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Trends and Determinants of 
Attitudes Towards People Living 
with HIV/AIDS Among Women of 
Reproductive Age in Tajikistan 

 
 
 
Hakim Zainiddinov1 
 
1Rutgers University, United States 

 
 
 

 
Vol. 8, No. 1 (2019)   |   ISSN 2166-7403 (online)  
DOI 10.5195/cajgh.2019.349 |   http://cajgh.pitt.edu 

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Abstract 

Introduction: Despite having one of lowest rates of newly diagnosed HIV infections among former Soviet countries, Tajikistan 
has a substantial level of discriminatory attitudes towards people living with HIV/AIDS (PLWHA). While initial attempts were 
made to explore discriminatory attitudes of a wide range of professionals, women’s general attitudes towards PLWHA received 
less scholarly attention. Employing a nationally representative sample from the 2000 and 2005 Multiple Indicator Cluster Surveys 
(MICS), sociodemographic determinants of HIV-related discriminatory attitudes of women aged 15-49 in Tajikistan were identified 
and examined over time.  
Methods:  A representative sample included 5,453 women of reproductive age from the capital city and four regions of Tajikistan. 
Two dichotomized scenarios  representing the agreement to let an HIV-infected teacher continue teaching in school and the 
willingness to buy food from an HIV-infected cashier were constructed. Univariate and multivariable analyses of HIV-related 
discriminatory attitudes were obtained using Stata 14.  
Results: Insignificant but positive changes were observed in the women’s attitudes between 2000 and 2005. Logistic regression 
models showed that negative attitudes were associated with the lack of knowledge of HIV/AIDS prevention methods, endorsement 
of HIV/AIDS transmission misconceptions, and never having been tested for HIV (p≤0.001). Women living in the rural areas, 
married, with lower education, and from low income households were less tolerant towards PLWHA.  
Conclusions: The data from Tajikistan underscore the persistence of HIV-related discriminatory attitudes among low 
socioeconomic status women. The study findings can be potentially used to target the disadvantaged groups and guide the design 
and implementation of programs that promote voluntary HIV-testing, raise awareness about HIV/AIDS prevention methods, and 
help dispel transmission misconceptions. 

Keywords: Tajikistan; HIV/AIDS; discriminatory attitudes; women; PLWHA 

 
Trends and Determinants of 
Attitudes Towards People Living with 
HIV/AIDS Among Women of 
Reproductive Age in Tajikistan 

 
 

 
Hakim Zainiddinov1 
 
1Rutgers University, United States; 
 

Research 

Introduction 

Despite the recent advances in HIV prevention 
and treatment technologies that transformed HIV into a 
manageable disease, HIV-related stigma and 
discrimination still represent a problem. Tajikistan, 
reporting one of lowest rates of newly diagnosed HIV 
infections among the former Soviet countries,1 is not 
exception from this general trend. According to the first 
national study on discrimination and stigmatization of 
HIV-infected people conducted by the Strategic Research 
Center under the President of Tajikistan, nearly every 
third person (28.9%) held negative attitudes towards 
people living with HIV/AIDS (PLWHA).2 
Discriminatory attitudes towards PLWHA have been 
reported in the form of labor and education restrictions, 

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in the context of medical care, and within families and 
communities.2 Although initial attempts were made to 
explore discriminatory attitudes of a wide range of 
professionals, including medical personnel, law-
enforcement men, service sector workers, teachers, local 
officials, mass media employees, lawyers, judges, and 
religious leaders,2 studies that examine women’s 
attitudes towards PLWHA in Tajikistan are nearly 
absent. Most of the previously published studies on 
HIV/AIDS in Tajikistan focused on high risk of HIV 
infection among injection drug users and labor migrants3 
or assessed comprehensive HIV/AIDS knowledge 
among women.3,4  Consequently, a limited number of 
qualitative research looked at the discrimination against 
HIV-positive injection drug users by health care 
providers5, as well as labor migrants’ wives’ knowledge, 
attitudes, and behaviors about HIV/AIDS risk and 
protection.6 The aim of this study was to identify 
sociodemographic determinants of HIV-related 
discriminatory attitudes of a nationally representative 
sample of women aged 15-49 in Tajikistan and examine 
these changes over time.  

