Understanding Discriminatory Attitudes Towards People Living With HIV/AIDS in Tanzania: The Role of Individual and Community Factors Among Reproductive-Aged Women

Background: HIV-related stigma and discrimination have substantial negative impacts on individuals' health, well-being, HIV-related medical procedures, and overall quality of life. Therefore, our study aimed to determine the prevalence of discriminatory attitudes and associated factors towards people living with HIV/AIDS in Tanzania. Methods: An Analytical cross-sectional study was conducted using the 2022 Tanzania Demographic and Health Surveys data. The sampling frame was stratified by geographic region and urban/rural areas, utilizing a two-stage sampling method. This method selected primary sampling units based on census enumeration areas, followed by household selection using a probability systematic sampling method. Multilevel logistic regression, accounting for the complex survey design, was used to identify individual and community-level factors associated with discriminatory attitudes. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and statistical significance was set at p < 0.05. Results: The prevalence of discriminatory attitudes towards people living with HIV/AIDS was 28.3% (95% CI: 27.0-29.7). At the individual level, women aged 25-34 and 35-49, those with secondary or higher education, literate women, those in the rich wealth quintile, women who had ever been tested for HIV, those with comprehensive HIV knowledge, and internet users were less likely to have discriminatory attitudes. At the community level, women in high-poverty communities had higher odds of discriminatory attitudes. In contrast, women in rural areas and the northern, central, southern, and lake zones showed lower odds. Conclusion: Discriminatory attitudes towards PLHIV remain prevalent among women of reproductive age in Tanzania, with significant regional and socioeconomic disparities. Addressing HIV-related stigma requires a comprehensive approach and context-specific interventions.