HIV-Related Knowledge, Attitudes, Perceived Benefits, and Risks of HIV Testing Among Pregnant Women in Rural Southern India

Abstract

The rising prevalence of HIV among pregnant women in rural India is of great concern. Prenatal voluntary counseling and HIV testing (VCT) is critical to prevent mother-to-child transmission of HIV (PMTCT). We surveyed 202 pregnant women attending a rural antenatal clinic in Southern India to investigate HIV-related knowledge, attitudes toward infant feeding practices, and perceived benefits and risks of HIV testing. Of the total of 202 women surveyed, 189 women (94%) had heard of HIV/AIDS and 60% of them had relatively good knowledge regarding risk factors for HIV transmission. However, 48% did not know that there are "means to prevent mother-to-child HIV transmission." If women were not to breastfeed her baby, negative attitudes expected from the partner would include 84% thinking that that the mother is harming the baby, 78% thinking she is not a good mother, 74% thinking she has HIV, and 66% thinking she has been unfaithful. Ninety-seven percent of women did not perceive themselves at risk for HIV and only 57% had been tested for HIV. Although, 85% of women expressed their willingness to be tested, most were concerned about confidentiality and disclosing HIV serostatus because of fear of negative reactions from their husbands, parents, and community. Many social and cultural barriers confront pregnant women when they decide to opt for HIV testing. If VCT and PMTCT interventions are to be successful, urgent attention must be focused on education, development of innovative culturally appropriate interventions that empower women to make decisions about HIV testing, involvement of men, and addressing stigma and discriminatory attitudes toward people living with HIV/AIDS.

A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs

“…Quantitative studies are based on samples ranging in size from 200 to 97 240 respondents from the student, general population (NACO, BSS-2006) and health staff (Mahendra et al, 2007;Pisal et al, 2007). Few studies have drawn samples from low income or rural communities (Bharat et al, 2001;Pallikadavath et al, 2005;Rogers, et al, 2006). In all the qualitative studies, with the exception of Bharat et al (2001), positive people are treated as a homogeneous group disregarding other identities they may have as sex worker or MSM.…”

“…Some of the earliest studies on AIDS in India were carried out in the 90s and a majority assessed knowledge about HIV/AIDS and attitudes towards HIV-infected people among the general public, mainly students (Ambati, Ambati & Rao, 1997;Lal, Vasan, Sarma, & Thankappan, 2000;Pramanik, Chartier & Koopman, 2006), adults in general population (Porter, 1993) or health providers, mainly nursing staff (Lal, Kumar, Ingle & Gulati,1998;Datta & Bandopadhyay,1997;Kermonde, Holmes, Langkham, Thomas & Gifford, 2005;Kumar, Lal, Ingle & Gulati, 1999;Kumar, Mohan, Seenu, Kumar, Nandi & Sarma, 2002), and more recently among pregnant women (Rogers, Meundi, Amma, Rao, Shetty, Antony et al, 2006;Rahbar, Garg, Tripathi, Gupta & Singh, 2007). The findings from these studies are fairly consistent with regard to attitudes towards PLHA.…”

“…Very few studies in India have examined AIDS stigma as a barrier to accessing testing, care and treatment services. Among pregnant women seeking antenatal care in a rural setting, willingness to be tested for HIV was high (85%) but a majority were concerned about confidentiality and stigma from husband, parents and community (Rogers et al, 2006) suggesting fear of stigma as a reason for low testing uptake. Perceived stigma discourages HIVpositive women from seeking care in public hospitals in Chennai (Thomas et al, 2008).…”

Knowledge, attitude, and perception of HIV / AIDS among married women

“…Acquired Immune Deficiency Syndrome (AIDS) epidemic knocks decades of countries national development and it can also devastate families and communities worldwide [1]. The rising prevalence of HIV among pregnant women in rural India is of great concern [2].In India; several thousand of HIV-infected babies are expected to be born every year [3]. India is now in the grip of so-called type 4 pattern of AIDS epidemic which shifts from high risk group to the bridge population (clients of sex workers, STD patients) and then to general population, as a whole [4].…”

Inducing Immune Protection Against Trichomonas vaginalis: A Novel Vaccine Approach to Prevent HIV Transmission

“…A study of pregnant women in India showed that although the majority of women stated they were willing to be tested for HIV, they were also highly concerned about the reactions of their husbands, families, and community should it be found that they were seropositive. Additionally, not breastfeeding (recommended to prevent maternal-child HIV transmission) was widely believed to be a sign that a woman was a bad mother or had been unfaithful to her husband (Rogers et al, 2006). Women in particular are often reluctant to speak about genital health issues, one study cites "shyness" as the single biggest barrier in seeking STI treatment (Gibney et al, 1999).…”