 

Methods 

Data source 

The data were obtained from the 2000 and 2005 
Multiple Indicator Cluster Surveys (MICS), conducted 
by the State Committee on Statistics of the Republic of 
Tajikistan with the financial and technical support of the 
United Nations Children’s Fund.7,8 The MICS employed 
a representative sample of women from the capital city 
and all four regions of Tajikistan. The final sample 
included 5,453 women aged 15-49 years. Both MICS 
surveys had high response rates of 98.8% and 96% for 
2000 and 2005 respectively.7,8 

Measures 

To measure discriminatory attitudes towards 
people living with HIV/AIDS, the 2000 survey included 

two questions: (1) “Should teacher with HIV/AIDS be 
allowed to teach in school?”; and (2) “Would you buy 
food from cashier with HIV/AIDS?”. The 2005 survey 
assessed discrimination using four questions: (1) “If a 
female teacher has the AIDS virus but is not sick, should 
she be allowed to continue teaching in school?”; (2) 
“Would you buy fresh vegetables from a shopkeeper or 
vendor if you knew that this person had the AIDS 
virus?”; (3) “If a member of your family became infected 
with the AIDS virus, would you want it to remain a 
secret?”; and (4) “If a member of your family became 
sick with the aids virus, would you be willing to care for 
him or her in your household?”. To be consistent across 
two years of the study, the first two questions from each 
survey were used.  

Key independent variables were women’s 
knowledge about HIV/AIDS prevention methods, 
transmission misconceptions, and their HIV/AIDS 
testing status. Research has already reported the 
association between these predictors and discriminatory 
attitudes towards PLWHA.9,10,11,12,13,14 Following prior 
research,3 the first two independent variables were 
operationalized as followed. A score measure of 
knowledge about HIV/AIDS prevention methods was 
created by combining answers from three questions 
asking whether women knew that they can avoid the 
AIDS virus by (1) having one uninfected and faithful 
partner; (2) using condoms; and (3) not having sex at all. 
The second independent variable, which is also a score 
measure, was based on three questions: can people get 
infected with the AIDS virus through (1) witchcraft or 
other supernatural means, (2) from mosquito bites, and 
(3) whether or not it is possible for a healthy-looking 
person to have the AIDS virus. All three answers were 
combined and coded into a dichotomous variable 
signifying respondent who did not endorse myths and 
misconceptions about HIV/AIDS transmission. The 
study also employed a number of demographic and socio-
economic status characteristics known to affect 
discriminatory attitudes towards HIV-infected 
people.12,14,15,16 Demographic characteristics were 

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Figure 1. Trends in positive attitudes towards people living with HIV/AIDS 

captured through variables such as age (ranging from 15 
to 49 years old), marital status (currently married versus 
all else), region of residence (a series of five dummy 
variables: Dushanbe, Khatlon, Sogd, Direct Rule 
Districts (DRDs) and Gorno-Badakhshan Autonomous 
Region (GBAO)), and area of residence (rural versus 
urban). Socioeconomic status measures were education 
(higher versus all else), and household income (recoded 
as tertiles: low, medium and high). The study used a 
dichotomous variable ‘year 2005’ that contrasted 
respondents who participated in the 2005 survey with 
those who did not.  

Statistical analysis 

First, a univariate analysis was used to show 
changes across the analyzed years. Second, chi-square 
and t-tests were conducted to assess whether independent 
and control variables differ significantly on two attitudes. 
Finally, three sets of binary logistic regression models 
were run to identify main sociodemographic 
determinants of HIV-related discriminatory attitudes 

among women aged 15-49 years in Tajikistan. Model 1 
displayed the logistic regression predicting tolerant 
attitudes towards PLWHA by three key independent 
measures: knowledge of HIV/AIDS prevention, myths 
about HIV/AIDS transmission, and having ever had an 
HIV/AIDS test. Model 2 added demographic 
characteristics. Model 3 built upon the previous model 
while controlling for socioeconomic characteristics. Stata 
14 was used for all analyses. 

 

Results 

Figure 1 presents the change in attitudes 
towards PLWHA from 2000 to 2005. The percentages of 
women who did not express discriminatory attitudes have 
increased insignificantly for both questions/scenarios 
beteween 2000 and 2005. The change was slightly higher 
for respondents who believed that an HIV-positive 
teacher should continue teaching (1.31%) than for 
respondents who would not buy food from an HIV-
positive cashier (1.02%).  

