Awareness of HIV/AIDS amongst pregnant women.

Sir,

There is no doubt about the fact that the greatest health crisis that has swept the earth and has changed our world is the HIV epidemic. The latest statistics of the world epidemic of HIV/AIDS as published by UNAIDS/WHO in Nov 2010 states that 33.2 million people were living with HIV, 2.7 million became newly infected with the virus, and 2 million people died of HIV related causes in a year.[1] As we know that prevention of an infection is more important, therefore awareness of the various aspects of this disease deserves the ultimate importance from the strategic point of view.

An observational cross sectional study was conducted in the antenatal clinic of the department of Obstetrics and Gynecology from 1st September 2008 to 31st Dec 2008. A total of 3000 antenatal women were given a questionnaire to evaluate the awareness and attitudes towards HIV.

A total of 2614 (87.13%) of the women under study had heard about HIV/AIDS at some time in their life, whereas 386(12.86%) women had never come across the term.

While analyzing the primary source of information it was observed that the television was the main source accounting for the knowledge of 2215 women (73.83%). It was noted that the sexual route was the route most commonly known by the women under study. Alarmingly, it was noticed that only 205 (6.83%) women knew/had heard about Mother to Child Transmission (MTCT). The majority, i.e., 2650 (88.33%) women had no idea that they had chances of transmitting the infection to their unborn child if they tested positive. Another 145 (4.83%) were reluctant to express anything about their awareness about MTCT; thus, indicating the association of stigma with this infection. Majority, 2719 (90.63%), did not know how to prevent MTCT. Out of those who knew about the disease, 95.90% were literate while 95.99% of the women who did not know about HIV/AIDS belonged to the illiterate category, i.e., 99.40% of the literate women knew about HIV/AIDS, whereas only 22.48% of the illiterate group had heard about the disease. (z value was 45.98 and P value was 0.000, which is significant)

Although 87.13% (i.e., majority) of the women had heard about HIV/AIDS and knew some aspects of it, the knowledge about MTCT was very sparse. Only 6.83% of the mothers knew about the possibility of vertical transmission. Luo et al[2] conducted a study in three antenatal clinics in three hospitals in China and concluded that the level of awareness seemed to be superficial and more education and knowledge about MTCT was needed in China. This finding is even true for a highly developed society like the United States where a study by Anderssen JE[3] reflected that just over one half of the women had correct knowledge of effective perinatal HIV prevention strategies. All these are suggestive of the need to scale-up health education about MTCT in the health facilities.

In the study by Ho CF and Loke AY[4] carried out in Hong Kong, there was a statistically significant difference in HIV/AIDS awareness between those with different levels of education (P < 0.001). In our study, 99.40% of the literate women knew about HIV/AIDS, whereas only 22.48% of the illiterate group had heard about the disease. (P value was 0.000, which is significant).

To stop a further epidemic spread, (as seen in Sub Saharan Africa) it is urgent to identify and intervene to reduce risk behaviors. In order to do so it is important to evaluate the current awareness of and attitude towards HIV.