Knowledge About HIV/AIDS and Its Transmission and Misconception Among Women in Bangladesh

Document Type : Original Article

Authors

1 Department of Health Sciences and Biostatistics, Swinburne University of Technology, Hawthorn, VIC, Australia

2 Transport and Road Safety (TARS) Research Centre, School of Aviation, University of New South Wales, Sydney, NSW, Australia

Abstract

Background 
Asian and pacific region countries are high risk countries for human immunodeficiency virus/ acquired immune deficiency syndrome (HIV/AIDS). Although the prevalence of HIV/AIDS is low in Bangladesh but women in Bangladesh have been identified as susceptible due to associated socioeconomic exposures. There are various misconceptions associated with HIV/AIDS transmission among the women in low- and middle-income countries including Bangladesh, which lead to a negative attitude towards the HIV/AIDS-infected. The purpose of this study was to assess the overall knowledge, transmission, and misconception about HIV/AIDS among the women in Bangladesh as well as its spatial distribution across the country.

Methods 
The study used data from the UNICEF (United Nations Children’s Fund) Multiple Indicator Cluster Survey (MICS) 2019, with a sample of 64 346 women. This was a cross-sectional, population-based survey of Bangladeshi women aged 15–49 conducted using a multistage, cluster sampling technique. Three binary outcome variables considered were knowledge about HIV/AIDS, knowledge about HIV/AIDS transmission and knowledge on myths and misconceptions on HIV/AIDS along with 10 predictors based on past literature. Bivariable analysis using chi-square tests of association was conducted to examine the unadjusted percentage differences of the outcome variables for each of the predictor variables and their associations. Multiple binary logistic regression models were then fitted to evaluate the association between the outcome variables and the predictors after adjusting for survey cluster, strata, and weights. All analysis was conducted in R software (V 2.5.0).

Results 
The percentage of women who held knowledge about HIV/AIDS, knowledge about HIV/AIDS transmission and knowledge on misconceptions about transmission of HIV were on average 60.3%, 52.2% and 71.7% respectively. The models indicated that women regularly exposed to media were 79%, 18% and 19% significantly more likely (odds ratio, OR: [95% CI] = 1.79: [1.70, 1.89]; 1.18: [1.10 1.26] and 1.19: [1.11, 1.27]) to have heard about HIV, aware about HIV transmission, and have less misconceptions about HIV respectively compared to those who were not exposed to media. Overall results indicate that women from peripheral districts living far from metropolitan cities were most unaware of HIV and had higher misconceptions about AIDS.

Conclusion 
The findings of this study should assist policy-makers and program implementers to focus on raising awareness to educating women about how HIV/AIDS is transmitted. Furthermore, interventions should be made by targeting the most disadvantaged groups, including younger women with low education living in rural areas, from poor households and limited access to information. Also, education on HIV transmission in Bangladesh should integrate cultural and ethnic considerations of HIV/AIDS.