16.31

8.09

17.62

9.11

0
2
4
6
8

10
12
14
16
18
20

Should teacher with
HIV/AIDS be allowed to

teach in school

Would buy food from
shopseller with HIV/AIDS

T
ol

er
an

t a
tt

itu
de

s t
ow

ar
ds

 P
L

W
H

A

Notes: Source: MICS 2000, 2005.
Proportions (%) are given for answer "yes."  

2000

2005

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Characteristics Should teacher with HIV/AIDS 
be allowed to teach in school 

Would buy food from 
shopseller with HIV/AIDS 

Knowledge of HIV/AIDS prevention 
Yes 
No 
Myths about HIV/AIDS transmission 
Do not endorse myths 
Endorse myths 
Ever had HIV/AIDS test 
Yes 
No 
Age  
In years (range: 15-49) 
Marital status  
Currently married 
Not married  
Region of residence 
Dushanbe  
Khatlon 
Sogd 
DRD 
GBAO 
Residence type 
Urban 
Rural 
Education  
Else  
Higher 
Household income 
Low 
Medium 
High 
N 
Percent  

     *** 
19.79% 
 11.58% 
        *** 
19.66% 
 4.64% 

        *** 
25.14% 
17.08% 

 
30.21   9.69 

*** 
14.96% 
23.66% 
    *** 

27.84% 
13.60% 
11.84% 
8.09% 

23.07% 
    *** 

24.65% 
12.32% 
      *** 
13.80% 
33.78% 
        *** 
9.32% 

13.35% 
24.97% 
5,453 

17.88% 

     ** 
9.58% 
7.17% 

         *** 
10.07% 
  1.24% 

            *** 
14.23% 
 8.45% 

       
  29.64    9.73** 

*** 
6.73% 

13.55% 
   *** 

11.88% 
9.07% 
4.98% 
3.18% 

14.58% 
    *** 

11.76% 
6.78% 
   *** 
7.37% 

15.45% 
        *** 
5.75% 
6.65% 

12.14% 
5,453 
9.02% 

Notes:  Means and standard deviations are presented for continuous variables; proportions (%) are presented for 
categorical variables. Proportions are given for answer “yes.” 
t-tests are used to assess significant differences between means for continuous variables; χ2 are used for 
categorical variables 
*p ≤ .05, **p ≤ .01, ***p ≤ .001. 

Table 1. Proportion of respondents showing positive attitudes, MICS 2000, 2005 

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Table 1 presents descriptive statistics for all 
variables used in the study. Overall, less than one in five 
(17.88%) respondents believed that an HIV-positive 
teacher should be allowed to teach. Only one in ten 
(9.02%) said that they would buy food from an HIV-
positive cashier.  

Significant differences in tolerance towards 
PLWHA were observed on all measures, except for the 
age variable on allowing an HIV-positive teacher to teach 
in school. Significantly higher proportions of 
respondents who knew about HIV/AIDS prevention and 
transmission methods and had ever been tested for 
HIV/AIDS said that an HIV-positive teacher should 
continue teaching and that they would buy food from an 
HIV-positive cashier. Compared to respondents from 
other regions of the country, significantly higher 
proportions of respondents from the capital city of 
Dushanbe and GBAO had positive attitudes to HIV-
infected teachers and cashiers. Significantly higher 
proportions of unmarried women and those who live in 
urban areas expressed less discriminatory attitudes 
compared to their married and rural dweller comparisons. 
For example, the percentage of urban respondents who 
believed that an HIV-positive teacher should continue 
teaching was twice as high (24.65%) in comparison to 
those from rural areas (12.32%). Additionally, the 
proportion of women who showed less HIV 
discriminatory attitudes had higher socioeconomic status 
characteristics.    

Table 2 reports results from the three sets of 
binary logistic regression models. As the baseline models 
(columns 1 on both panels) indicated, all three key 
independent measures were strong predictors of 
stigmatizing attitudes, except for the insignificant 
association between knowledge of HIV/AIDS prevention 
and buying food from an HIV positive cashier. Women 
who had knowledge on HIV/AIDS prevention methods, 
correctly identified myths about HIV/AIDS 
transmission, and had ever been tested for HIV/AIDS, 
were respectively 1.63, 4.45, and 1.46 (p≤0.001) times 

more likely than their counterparts to believe that an 
HIV-positive teacher should continue teaching. 
Similarly, women who did not endorse myths and had an 
HIV/AIDS test before, were over eight (OR=8.36, 
p≤0.001) and near two times (OR=1.74, p≤0.001) more 
likely to buy food from an HIV-positive cashier.  

