HIV prevalence and awareness among wives of rural migrant workers of Muzaffarpur district in Bihar, India

Background: There is paucity of study about HIV prevalence among the wives of migrant workers from rural areas of Bihar, India. This is the first population-based study conducted among the wives of migrant workers of Muzaffarpur district with objectives to estimate the prevalence of HIV, and describe the sexual and other risk behaviors; and delineate the knowledge, attitudes and risk perception related to HIV/AIDS.Methods: We used a combination of both qualitative and quantitative research methods. First we conducted in-depth interviews among 24 wives of migrant workers. Based on the information collected, structured questionnaire was developed and tested. A cluster survey was conducted selecting 34 villages as primary selection units (PSUs), and then selecting 25 eligible wives randomly from sampling frames. A total of 850 wives were interviewed and blood samples were collected for HIV testing.Results: HIV prevalence was 0.59% (95% CI : 0.19 - 1.37%) among the wives of migrant workers. The odds of risk of HIV infection among wives of migrant workers was more than 3-folds as compared to women in the general population (0.19%). In course of in-depth interviews, 15 out of 24 wives (62.5%) wives were found to be aware of HIV/AIDS, whereas in main interview the proportion of wives who were aware of HIV/AIDS was nearly 15.52% (95% CI : 14.5 - 16.5). Knowledge was found significantly associated with age group 15-24 years, education level of women, TV set in house and husbands' education in a multivariate regression analysis. Condoms use (OR = 3.21 (95% CI : 1.22 - 7.90) and premarital sex (OR=7.44 (95% CI: 1.6 - 33.67) were found significantly associated with HIV knowledge of wives. Out of 132 wives having knowledge about HIV, 72% of them had good level of knowledge about transmission and protection, and high positive attitude towards HIV/AIDS. Wives had very low level of perception about their own risk, but perceived their husband at higher risk. Condoms use was very low among them.Conclusions: HIV prevalence among the wives of migrant workers was higher than the prevalence among women in the general population. Education was found to be associated with good level of awareness about HIV. Our findings can support the designing and implementation of effective interventions for prevention of HIV among wives of migrant workers