YOUNG WOMEN’S DISCRIMINATORY ATTITUDE TOWARDS PEOPLE LIVING WITH HIV/AIDS (PLWHA) IN INDONESIA 2017

Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) is an emergency problem in every country. Since its first appearance in 1987, the number of HIV cases has continued to increase every year. Various actions have been made to prevent and deal with the spread of HIV/AIDS infection. The high discriminatory attitude towards people living with HIV/AIDS (PLWHA) is one of the inhibiting factors in the curing process of the disease. The adolescent is the potential resource for national development, mainly as the agent of change. Hence, they can be prepared as a new generation who are not discriminative to PLWH, specifically female adolescents who tend to perform discriminative attitudes than males. This study provides an analyze of the determinants of discriminatory attitudes of young women towards PLWHA in Indonesia 2017. The data extracted from the Indonesian Demographic and Health Survey (IDHS) 2017 were analyzed by applying binary logistic regression. The results show that the discriminatory attitudes of young women towards PLWHA in Indonesia in 2017 are significantly affected by the variables of residence, exposure to media/information, comprehensive knowledge, and level of education.


INTRODUCTION
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome and attitudes that discriminate and even isolate PLWHA will make people at risk reluctant to take an HIV test, do not want to know their test results, do not try to get proper treatment, and tend to hide their disease status (IDHS, 2017). The consequences of stigma and discriminatory attitudes towards PLWHA can actively hinder access to HIV/AIDS screening and care (WHO, 2017). People living with HIV are afraid to reveal their HIV status and decide to postpone seeking treatment for their infection. This situation can make the HIV infection worse. Moreover, the transmission of HIV infection cannot be controlled or treated well. Overall, widespread HIV/AIDS discrimination leads to low participation in HIV counseling and testing, identity crisis, isolation, loneliness, low self-esteem, and lack of interest in tackling the disease (WHO, 2016).
Adolescent is defined as never-married women and men aged 15-24 years old (IDHS, 2017). Adolescents are the largest age group in the population structure in Indonesia. The result of the 2020 Population Census recorded that there were 46.07 million youths (BPS, 2021). The result also shows that the number of adolescents increases by more than 12 percent compared to 2010. This large number of adolescents is a challenge for the government. Adolescents are a strategic and potential resource for the Indonesian future as a demographic bonus. Hence, adolescents with good quality will benefit Indonesia's productivity and economic growth in the next few years. Otherwise, without proper treatment, they will become a demographic burden.
Discriminatory attitudes in adolescents against PLWHA are a crucial issue. The low level of comprehensive knowledge of adolescents related to HIV/AIDS is one of the factors that cause high discriminatory attitudes towards PLWHA among adolescents. Maharani (2017) shows that the average high school teenager in Pekanbaru did not want to be near or in direct contact with PLWHA. Many adolescents think that HIV/AIDS is a cursed disease. Thus, the PLWHA are deserved to get bad treatment from their environment. another study shows that the level of acceptance of PLWHA from teenagers is also concerning (Baroya, 2017). In that study, 81.4 percent of teenagers are not willing to buy food if they know the seller has HIV positive, 50 percent of teenagers disagree whether IV-positive female teachers continue to teach even though they are not sick, and almost 50 percent of teenagers have not been able to accept HIV-positive children for schools with HIV-negative children (Baroya, 2017). These results indicate the high discriminatory attitude towards PLWHA among adolescents. It is not easy for teenagers to accept PLWHA because of fear of being infected and other negative assumptions.
Young women tend to discriminative than young men (Pitasi, 2018). Another study also found that young women tend to be twice as high as young men to be discriminative (Baroya, 2017 Based on these problems, this study aims to determine the general description of the discriminatory attitudes of young women towards PLWHA and identify the variables that influence the discriminatory attitudes of young women towards PLWHA in Indonesia 2017.

METHOD
The data for the study is extracted from the Indonesia Demographic and Health Survey (IDHS) 2017. The unit of analysis is unmarried women aged 15-24 years (young women) who had heard about HIV/AIDS. The number of samples in this study was 9,665 young women. This study implements both descriptive and inferential analyses. The descriptive analysis is applied to describe the characteristics of young women based on the discriminatory attitudes towards PLWHA. The binary logistic regression is used to examine the association of the explanatory variables and discriminatory attitudes toward PLWHA. The response variable and explanatory variables used in this study are defined clearly in table 1. Sources of information related to HIV/AIDS were obtained from radio, television, newspapers/magazines, leaflets/posters, health workers, religious associations, schools/teachers, community gatherings, friends/family, workplace, internet, and others. Each source of information is given a score of 1, so the maximum score is 12.
Code 0: if the total score is more than 3 (high) Code 1: if the total score is 2 to 3 (medium) Code 2: if the total score is less than equal to 1 (low)

