Determinants Of Knowledge And Awareness About AIDS: Urban -Rural Differentials In Bangladesh

摘要

This study utilized data from Bangladesh Demographic and Health Survey 2004 to identify the determinants of knowledge about AIDS for women of urban and rural area of Bangladesh, Bi-variate and multivariate logistic regression methods were employed in analyzing data. This study found that a wider gap exists between urban and rural areas regarding knowledge about AIDS, where every 8 out of 10 urban women know about AIDS but almost half of the rural women still do not know about AIDS. Mass media play a major role for growing awareness about AIDS in both of these areas. In the urban area 61.6 percent women knew at least one correct way to avoid AIDS but rural women are in miserable condition because the corresponding figure for rural women was only 31.3 percent that means 37.7 percent and 67.7 percent among urban and rural women respectively still did not know how to avoid AID. Binary logistic regression method shows that that education, occupation, ever use of contraception, currently using condom, permission to go to hospital/health center, mass media exposure, region of residence and wealth index significantly influence the knowledge about AIDS among rural women, whereas, in the urban areas except occupation and currently using condom all these remaining variables appear as the significant predictors of knowledge about AIDS. Introduction Bangladesh with its 127 million populations is still considered as a low HIV/AIDS prevalent country. However, it is at a critical moment in the course of its AIDS epidemic. It is estimated that there are 13,000 HIV-positive people in the country and that HIV prevalence in the adult population is less than 0.01 percent 1 . However, the country's vulnerability is very high. The presence of covert multi-partner sexual activity and denial, the low level of knowledge and low condom use, unsafe professional blood donations, lack of a desirable environment and violation of Human Rights, all contribute to the spread of HIV in Bangladesh 2 .Since the first detection of HIV in Bangladesh in 1989, the rate of infection has not been increased in comparison to our neighbors. A total of 240 AIDS cases were detected so far of which 109 have already died 3 . Indeed, there is a host of factors that render the country highly vulnerable to a surge in the epidemic 4 . These include the overall poverty levels, the documented risk behaviors including injecting drug use, growing sex work, considerable population movements in and out of the country, persisting gender disparities and inequities, not to mention low levels of general awareness and knowledge about HIV/AIDS among the population in general and, critically, among those who are most vulnerable and/ or engaging in risk behaviors. Meanwhile, most of the people of country are unaware about the deadly disease. The 1999-2000 Bangladesh Demographic and Health Survey found that only 31 per cent of married women and 50 per cent of newly married men had heard of AIDS 5. Over 90 per cent of rickshaw pullers could not identify a single method of HIV prevention. There is also a relative lack of availability and access to relevant services (sexual and reproductive health, HIV counseling and testing). There is also HIV/AIDS-related stigma and discrimination prevalent in the society. Bangladesh is therefore geographically vulnerable to HIV and AIDS, and at risk due to the prevalence of high-risk behaviors like injecting drug use, commercial unprotected sex with an overlap between more vulnerable and bridging populations, and high rates of sexually transmitted infections (STIs). There are also low levels of HIV and AIDS awareness; migration and trafficking; poverty gaps; low nutritional status; gender inequalities that place women and young girls at risk; and gaps in the healthcare delivery system To meet the targets and goals of AIDS prevention and control, there is strong need to assess the current levels of specific knowledge about AIDS transmission and prevention by urba