Keywords


  • epublished Author Accepted Version: January 9, 2022
  • epublished Final Version: February 8, 2022
  1. Factsheet: Global AIDS Update. 2019. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf.
  2. Joint United Nations Programme on HIV/AIDS-Prevention Gap Report. 2016. p. 30-39. https://www.unaids.org/sites/default/files/media_asset/2016-prevention-gap-report_en.pdf.
  3. Elford J, Dwyer J. HIV and AIDS in Asia and the Pacific. AIDS Care. 1993;5(3):259-260. doi:1080/09540129308258608
  4. Azim T, Khan SI, Nahar Q, et al. 20 Years of HIV in Bangladesh. Washington, DC: World Bank; 2009. doi:1596/27592
  5. Marsh K, Eaton JW, Mahy M, et al. Global, regional and country-level 90-90-90 estimates for 2018: assessing progress towards the 2020 target. AIDS. 2019;33(Suppl 3):S213-S226. doi:1097/qad.0000000000002355
  6. Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. 2021. https://www.unaids.org/en/resources/documents/2021/2021_political-declaration-on-hiv-and-aids.
  7. Sheikh MT, Uddin MN, Khan JR. A comprehensive analysis of trends and determinants of HIV/AIDS knowledge among the Bangladeshi women based on Bangladesh Demographic and Health Surveys, 2007-2014. Arch Public Health. 2017;75:59. doi:1186/s13690-017-0228-2
  8. Haque MA, Hossain MSN, Chowdhury MAB, Uddin MJ. Factors associated with knowledge and awareness of HIV/AIDS among married women in Bangladesh: evidence from a nationally representative survey. SAHARA J. 2018;15(1):121-127. doi:1080/17290376.2018.1523022
  9. Hossain M, Mani KK, Sidik SM, Shahar HK, Islam R. Knowledge and awareness about STDs among women in Bangladesh. BMC Public Health. 2014;14:775. doi:1186/1471-2458-14-775
  10. Khosla N. HIV/AIDS interventions in Bangladesh: what can application of a social exclusion framework tell us? J Health Popul Nutr. 2009;27(4):587-597. doi:3329/jhpn.v27i4.3404
  11. Miedema EA, Maxwell C, Aggleton P. Education about HIV/AIDS--theoretical underpinnings for a practical response. Health Educ Res. 2011;26(3):516-525. doi:1093/her/cyq088
  12. Igulot P, Magadi MA. Socioeconomic status and vulnerability to HIV infection in Uganda: evidence from multilevel modelling of AIDS indicator survey data. AIDS Res Treat. 2018;2018:7812146. doi:1155/2018/7812146
  13. Fred T, Jungari S, Chauhan G, Denis M. Factors associated with knowledge of transmission and prevention of HIV/AIDS among men and women in Uganda: evidence from Demographic Health Survey of Uganda 2016. J HIV AIDS Infect Dis. 2019;5:1-13. doi:17303/jaid.2019.5.102
  14. Aliyu G, Mohammad M, Saidu A, et al. HIV infection awareness and willingness to participate in future HIV vaccine trials across different risk groups in Abuja, Nigeria. AIDS Care. 2010;22(10):1277-1284. doi:1080/09540121003692219
  15. Appiah-Agyekum NN, Suapim RH. Knowledge and awareness of HIV/AIDS among high school girls in Ghana. HIV AIDS (Auckl). 2013;5:137-144. doi:2147/hiv.s44735
  16. The World Bank. HIV/AIDS in Bangladesh. World Bank Research Observer. http://www.worldbank.org/en/news/feature/2012/07/10/hiv-aids-bangladesh. Accessed July 13, 2020. Published 2012.
  17. Van Son N, Luan HD, Tuan HX, Cuong LM, Duong NTT, Kien VD. Trends and factors associated with comprehensive knowledge about HIV among women in Vietnam. Trop Med Infect Dis. 2020;5(2):91. doi:3390/tropicalmed5020091
  18. Iqbal S, Maqsood S, Zafar A, Zakar R, Zakar MZ, Fischer F. Determinants of overall knowledge of and attitudes towards HIV/AIDS transmission among ever-married women in Pakistan: evidence from the Demographic and Health Survey 2012-13. BMC Public Health. 2019;19(1):793. doi:1186/s12889-019-7124-3
  19. Biswas RK, Rahman N, Islam H, Senserrick T, Bhowmik J. Exposure of mobile phones and mass media in maternal health services use in developing nations: evidence from Urban Health Survey 2013 of Bangladesh. Contemp South Asia. 2021;29(3):460-473. doi:1080/09584935.2020.1770698
  20. Asaduzzaman M, Higuchi M, Sarker MA, Hamajima N. Awareness and knowledge of HIV/AIDS among married women in rural Bangladesh and exposure to media: a secondary data analysis of the 2011 Bangladesh Demographic and Health Survey. Nagoya J Med Sci. 2016;78(1):109-118.
  21. UN General Assembly. Work of the Statistical Commission pertaining to the 2030 Agenda for Sustainable Development (A/RES/71/313). https://ggim.un.org/documents/a_res_71_313.pdf.
  22. Rimer BK, Glanz K. Theory at a glance: A guide for health promotion practice. Bethesda, Maryland: National Institutes of Health, National Cancer Institute; 2005:57. https://cancercontrol.cancer.gov/sites/default/files/2020-06/theory.pdf.
  23. Zainiddinov H, Habibov N. Trends and predictors of knowledge about HIV/AIDS and its prevention and transmission methods among women in Tajikistan. Eur J Public Health. 2016;26(6):1075-1079. doi:1093/eurpub/ckw077
  24. Petosa R, Wessinger J. Using the health belief model to assess the HIV education needs of junior and senior high school students. Int Q Community Health Educ. 1989;10(2):135-143. doi:2190/2m88-72l9-q7xy-xe92
  25. Petosa R, Wessinger J. The AIDS education needs of adolescents: a theory-based approach. AIDS Educ Prev. 1990;2(2):127-136.
  26. Lux KM, Petosa R. Using the health belief model to predict safer sex intentions of incarcerated youth. Health Educ Q. 1994;21(4):487-497. doi:1177/109019819402100411
