Background: Statistics around the world show a rapid increase in HIV infection in the older population. Many older women remain sexually active and are therefore exposed to heterosexual transmission of HIV infection. Older women are most likely considered respected opinion leaders within the families and communities and are likely to influence others' attitudes and behaviours. An increase in knowledge through information plays a fundamental role and is a prerequisite for behavioural change that may prevent new HIV infections. The purpose of the current study was to assess the knowledge and misconceptions regarding the spread and prevention of HIV in older women attending the Tshwane District Hospital (TDH) in South Africa.

Methods: A prospective cross-sectional study of 100 women, aged 50 to 80 years, attending the TDH out-patient section during November and December 2006 was done. The levels of knowledge were determined by using a directed questionnaire.

Results: Eight per cent of the participants answered all the questions correctly, showing knowledge gaps in the remaining 92% (95% confidence interval: 86.7%-97.3%). Many participants were unaware of the protective effects of condom use, especially female condoms, and of HIV spread by anal transmission, the sharing of needles and blood transfusion. Three or more misconceptions were present in 48% of the participants, such as HIV spread by casual contact, the sharing of personal items, air-borne infection, mosquito bites, HIV testing and AIDS prevention or cure by traditional medicines or alternatives. Sixty-two per cent of the older women were found to have adequate knowledge (95% confidence interval: 52%-71.5%), knowing the basic concepts regarding HIV transmission.

Conclusion: There is a significant need for HIV-related preventive health education in older women, not only to decrease potential high-risk behaviours, but also to reduce unnecessary feelings of anxiety and misconceptions. Family physicians, due to their unique role, might be able to use the present study in their practices in order to optimise the planning and structuring of awareness interventions and prevention programmes.