agricultural purposes and other uses compared to unaffected households. Findings also show that on average unaffected households earn more than affected households per month. This is supported by differences in consumption expenditures. Average income of the affected households is positively influenced by the number of orphans and size of the household, while the number of dependents and child-headed households influences negatively the average income of the affected households. In comparison to affected households, the average income of unaffected households is negatively influenced by the presence of a seriously ill adult member in the household and the number of dependents, while the size of the household influences positively the average income of the unaffected households. In terms of average income which is saved per month, the majority of affected households save less compared to unaffected households. Moreover, affected households lose more working days in caring for sick members. Average number of meals per day taken by affected households is negatively influenced by child-headed households, while among unaffected households the average number of meals per day is negatively influenced by number of orphans in the household and child-headed household. Firm results show that firms are affected through loss of manpower, low productivity, low output, increased costs of production and training among new workers. Future actions should focus on the provision of HIV/AIDS education to the public and embark on workshops for community leaders. This should include public education on risk management strategy for future unexpected events at household level to help create a tradition of saving. Also Local Authorities should work with the numerous NGOs involved in health and community development activities to support and help care for people living with HIV/AIDS. Economic policies should be more focused on job creation and education to address the poverty caused by HIV/AIDS. Finally, company registration regulations should add a prerequisite that all firms should have a well-defined and documented HIV/AIDS policy. | en_US |
| dc.identifier.citation | Silas, J. (2013) Sexual behaviour, HIV/AIDS knowledge, stigma and economic consequences of HIV/AIDS in Tanzania. Doctorial dissertation, University of Dar es Salaam. Dar es Salaam. | en_US |
| dc.identifier.uri | http://41.86.178.5:8080/xmlui/handle/123456789/11117 | |
| dc.language.iso | en | en_US |
| dc.publisher | University of Dar es Salaam | en_US |
| dc.subject | Sexual behaviour | en_US |
| dc.subject | HIV/AIDS knowledge | en_US |
| dc.subject | economic consequences | en_US |
| dc.subject | HIV/AIDS | en_US |
| dc.subject | Tanzania | en_US |
| dc.subject | Housholds and firms | en_US |
| dc.title | Sexual behaviour, HIV/AIDS knowledge, stigma and economic consequences of HIV/AIDS in Tanzania | en_US |
| dc.type | Thesis | en_US |