  27. Agustin DA, Prasetyo AA, Murti B. A path analysis on adherence to antiretroviral therapy among HIV/AIDS patients at Dr. Moewardi hospital, Surakarta using health belief model. J Health Promot Behav. 2018 Jun 6;3(1):48-55. doi:26911/thejhpb.2018.03.01.05
  28. Gebru T, Lentiro K, Jemal A. Perceived behavioural predictors of late initiation to HIV/AIDS care in Gurage zone public health facilities: a cohort study using health belief model. BMC Res Notes. 2018;11(1):336. doi:1186/s13104-018-3408-4
  29. Khumsaen N, Stephenson R. Beliefs and perception about HIV/AIDS, self-efficacy, and HIV sexual risk behaviors among young Thai men who have sex with men. AIDS Educ Prev. 2017;29(2):175-190. doi:1521/aeap.2017.29.2.175
  30. Glanz K, Rimer BK, Viswanath K. eds.. Health behavior and health education: theory, research, and practice. John Wiley & Sons; 2008. https://www.academia.edu/6487965/HEALTH_BEHAVIOR_AND_HEALTH_EDUCATION_Theory_Research_and_Practice_4TH_EDITION.
  31. Bangladesh Bureau of Statistics (BBS), UNICEF. Progotir Pathey Bangladesh. Dhaka: BBS, UNICEF; 2019. https://www.unicef.org/bangladesh/en/reports/progotir-pathey-bangladesh.
  32. Ochako R, Ulwodi D, Njagi P, Kimetu S, Onyango A. Trends and determinants of comprehensive HIV and AIDS knowledge among urban young women in Kenya. AIDS Res Ther. 2011;8:11. doi:1186/1742-6405-8-11
  33. Siziya S, Muula AS, Rudatsikira E. HIV and AIDS-related knowledge among women in Iraq. BMC Res Notes. 2008;1:123. doi:1186/1756-0500-1-123
  34. Tenkorang EY. Myths and misconceptions about HIV transmission in Ghana: what are the drivers? Cult Health Sex. 2013;15(3):296-310. doi:1080/13691058.2012.752107
  35. Azim T, Chowdhury EI, Reza M, et al. Prevalence of infections, HIV risk behaviors and factors associated with HIV infection among male injecting drug users attending a needle/syringe exchange program in Dhaka, Bangladesh. Subst Use Misuse. 2008;43(14):2124-2144. doi:1080/10826080802344583
  36. Zhang T, Miao Y, Li L, Bian Y. Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study. BMC Public Health. 2019;19(1):1630. doi:1186/s12889-019-7992-6
  37. Martinez-Cajas JL, Invernizzi CF, Ntemgwa M, Schader SM, Wainberg MA. Benefits of an educational program for journalists on media coverage of HIV/AIDS in developing countries. J Int AIDS Soc. 2008;11:2. doi:1186/1758-2652-11-2
  38. Rahman MS, Rahman ML. Media and education play a tremendous role in mounting AIDS awareness among married couples in Bangladesh. AIDS Res Ther. 2007;4:10. doi:1186/1742-6405-4-10
  39. Mahmood SA. TB and HIV/AIDS in Bangladesh. J AIDS HIV Res. 2010;2(4):66-78. doi:5897/jahr.9000051
  40. Corno L, de Walque D. Socioeconomic determinants of stigmatization and HIV testing in Lesotho. AIDS Care. 2013;25(Suppl 1):S108-113. doi:1080/09540121.2012.736937
  41. Stephenson R. A community perspective on young people's knowledge of HIV/AIDS in three African countries. AIDS Care. 2009;21(3):378-383. doi:1080/09540120802241889
  42. van Velthoven MH, Brusamento S, Majeed A, Car J. Scope and effectiveness of mobile phone messaging for HIV/AIDS care: a systematic review. Psychol Health Med. 2013;18(2):182-202. doi:1080/13548506.2012.701310
  43. Chib A, Wilkin H, Ling LX, Hoefman B, Van Biejma H. You have an important message! Evaluating the effectiveness of a text message HIV/AIDS campaign in Northwest Uganda. J Health Commun. 2012;17 Suppl 1:146-157. doi:1080/10810730.2011.649104
  44. Ahmed T, Bloom G, Iqbal M, et al. E-Health and M-Health in Bangladesh: Opportunities and Challenges. Brighton: Institute of Development Studies (IDS); 2014.
  45. Thanavanh B, Harun-Or-Rashid M, Kasuya H, Sakamoto J. Knowledge, attitudes and practices regarding HIV/AIDS among male high school students in Lao People's Democratic Republic. J Int AIDS Soc. 2013;16(1):17387. doi:7448/ias.16.1.17387
  46. Yaya S, Bishwajit G, Danhoundo G, Shah V, Ekholuenetale M. Trends and determinants of HIV/AIDS knowledge among women in Bangladesh. BMC Public Health. 2016;16(1):812. doi:1186/s12889-016-3512-0
  47. Mondal MN, Rahman MM, Rahman MO, Akter MN. Level of awareness about HIV/AIDS among ever married women in Bangladesh. Food Public Health. 2012;2(3):73-78. doi:5923/j.fph.20120203.03
  48. Mwamwenda TS. Education level and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) knowledge in Kenya. J AIDS HIV Res. 2014;6(2):28-32. doi:5897/jahr2013.0279
  49. Tembon M. Bangladeshi women are rising-onwards and upwards! World Bank Blog. https://blogs.worldbank.org/endpovertyinsouthasia/bangladeshi-women-are-rising-onwards-and-upwards. Published 2021.
  50. Mujeri MK. Women’s economic empowerment and future development of Bangladesh. The Financial Express. https://thefinancialexpress.com.bd/views/womens-economic-empowerment-and-future-development-of-bangladesh-1609856560. Published 2021.
  51. Fladseth K, Gafos M, Newell ML, McGrath N. The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa. PLoS One. 2015;10(4):e0122671. doi:1371/journal.pone.0122671
Volume 11, Issue 11
November 2022
Pages 2542-2551
  • Receive Date: 05 May 2021
  • Revise Date: 04 January 2022
  • Accept Date: 08 January 2022
  • First Publish Date: 09 January 2022