No substantial changes occurred once 
demographic and socioeconomic status characteristics 
were introduced in Models 2 and 3. Overall, the effects 
of three key predictors of stigmatization attitudes 
persisted in these models (columns 2 and 3 on both 
panels). A noticeable difference was observed with 
respondents who had an HIV/AIDS test. The magnitudes 
of effects for these respondents who believe that an HIV-
positive teacher should continue teaching attenuated by 
10% and further 5% with the introduction of 
demographic and socioeconomic measures respectively, 
turning the previously highly significant estimate 
(OR=1.46, p≤0.001) into significant (OR=1.31, p≤0.05) 
and marginally significant (OR=1.24, p≤0.10) when 
comparing the coefficients in Model 1 to Model 2 and 
Model 2 to Model 3. The introduction of the demographic 
characteristics increased the magnitudes of effects nearly 
by 5%, turning the highly significant estimate into 
significant (OR=1.74, p≤0.001 vs OR=1.82, p≤0.05), 
whereas the inclusion of socioeconomic controls 
decreased the magnitudes and returned the estimate to 
highly significant (OR=1.82, p≤0.05 vs OR=1.76, 
p≤0.001).  

There was no association between age and 
discriminatory attitudes. Marital status and rural location 
were negatively associated, whereas education and 
household income were positively associated with 
discriminatory attitudes. On the first outcome (an HIV-
positive teacher should continue teaching in school), 
women living in the capital city of Dushanbe were less 
likely to report discriminatory attitudes than respondents 
from all regions of the country, except for GBAO. 
Similar associations were observed on the second 
outcome (buying food from an HIV-positive shopseller), 

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 Should teacher with HIV/AIDS be 
allowed to teach in school 

Would buy food from shopseller with 
HIV/AIDS 

Model 1 Model 2 Model 3 Model 1 Model 2 Model 3 

Knowledge of 
HIV/AIDS prevention 
Myths about HIV/AIDS 
transmission 
HIV/AIDS test (yes) 
 
Age (range: 15-49) 
 
Currently married (ref. 
Not married)  
Khatlon (ref. 
Dushanbe) 
Sogd (ref. Dushanbe) 
 
DRD (ref. Dushanbe) 
 
GBAO (ref. Dushanbe) 
 
Rural (ref. Urban) 
 
Higher education (ref. 
Other)  
Medium income (ref. 
Low income) 
High income 
household (ref. Low 
income) 
 
Year 2005 
 
 

1.63***  
(1.34-1.97) 

4.45***  
(3.05-6.47) 

1.46***  
(1.16-1.83) 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

1.08 
(0.88-1.31) 

0.03*** 
 

1.61*** 
(1.32-1.98) 

3.45***  
(2.36-5.05) 

1.31*  
(1.04-1.67) 

1.01  
(0.95-1.07) 

0.60*** 
(0.50-0.72) 

0.64*** 
(0.49-0.84) 

0.60*** 
(0.48-0.76) 

0.44*** 
(0.32-0.61) 

1.43** 
(1.13-1.82) 

0.54*** 
(0.44-0.65) 

 
 
 
 
 
 
 
 

0.85 
(0.69-1.05) 

0.09***  
 

1.51*** 
(1.23-1.85) 

3.04***  
(2.07-4.45) 

1.24+  
(.98-1.58) 

.98 
(0.92-1.04) 

0.66*** 
(0.54-0.79) 

0.79+ 
(0.59-1.04) 

0.69** 
(0.54-0.87) 

0.50*** 
(0.36-0.70) 

1.47** 
(1.15-1.88) 

0.74** 
(0.59-0.92) 

2.05*** 
(1.73-2.43) 

1.14 
(0.89-1.46) 

1.55*** 
(1.19-2.02) 

 
 

0.99 
(0.80-1.23) 

0.08*** 
 

1.15  
(0.91- 1.47) 

8.36***  
(4.13-16.94) 

1.74***  
(1.31-2.32) 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

1.20 
(0.92-1.57) 

0.01*** 

1.23 
(0.95-1.58) 

5.87***  
(2.89-11.95) 

