Knowledge, Awareness, and Practices: Impact on HIV Prevention Among Women Aged 15–49 Years Attending ANC and PMTCT Services in South Sudan, 2023: A Cross-Sectional Study.
DOI:
https://doi.org/10.47941/ijhs.3894Keywords:
HIV Prevention; Reproductive-Aged Women; Antenatal Care; South Sudan; HIV Testing; Socio-Cultural Barriers.Abstract
Purpose: This study assessed knowledge, awareness, and practices related to HIV transmission and prevention among reproductive-aged women attending antenatal care (ANC) clinics in South Sudan and examined associations with HIV status, HIV testing uptake, and socio-cultural barriers.
Methodology: A cross-sectional study was conducted in July 2023. Data were collected using a structured questionnaire administered to study participants, alongside laboratory testing to determine HIV status. Descriptive statistics were used to summarize participants’ characteristics using frequencies and percentages. Multivariable logistic regression analysis was performed to identify factors independently associated with HIV infection, and results were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CI) and p-values.
Findings: Although general awareness of HIV prevention was high, socio-cultural and gender-related barriers were common. Most participants 87.6% and HIV-positive women (96.3%) expressed positive beliefs about condom use; however, 70.8% reported that women should not use condoms without spousal consent. Stigmatizing attitudes were also prevalent, with over 70% believing that condom use promotes adolescent sexual activity, and only 38.2% supporting the right of HIV-positive women to marry. In multivariable analysis, knowledge that HIV can be transmitted through sexual intercourse was associated with higher HIV testing uptake (aOR: 3.77, 95% CI: 1.50–9.48; p < 0.01). Awareness of mother-to-child transmission during pregnancy was also strongly associated with HIV testing (aOR: 15.89, 95% CI: 2.21–114.09; p = 0.006), and knowledge of HIV transmission through breastfeeding increased the likelihood of HIV testing (aOR: 6.00, 95% CI: 1.02–35.31; p = 0.048).
Unique Contribution to Theory, Practice and Policy: We conclude that the high prevalence of HIV infection in South Sudan is associated with limited autonomy in condom use and persistent stigmatizing attitudes toward HIV-positive women. Knowledge of key HIV transmission routes—particularly sexual intercourse, transmission during pregnancy, and breastfeeding—was independently associated with increased HIV testing uptake. Culturally sensitive, gender-responsive interventions are needed to reduce stigma and strengthen women’s reproductive decision-making power. Improving education on mother-to-child HIV transmission is essential to enhance HIV testing and prevention outcomes.
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Copyright (c) 2026 Samuel John Aban Yor, Kamal Elbssir Mohamed Ali
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