AWARENESS OF SEXUALLY-TRANSMITTED DISEASE AMONG WOMEN AND SERVICE PROVIDERS IN RURAL BANGLADESH

Sexually transmitted disease (STD) in rural Bangladesh is currently a topic of great concern. To date, little information is available in th e literature regarding its prevalence. It is now known, however, that the current level of STD awareness among the rural population with reg ard to modes of transmission and means of prevention is inadequate. In 1994, the MCH-FP Extension Project (Rural) of ICDDR, B surveyed 8674 married women of reproductive age (MWRA) in 4 rural thanas to examine their awareness of STDs. The association between sociodemographic and programmatic factors (variables which affect STD information availabil ity) and awareness of STDs was examined by both bivariate and multivar iate analyses. Seven focus group discussions were conducted among grou ps of government health and family planning workers and paramedics to assess their knowledge of STDs and attitudes about their prevention. O nly 12% of the original group had even a basic understanding about STD s and how to protect themselves from them. Twenty-five per cent of the women surveyed had ever heard of either syphilis or gonorrhoea. Of th ese women, less than half could mention specific mechanisms involved i n the transmission of these diseases. Seven per cent reported that syp hilis and gonorrhoea are transmitted through sexual intercourse. Thirt een per cent reported that the infections are transmitted from spouses to their partners. Four per cent reported that STDs can be spread by having multiple sexual partners. The results of logistic regression an alysis indicate that awareness of STDs was higher among relatively old er women than among younger women. Awareness of STDs was most strongly and positively associated with the education of both the women and th eir husbands. Awareness of STDs was also found to be higher among wome n who were more socially mobile (e.g. those who frequent cinemas or mo thers' clubs). The findings of focus group discussions indicate that f amily planning and health care service providers have a moderate level of STD awareness. Modes of transmission and means of prevention, howe ver, were areas of weakness. It will, therefore, be necessary, whether to prevent a potential STD epidemic or to combat current STD prevalen ce, to implement culturally acceptable and affordable means of dissemi nating knowledge in rural areas of Bangladesh. Training of health care providers will be an essential first step.