1.82*  
(1.35-2.46) 

1.01  
(0.94-1.09) 

0.49*** 
(0.39-0.63) 

1.20*** 
(0.86-1.69) 

0.69* 
(0.50-0.94) 

0.49** 
(0.30-0.80) 

2.25*** 
(1.66-3.06) 

0.55*** 
(0.43-0.71) 

 
 
 
 
 
 
 
 

0.87 
(0.66-1.16) 

0.02***  

1.17 
(0.91-1.52) 

5.39***  
(2.65-10.98) 

1.76***  
(1.30-2.38) 

0.99  
(0.91-1.07) 

0.53*** 
(0.41-0.67) 

1.40+ 
(0.99-1.98) 

0.75* 
(0.54-1.04) 

0.54* 
(0.33-0.89) 

2.35*** 
(1.73-3.19) 

0.71* 
(0.54-0.95) 

1.52*** 
(1.22-1.91) 

0.87 
(0.63-1.19) 

1.30 
(0.93-1.82) 

 
 

0.96 
(0.72-1.28) 

0.02*** 

Notes:      Effect estimates are presented as odds ratios. Confidence intervals are given in parentheses. 
 +p < 0.10, *p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001. 

Table 2. Binary logistic regression predicting positive attitudes towards people living with HIV/AIDS, MICS 2000, 2005 

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where women from Khatlon joined women from GBAO 
in reporting less discriminatory attitudes than women 
from Dushanbe. 

 

Discussion 

Using a nationally representative sample, the 
study aimed to identify sociodemographic determinants 
of HIV-related discriminatory attitudes of women aged 
15-49 in Tajikistan, as well as to examine changes over 
time. Over five years, changes in women’s attitudes 
occurred insignificantly or at very low rates. The 
shortage of HIV/AIDS awereness program and 
incentives for voluntary HIV testging, due to the slow 
recovery of the country following a five-year civil war 
from 1992-1997, might account for such low and 
insignificant changes. The key finding of the study, 
demonstrating that women’s knowledge of HIV 
prevention and transmission methods and HIV testing are 
significant predictors of tolerant attitudes towards 
PLWHA, supports this assertion. The the association 
remained significant even after controlling for 
demographic and socioeconomic status characteristics. 
Prior research indicates that during the period of 2000-
2005 there was a two-fold increase in general knowledge 
about HIV/AIDS, accompanied by a substantial decrease 
in the ability to correctly identify prevention methods and 
transmission misconceptions among women of 
reproductive age in Tajikistan.3 With the availability of 
next waves of the survey, the study should be replicated 
to continue monitoring changing trends of discriminatory 
attitudes towards PLWHA. Some positive changes were 
shown by recent studies. According to the 2007 National 
Study, the percentages of people who believed that an 
HIV-infected teacher should be allowed to teach and that 
they would buy food from an HIV-positive vendor were 
39.4% and 23.3% respectively.2  

The findings on the first two main predictors are 
consistent with numerous previous studies.12,13,14 
Concerning the third predictor, the finding corroborates 

with some studies that found negative association 
between the probability of being tested and HIV 
stigmatizing attitudes10,11,12 and contradicts others that 
demonstrated that HIV testing was not a significant factor 
in achieving positive attitudes towards PLWHA.13 Our 
findings suggests the importance of HIV testing in 
reducing discriminatory attitudes. Efforts should be made 
towards programs that promote and encourage voluntary 
HIV testing. Debilitating fear of encountering 
discrimination affects negatively women’s intentions, 
whereas health education on HIV counselling and testing 
increases their willingness to test for HIV.17 

Consistent with previous research, it was found 
that women’s tolerant attitudes were positively 
associated with education, high income, and urban 
residency.12,16 Women in poverty, less educated, and 
from rural areas were found to be more likely to express 
discriminatory attitudes towards PLWHA.  

With the exception of women from GBAO, 
respondents from other regions reported higher rates of 
discriminatory attitudes than those from the capital. This 
could be linked to high rates of education among the 
GBAO women. These women participate more actively 
in household decisions, have higher rates of modern 
contraceptives use, highest median age at first marriage, 
and more advanced median age at first birth,18 which are 
comparable to women with higher education.  

