In rural India, where HIV infection is increasingly common, the disease is spreading to a large number of women via their partners. Knowledge is the main, critical step towards stopping the spread of HIV to women. What factors prevent women from gaining and using knowledge of HIV and AIDS to protect themselves and others?

India has one of the highest numbers of HIV infected people in the world, estimated at 3.82 to 4.58 million people. HIV infection is spreading from high risk to low risk population groups, to rural areas and to women in large numbers. A report in 2000 showed that around 40 percent of women in India were aware of AIDS. While knowledge of AIDS appears to have improved overall since then, a gap still exists between women and men.

Research by the UK's University of Southampton identifies the social, cultural and reproductive health factors associated with awareness of HIV and AIDS among rural women in the Indian states of Maharashtra and Tamil Nadu, where urban HIV infection is relatively high. It also looked at factors associated with women’s knowledge of whether AIDS can be avoided and awareness of what steps can be taken to avoid infection.

The study found women’s knowledge of HIV and AIDS is increasing but this is not taking place in a uniform manner, with significant differences noted across sub-groups of people. It makes the following findings:

• In Maharashtra, 47 percent of rural women were aware of HIV and AIDS but only 28 percent were aware that it can be avoided and only 16 percent knew how it is transmitted.
• In Tamil Nadu, 82 percent of rural women had knowledge of HIV and AIDS and 71 percent were aware it can be avoided while only 31 percent knew how it is transmitted.
• In both states, women from groups considered socially and economically backward were comparatively lacking in awareness of HIV and AIDS and how to avoid contracting the disease.
• Socio-cultural and reproductive health factors associated with knowledge of HIV and AIDS and the effect of contact with family planning workers differed in the two states.

As HIV and AIDS are spreading from urban to rural areas, a greater effort is needed to actively disseminate knowledge of the disease to encourage protection against infection, rather than to allow awareness to result from HIV infection in rural communities. The study made a number of suggestions for HIV and AIDS intervention programmes, including:

• Health workers such as those in family planning could be used to a greater degree to spread knowledge of HIV and AIDS, as this method appears to be underutilised.
• As knowledge of HIV and AIDS varies among sub-groups, programmes to reduce infection rates will need to be innovative to reach sub-groups rather than uniformly targeting the population. 
• Greater use could be made of identified routes for the transfer of health knowledge, such as television in Maharashtra, rural health workers in Tamil Nadu and schools in both states.
• Interventions will need to target men due to the dynamics of condom use in male-dominated cultures and because HIV is more easily transmitted heterosexually from men to women.

Source(s):
‘Rural women’s knowledge of AIDS in the higher prevalence states of India: reproductive health and sociocultural correlates’, Health Promotion International 20(3), pages 249-259, by Saseendran Pallikadavath, et al, 2005
HINARI subscribers can access the full-text article here. Full document.

Funded by: UK Department for International Development (DFID)

id21 Research Highlight: 12 April 2006

Further Information:
R. William Stones
Centre for AIDS Research
University of Southampton
Highfield
Southampton SO17 1BJ
United Kingdom

Tel: +44 (0) 23 8079 6033
Fax: +44 (0) 23 8078 6988
Contact the contributor: r.w.stones@soton.ac.uk

Centre for AIDS Research, University of Southampton, UK

Other related links:
'The risk of HIV infection in India's female sex workers'

'Out of sight, out of mind: children affected by HIV/AIDS in India'

'Predicting health care needs and costs at HIV/AIDS clinics in India'

'What are condoms used for? Insights from Orissa'

'Home help – how communities cope with HIV'

'Awareness and knowledge of AIDS among Indian women: evidence from 13 states', Health Transition Review, 7 Suppl, pages 421-465, by D. Balk and S. Lahiri, 1997

'Indian women face peril of HIV', BBC News Online, 21 September 2005