Designing strategies to reach the maximum number of women for comprehensive knowledge of Human Immunodeficiency Virus (HIV)

Abstract

Introduction: Globally women are the major victims of socio-economic and political inequalities. This applies equally to stigma and discrimination related to HIV awareness and treatment. India has the second largest HIV epidemic in the world with 2.467 million people living with HIV in 2023. India shares 6.3% of global cases of people living with HIV. The biggest challenge is not only to reach all HIV-infected people but also to reach the maximum number of people for counseling and testing to avoid future transmission. There is a need to frame cost-effective, rapid, and confidential awareness strategies that will eventually encourage people to HIV testing. Design: Anonymized, publicly available data of the India National Family Health Survey (NFHS-5) and ASHAs per state is collected from the Ministry of Health and Family Welfare, India. The sample consisted of 724,115 women of 15–49 years of age and were sub-grouped as urban and rural women. Descriptive statistical analysis, linear regression analysis, and Pearson correlation coefficient analysis were done for the data. Results: The multiple linear regression equation for women with comprehensive HIV knowledge (%) Y is ŷ = -0.19433X₁ + 0.32387X₂ + 12.32505 where X1 is the percentage of ASHAs per state and X2 is the percentage of women with Internet access. It shows an R square value of 0.2338 for an overall p-value of 0.0123. Pearson correlation indicated that there is a non-significant medium negative relationship between ASHAs per state (%) and women with knowledge of HIV (%) (r = -0 .315, p = 0.061). Whereas, the results of the Pearson correlation indicated that there is a significant medium-positive relationship between the percentage of women with internet access and the percentage of women with comprehensive knowledge of HIV, (r = 0 .481, p = 0.003). Conclusion: More urban women have access to the Internet as compared to rural women, which may be the reason why the knowledge of HIV is higher in urban women as compared to their rural counterparts. Internet access to women is more beneficial in states where the rate of literacy is high. In areas where internet access and understanding content in English is an issue, community health workers can provide better support to spread awareness about HIV.