The finding on significance of marital status is 
consistent with previous research.15 Married women 
were more likely to report discriminatory attitudes. An 
explanation can be sought in fear related to AIDS.15 
Tajikistan has an estimated one million male labor 
migrants who are “likely to have unprotected contacts 
with sex workers and return home without HIV testing.”6 
Fear concerning contracting the disease might shape 
negative attitudes of married women whose husbands 
construct the backbone of labor migrant force of the 
country.    

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The study has several limitations. First, the 
MICS survey focuses on women’s attitudes towards 
PLWHA, as this study has not collected data from people 
experiencing discriminatory acts. Prior research 
demonstrates a weak relationship between attitudes and 
discrimination.19,20 Future surveys should include 
questions that measure PLWHA’s own perceptions of 
HIV-related discrimination. A significantly negative 
impact of perceived HIV stigma on quality of PLWHA’s 
both physical and psychosocial dimensions of life has 
been demonstrated by previous research.21 Second, since 
the data focus primarily on female respondents, it is not 
possible to identify gender differences in attitudes 
towards people living with HIV/AIDS. Prior studies 
show that men express discriminatory attitudes towards 
HIV-infected people at higher rates than women.12 Third, 
the data do not reveal socioeconomic status of PLWHA. 
Studies demonstrate that discriminatory attitudes are 
more austere towards marginalized groups, such as 
homosexual men, sex workers, and injection drug users 
who engaged in behaviors that potentially led to the 
disease.9 Finally, since the current MICS surveys on 
Tajikistan were conducted 14 and 19 year ago, 
applicability of such data to current situation can raise 
questions. With the emergence of new data, the study 
should be replicated to demonstrate evolution of attitudes 
over the current period.    

Although worldwide advances in medicine, 
technology, and treatment have transformed HIV into a 
managed and chronic disease, pervasiveness and harmful 
consequences of HIV-related discrimination remain 
acute. Combatting negative attitudes towards PLWHA to 
ensure that PLWHA enjoy their human rights, maintain a 
good quality of life, and continue to be productive local 
and global citizens is an essential component of the 
global HIV response toward the creation of an AIDS-free 
generation. While local communities, national 
governments, and international organizations around the 
globe employ policies and implement programs to reduce 
HIV-related discrimination, empirical studies identifying 
effective interventions to guide such policies are crucial. 

The data from Tajikistan underscore the persistence of 
HIV-related discriminatory attitudes among women of 
reproductive age. Consistent with previous research, lack 
of adequate knowledge on HIV/AIDS prevention and 
transmission methods and restraining practices on HIV 
testing are shown to be powerful factors that shape 
negatively women’s attitudes towards PLWHA. The 
study suggests the need for programs that promote 
voluntary HIV-testing, raise awareness about HIV/AIDS 
prevention methods, and help dispelling transmission 
misconceptions aimed at reduction of HIV-related 
discrimination. These findings also call for designing and 
implementing comprehensive interventions for women 
who are in poverty, married, live in rural areas, and less 
educated to change their attitudes towards PLWHA. 
Given the importance of reducing HIV-related 
discrimination worldwide, the findings from Tajikistan 
could inform policy interventions in the former Soviet 
Central Asian countries with similar sociopolitical 
background and economic transformation, as well as in 
other countries across the world with low HIV 
prevalence. 

 

References  

1. UNAIDS. World AIDS day report 2012. 
Geneva: UNAIDS; 2012. 

2. SRC (Strategic Research Center under President 
of Tajikistan). National study on the 
stigmatization and forms of discrimination 
against people living with HIV, 2007. 
Dushanbe, Tajikistan: Strategic Research 
Center under President of Tajikistan; 2007. 

3. Zainiddinov H, Habibov N. Trends and 
predictors of knowledge about HIV/AIDS and 
its prevention and transmission methods among 
women in Tajikistan. European Journal of 
Public Health 2016; 26(6):1075-9. 

4. Zainiddinov H,  Habibov N. A comparison of 
comprehensive HIV/AIDS knowledge among 
women across seven post-Soviet countries. 

http://www.library.pitt.edu/
http://www.pitt.edu/
http://www.library.pitt.edu/articles/digpubtype/index.html
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This work is licensed under a Creative Commons Attribution 4.0 United States License. 

