This paper examines findings from a cross-sectional survey of HIV/AIDS knowledge and behaviors among young, Ghanaian market women. The World Health Organization HIV/AIDS Prevention Indicator Survey: Knowledge, Attitudes, Sexual Behavior, Stigma (WHO-HIV/PREV Survey) was anonymously administered to a convenience sample of 138 volunteer participants recruited from a major market in Accra, Ghana.
A mere 18% of women used condoms both the first time and the last time they had sex. Chi-square analyses were computed to examine a relationship between knowledge and behavior. The first chi square examined if there was a relationship between AIDS knowledge composite score and condom use. There were no differences in knowledge score by condom use (chi square = 2.54, df = 1, P < 0.11). While 76 % of respondents reported that they knew that condom use can prevent HIV transmission, 82% of respondents reported that they did not use condoms the last time they had sexual intercourse. Consistent with previous studies examining the relationship between HIV knowledge and condom usage, Ghanaian market women's HIV knowledge did not positively impact the level of condom usage (Bosompra, 2001). The data illustrate significant discrepancies between HIV knowledge and the practice of HIV-related protective behaviors.
The findings of the current study suggest that women's control over their sexuality is severely limited by their positionality. These findings are consistent with the literature which suggests that while women Ghanaian women are aware that condom usage may protect them from HIV transmission, issues such as personhood---as reflected in low educational attainment, occupation and low social status as well as a lack of HIV/AIDS-related communication and lack of partner negotiation may serve as barriers to condom usage with their partners. According to summary research published by Max Planck Institute for Demographic Research, a complex mélange of factors decrease a woman's ability to protect her from HIV infection---among them being financial dependence on men (Smith, 2005). This dependence compromises a woman's ability to leave an unfaithful partner and or insist on condom use.
The HIV/AIDS epidemic's escalating impact on Africa's women is very much a reflection of profound gender and class-based inequalities. While the study's small sample size limits the generalizability of the findings, the preponderance of the literature suggests that broad macro-level issues such as culture, gender, poverty and education may contribute to micro level realities impacting a woman's ability to protect her from HIV/AIDS. Any serious discussions regarding HIV prevention strategies must acknowledge the role of these broad contextual issues in fueling the epidemic.