Abstract
Introduction
Although improvements in HIV prevention and control have been made worldwide, adolescents and young women remain at increased risk for HIV infection, especially in developing countries. In Cambodia, the prevalence of HIV has decreased substantially from the peak of the HIV epidemic (2%) in the 1990s to 0.6% in 2021. While young women aged 15-24 years are most affected, especially sexually active ones, insight into the factors associated with their knowledge and attitudes toward HIV prevention is critically important for targeted HIV prevention efforts. Therefore, an investigation on this age range is needed to systematically examine the influence of sociodemographic and structural factors on their knowledge and attitudes toward HIV prevention in Cambodia.
Methods
The study was carried out with secondary data from the 2021-2022 Cambodia Demographic and Health Survey (CDHS). It involved 1,389 women aged 15–24 years. The dependent variables were levels of knowledge and attitudes toward HIV prevention, which were categorized as good or poor. The explanatory variables included educational status, wealth index, age group, marital status, residence, health facility visits, and exposure to media. The data were analyzed using descriptive statistics and bivariate and multivariable logistic regression models. The significance level of alpha (0.05) was used to test the statistical significance.
Results
Overall, 63.8% of these young women demonstrated a good level of knowledge about HIV/AIDS, whereas 56.7% had moderately positive attitudes. Good knowledge of HIV prevention was independently associated with being aged 20–24 years with an adjusted odds ratio (AOR) of 1.28 (95% CI: 1.02–1.62), being rich (AOR=1.38, 95% CI: 1.03–1.83), having a higher education level with AOR=3.21 (95% CI: 1.57–7.53), and having regular internet access (AOR=1.53, 95% CI: 1.15–2.02). For positive attitudes toward HIV prevention, independent associations were found among women aged 20-24 years with AOR=1.51 (95% CI: 1.17-1.96), married/living with a partner (AOR=2.26, 95% CI: 1.67-3.06), being rich (AOR=1.36, 95% CI: 1.01-1.83), and with higher education (AOR=8.86, 95% CI: 3.83-20.50).
Conclusion
The finding reveals that young women aged 20-24 years, being in the rich wealth quintile, having higher education, and having regular internet access are important predictors of good knowledge and positive attitudes toward HIV prevention. The study also revealed that positive attitudes toward HIV prevention were associated with marital status. Therefore, intervention efforts should focus on younger women aged 15-19 years and those with a lower socioeconomic status, low education level and nonmarried status.