Community socioeconomic disadvantage and HIV/AIDS-related knowledge among women: Evidence from a large, population-based study

Background: While the global incidence of HIV has been stabilized or declined in many countries, Bangladesh is the only country in the South Asia region where new HIV infections are increasing. It is important to understand if women living in disadvantaged communities are at greater risks of lacking knowledge of HIV transmission.

Methods: Data came from the 2011 Bangladesh Demographic Health Surveys (BDHS) which covers a representative probability sample of 17,141 households in 600 communities. Two dependent variables were if women had ever heard of AIDS and their comprehensive knowledge of HIV transmission. The predictor community disadvantage was measured by four indicators at the community level: (1) proportion of women who live in the poorest households, (2) proportion of women who have less than primary level of education, (3) patriarchal gender norms, and (4) mean media consumption.

Results: Multilevel logistic regression results showed that three of the four community disadvantage indicators were related to HIV related knowledge among married women, even after individual socioeconomic (SES) characteristics were taken into consideration. Living in disadvantaged communities characterized by higher levels of poverty, low-literacy among women, and strong patriarchal norms were significantly associated with women’s likelihood of poor HIV knowledge. Mean media consumption at the community level was not associated significantly with knowledge of HIV. Significant disparities in HIV knowledge among women were observed at the individual level based on their educational attainment and household level wealth.

Conclusions: Findings underscore the need for HIV prevention programs to target women in disadvantaged communities.