 
This journal is published by theUniversity Library System of the University of Pittsburgh as part  

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Central Asian Journal of Global Health 
Volume 8, No. 1 (2019) |  ISSN 2166-7403 (online) | DOI 10.5195/cajgh.2019.349|http://cajgh.pitt.edu 

 
 

Central Asian Journal of Global Health 2018; 
7(1) doi: 
10.5195/cajgh.2018.295|http://cajgh.pitt.edu. 

5. Latypov A. Two decades of HIV/AIDS in 
Tajikistan: Reversing the tide or the coming of 
age paradigm? China and Eurasia Forum 
Quarterly 2008; 6(3):101-28. 

6. Golobof A, Weine S, Bahromov M, Luo J. The 
roles of labor migrants’ wives in HIV/AIDS risk 
and prevention in Tajikistan. AIDS Care 2011; 
23:91–7. 

7. SSA (State Statistical Agency of the Republic of 
Tajikistan). Tajikistan multiple indicator cluster 
survey 2000. Dushanbe, Tajikistan: State 
Statistical Agency of the Republic of Tajikistan; 
2000. 

8. SCS (State Committee on Statistics of the 
Republic of Tajikistan). Tajikistan multiple 
indicator cluster survey 2005. Dushanbe, 
Tajikistan: State Committee on Statistics of the 
Republic of Tajikistan; 2007. 

9. Herek GM, Capitanio JP, Widaman KF. HIV-
related stigma and knowledge in the United 
States: Prevalence and trends, 1991–1999. 
American Journal of Public Health 
2002;92(3):371–7. 

10. Genberg BL et al. A comparison of HIV/AIDS-
related stigma in four countries: Negative 
attitudes and perceived acts of discrimination 
towards people living with HIV/AIDS. Social 
Science & Medicine 2009; 68(12):2279–87. 

11. Young SD et al. HIV-related stigma, social 
norms, and HIV testing in Soweto and 
Vulindlela, South Africa: National institutes of 
mental health project accept (HPTN 043). 
Journal of Acquired Immune Deficiency 
Syndrome 2010; 55(5):620-4.  

12. Corno L, De Walque D. Socioeconomic 
determinants of stigmatization and HIV testing 
in Lesotho. AIDS Care 2013; 25(1):108-13. 

13. Mutombo N, Maina B. Factors influencing 
attitudes towards people living with HIV/AIDS 
in Zambia: Does HIV testing matter? J Infect 
Dis Ther 2014; 3:197.  

14. Terzic-Supic Z et al. Cross sectional study on 
attitudes of Serbian mothers with preschool 
children: Should a HIV-positive female teacher 
be allowed to continue teaching in school? 
BMC International Health and Human Rights 
2015; 15:31. 

15. Lau JFT, Tsui HY. Discriminatory attitudes 
towards people living with HIV/AIDS and 
associated factors: A population based study in 
Chinese general population. Sex Transm Infect 
2005; 81:113–9.  

16. Gurmu E, Etana D. HIV/AIDS knowledge and 
stigma among women of reproductive age in 
Ethiopia. African Journal of AIDS Research 
2015; 14(3):191-9. 

17. Adeneye AK et al. Willingness to seek HIV 
testing and counseling among pregnant women 
attending antenatal clinics in Ogun State, 
Nigeria. International Quarterly of Community 
Health Education 2006; 26(4):337–53. 

18. Statistical Agency, Republic of Tajikistan, and 
ICF International. 2012 Tajikistan demographic 
and health survey: Key findings. Dushanbe, 
Tajikistan and Calverton, Maryland, USA: 
Statistical Agency (Tajikistan), and ICF 
International; 2013. 

19. LaPiere RT. Attitudes vs. actions. Social Forces 
1934; 13:230–7.  

20. Eagly A, Chaiken S. The impact of attitudes on 
behavior. In: Eagly A, Chaiken S, Youngblood 
D, editors. The psychology of attitudes, New 
York: Harcourt; 1993, p. 155-281. 

21. Holzemer WL et al. Exploring HIV stigma and 
quality of life for persons living with HIV 
infection. J Assoc Nurses AIDS Care 2009; 
20(3):161–8.

 

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	Trends and Determinants of Attitudes Towards People Living with HIV/AIDS Among Women of Reproductive Age in Tajikistan
	Abstract
	Keywords: Tajikistan; HIV/AIDS; discriminatory attitudes; women; PLWHA
	Trends and Determinants of Attitudes Towards People Living with HIV/AIDS Among Women of Reproductive Age in Tajikistan
	Research