RESULTS
The percentage of young women who are discriminative towards PLWHA is higher than young women who are non-discriminative. There is 74 percent of young women which performs discriminatory attitude towards PLWHA. The high level of discriminatory attitudes found in young women makes it important to make efforts to reduce discriminatory attitudes in young women in Indonesia. who have a high level of education will be more non-discriminatory.
The results of inferential analysis using binary logistic regression yield the chi square value of the simultaneous test of all variables included in the model is 328.690 with a p-value of 0.000. The p-value is less than 0.05, it can be concluded that at least one explanatory variable has a significant influence on the discriminatory attitudes of young women towards PLWHA in Indonesia 2017. Considering the result of the simultaneous test, then the partial test is carried out. This test is applied to investigate which explanatory variables have significant effects on the discriminatory attitude of young women toward PLWHA. Table 3 summarizes the results of the partial test. Based on Table 3, Four variables such as residence, comprehensive knowledge, exposure to media/information, and level of education significantly affect the discriminatory attitudes of young women towards PLWHA.

DISCUSSION
The results of the partial test decision (Table 3) for the age variable in this study indicate that the age variable has no significant effect on the discriminatory attitudes of young women towards PLWHA in Indonesia in 2017. This fact is in line with the fact that there is no difference in the percentage of young women with discriminative attitudes toward PLWHA in both age groups. Moreover, both age groups cover young women who are still of school age.
Hence, the knowledge about HIV/AIDS is obtained mainly from the teachers at the school. As  (Irwan, 2017).
The residence of young women has a significant effect on the discriminatory attitudes of young women towards PLWHA in Indonesia in 2017 (p-value = 0.036). The odds ratio of young women living in rural areas is 1.109, meaning that young women who live in rural areas have 1.109 times more likely to discriminate against PLWHA than young women who live in an urban area. This result is in line with the research in Ethiopia that showed that people living in rural areas to be more discriminatory towards PLWHA (Gedefaw et al., 2020). Another study also shows that residents living in rural areas tend to reject PLWHA compare with residents living in urban areas (Wahyuni and Ronoatmodjo, 2017). People living in urban areas have better access to media or information providing health information and especially information about stigma and discrimination to the public (Gedefaw et al., 2020). Meanwhile, generally rural residents have limited access to media/information and have low education (Rahani, 2019).
The comprehensive knowledge performs a significant effect on the discriminatory attitudes towards PLWHA. The odds ratio for young women who do not have comprehensive knowledge about HIV/AIDS is 2.468. It means that young women who do not have comprehensive knowledge of HIV/AIDS tend 2,468 times to discriminate against PLWHA compared to young women who have comprehensive knowledge. A study states that people without comprehensive knowledge of HIV/AIDS will tend to be twice as likely to discriminate against PLWHA (Rahani, 2019). This discrimination depends on the misunderstandings and a lack of knowledge that triggers discriminatory attitudes. Another study also shows that knowledge about HIV/AIDS is the dominant factor influencing the rejection of PLWHA in society (Wahyuni and Ronoatmodjo, 2017).
Based on the media exposure, there is a significant effect of medium-level and lowlevel media exposure on the discriminatory attitudes of young women towards PLWHA in Indonesia in 2017. The odds ratio of the medium-level exposure category is 1.176, which means that young women exposed to media/information exposure in medium-level will tend to be 1.176 times more likely to be discriminatory than young women who get high media/information exposure. Furthermore, the odds ratio in the low-level exposure category is 1.276. This result means that young women with low-level media/information access will have a 1.276 times higher tendency to discriminate against PLWHA than women with high media/information exposure. These results reveal that the discriminatory attitudes of young women towards PLWHA tend to be higher along with the lower exposure to media/information they receive. A previous study conducted by Gedefaw et al. (2020) found that having limited access to media leads to discrimination. Media is one source of information for HIV/AIDS prevention and ways to reduce stigmatizing behaviours and discriminatory attitudes towards PLWHA. The HIV/AIDS knowledge provided by media can improve one's understanding of HIV/AIDS. In addition, access to media has a significant impact on a person's attitude towards PLWHA (Wahyuni and Ronoatmodjo, 2017). Therefore, the higher the media exposure that a person gets, the more positive the attitude shown by a person towards PLWHA.
The education level has a significant effect on the discriminatory attitudes of young women towards PLWHA in Indonesia in 2017. The odds ratio of secondary education level is 1.180, which means that young women who have or are currently undergoing education up to high school have a 1.180 times higher tendency to discriminate against PLWHA than young women who have or are currently undergoing education in college. Furthermore, the odds ratio value for the category of primary education level is 1.533, meaning that young women who have a primary level of education will have a 1.533 times higher tendency to discriminate against PLWHA than young women who have or are currently undergoing education in college. This result shows that the lower the level of education, the higher the tendency of young women to be discriminatory. In line with this result, a study that uses primary data from adolescents aged 15-19 years in the Jember district shows that adolescents with education up to elementary and junior high school levels tend to be more discriminatory than adolescents with high school and college education levels (Baroya, 2017

COMPETING INTEREST
Authors declare that wehave no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

AUTHORS' CONTRIBUTION
Corresponding author collects and extract the data, conducts research, interpret the result and write the manuscript. Second author takes role as advisor who has been making sure this research stays on the track.