title: HIV-related discrimination among grade six students in nine Southern African countries.
abstract: BACKGROUND
  HIV-related stigmatisation and discrimination by young children towards their peers have important consequences at the individual level and for our response to the epidemic, yet research on this area is limited.
  
  
  METHODS
  We used nationally representative data to examine discrimination of HIV-positive children by grade six students (n = 39,664) across nine countries in Southern Africa: Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe. Descriptive statistics are used to compare discrimination by country, gender, geographic location and socioeconomic status. Multivariate logistic regression is employed to assess potential determinants of discrimination.
  
  
  RESULTS
  The levels and determinants of discrimination varied significantly between the nine countries. While one in ten students in Botswana, Malawi, South Africa and Swaziland would "avoid or shun" an HIV positive friend, the proportions in Lesotho, Mozambique, Zambia and Zimbabwe were twice as high (approximately 20%). A large proportion of students believed that HIV positive children should not be allowed to continue to attend school, particularly in Zambia (33%), Lesotho (37%) and Zimbabwe (42%). The corresponding figures for Malawi and Swaziland were significantly lower at 13% and 12% respectively. Small differences were found by gender. Children from rural areas and poorer schools were much more likely to discriminate than those from urban areas and wealthier schools. Importantly, we identified factors consistently associated with discrimination across the region: students with greater exposure to HIV information, better general HIV knowledge and fewer misconceptions about transmission of HIV via casual contact were less likely to report discrimination.
  
  
  CONCLUSIONS
  Our study points toward the need for early interventions (grade six or before) to reduce stigma and discrimination among children, especially in schools situated in rural areas and poorer communities. In particular, interventions should focus on correcting misconceptions that HIV can be transmitted via casual contact.
authors.affiliation: Southern Africa Labour and Development Research Unit (SALDRU), University of Cape Town, Cape Town, Western Cape, South Africa.
authors.forename: Brendan
authors.initials: B
authors.lastname: Maughan-Brown
authors.affiliation: Research on Socioeconomic Policy Group (RESEP), University of Stellenbosch, Stellenbosch, Western Cape, South Africa.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Spaull
mesh_terms: D000353:Africa, Southern; D002648:Child; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D012737:Sex Factors; D063508:Social Discrimination / Q000523:psychology*; D057545:Social Stigma; D012959:Socioeconomic Factors
references.citation: AIDS Care. 2010 Jul;22(7):803-15
references.pmid: 20635244
references.citation: Soc Sci Med. 2010 Sep;71(5):975-85
references.pmid: 20591546
references.citation: AIDS Behav. 2014 Jun;18(6):1054-62
references.pmid: 24158487
references.citation: Cult Health Sex. 2004 Jan;6(1):1-18
references.pmid: 21972829
references.citation: Ann Behav Med. 2012 Jun;43(3):362-71
references.pmid: 22367752
references.citation: AIDS Care. 2011 Jul;23(7):873-9
references.pmid: 21400305
references.citation: AIDS Care. 2010 Feb;22(2):170-86
references.pmid: 20390496
references.citation: Soc Sci Med. 2009 Oct;69(8):1186-93
references.pmid: 19713022
references.citation: J Health Popul Nutr. 2003 Dec;21(4):347-57
references.pmid: 15038590
references.citation: Sex Transm Infect. 2005 Dec;81(6):511-6
references.pmid: 16326857
references.citation: AIDS Care. 2006 Nov;18(8):1050-3
references.pmid: 17012099
references.citation: Trop Med Int Health. 2006 Apr;11(4):513-27
references.pmid: 16553935
references.citation: Child Abuse Negl. 2010 Oct;34(10):793-803
references.pmid: 20880588
references.citation: AIDS Care. 2009 Apr;21(4):403-10
references.pmid: 19283643
references.citation: J Acquir Immune Defic Syndr. 2010 Dec 15;55(5):620-4
references.pmid: 20980913
references.citation: Soc Sci Med. 1994 Nov;39(9):1339-58
references.pmid: 7801170
references.citation: AIDS Behav. 2014 May;18(5):958-65
references.pmid: 24101100
references.citation: AIDS Care. 2007 Mar;19(3):318-25
references.pmid: 17453564