HIV transmission knowledge among Rohingya refugee women in Bangladesh: a cross-sectional survey

Abstract

Background and objectiveIncreasing numbers of Rohingya refugees have been found to be infected with HIV since they arrived in Bangladesh after being ousted from Myanmar in 2017. This study aimed to examine the knowledge about HIV transmission among Rohingya refugee women and to identify factors that are associated with that knowledge.DesignA cross-sectional survey was conducted using a structured questionnaire that was based on the standard questionnaire of the Demographic and Health Survey programme.SettingRohingya settlements in the Kutupalong refugee camp at Ukhiya, Cox’s Bazar, Bangladesh.ParticipantsInterviews were conducted with 508 women who had married or given birth in the 2 years before the survey was done.Outcome measureThe participants were asked to answer a set of questions to assess their knowledge about HIV transmission.ResultsAround 70% of the women could not accurately answer four of the eight questions, and there were substantial misconceptions about the modes of HIV transmission. Knowledge regarding HIV transmission among participants increases in conjunction with the age at which they were first married. Women who were involved in work outside their households or those whose husbands were employed were more likely than others to demonstrate relatively good knowledge of transmission. Women who had received some formal education were 2.37 times likely to show relatively good knowledge of HIV transmission than those who had not received any education. Availability of healthcare facilities in the blocks where women resided is also associated with better knowledge. However, knowledge of HIV transmission among Rohingya women was significantly lower than among women in Bangladesh and Myanmar.ConclusionMost Rohingya women have inadequate knowledge of HIV transmission. Targeted interventions are needed to provide HIV education and to assist with prevention and behavioural changes.

The changing dynamics of HIV/AIDS during the Covid-19 pandemic in the Rohingya refugee camps in Bangladesh – a call for action

“…These organisations operate 170 basic health units covering 7,647 people per unit, 33 primary health centres covering 39,394 people per unit, and ten secondary care facilities covering 130,000 people per unit [19]. Therefore, the indicators of HIV treatment and care cascade among the Rohingya refugees in Bangladesh are below the MISP standard [5]. Furthermore, in the context of the unfolding COVID-19 crisis, more emphasis has been placed on COVID-19 treatment and care rather than other health issues, exacerbating the already dire situation with HIV detection, management, and prevention among Rohingya refugees.…”

“…There are multiple interrelated economic, sociocultural, and behavioural factors which are responsible for poor access to HIV care for Rohingya refugees [5]. Forced displacement has destroyed Rohingya refugees' livelihood, food security, income, and health [20].…”

“…The majority of Rohingya refugees are illiterate, and very few can read and write [23]. Awareness and knowledge about HIV and STIs is poor [5], and most Rohingyas consider HIV and STIs normal diseases [24]. Condom use is generally low [25] and levels of HIV/STI stigma and discrimination are high as conservative cultural norms prevent Rohingya from discussing sexual issues [5].…”

“…Awareness and knowledge about HIV and STIs is poor [5], and most Rohingyas consider HIV and STIs normal diseases [24]. Condom use is generally low [25] and levels of HIV/STI stigma and discrimination are high as conservative cultural norms prevent Rohingya from discussing sexual issues [5]. Sex and sexuality are considered taboo or a 'sin', while HIV and STIs are seen as 'a curse of God, so humans cannot do anything about these diseases' [19].…”

“…The 2017 military clampdown, state-sponsored genocide and violence in Myanmar have forced the Rohingya to flee to neighbouring countries [5]. As of 2017, there were approximately 1.2 million Rohingya refugees in Bangladesh, over 102,000 in Malaysia, 55,000 in Pakistan, over 40,000 in India, and 600 in Nepal [6].…”