Discriminatory Attitudes Towards People Living With HIV Among Key Populations in Nigeria: A Latent Class Analysis

Background: HIV-related discrimination remains a significant barrier to the uptake of HIV prevention and treatment services in sub-Saharan Africa among key populations (KPs). However, despite the substantial risk of HIV among peers within their social networks, there is a paucity of data on their attitudes towards people living with HIV (PLHIV). This study aimed to examine discriminatory attitudes towards PLHIV among KPs in Nigeria. Methods: This study was a secondary data analysis of the 2020 Integrated Biological and Behavioral Surveillance Survey in Nigeria, which included 17,975 KPs. We operationalized discriminatory attitudes as negative responses to questions on caring for PLHIV, buying food from PLHIV, working with PLHIV, sharing a meal with PLHIV, and a positive response to quarantining PLHIV. We conducted weighted descriptive statistics to summarize the data, and latent class analysis was used to determine the patterns of discriminatory attitudes. The predicted probabilities of the classes for each KP characteristic were estimated while holding all other characteristics in the model at their means. The data analysis was conducted using Stata 18. Results: About 13.5% of participants indicated they would not provide care for PLHIV , 29.7% would not buy food from them, 15.8% would not work with them, 27.9% would not share a meal with them,and 16.3% believed that PLHIV should be quarantined. Three latent classes of discriminatory attitudes were identified: low discriminatory attitude (65%), moderate discriminatory attitude (23%), and high discriminatory attitude (11%). The highest predicted probability of high discriminatory attitude was observed among KPs with unknown HIV status (42%), followed by those residing in the Southeast region (39.7%). Conclusion: Discriminatory attitudes towards PLHIV are common among KPs in Nigeria. Interventions aimed at reducing HIV-related discrimination should also target KPs.