Background Before the people can reduce the risk and vulnerability to HIV, individuals and communities must understand the urgency to the epidemic. They must be given basic facts about HIV/aids, taught set of protective skills and offered access to appropriate services and products.

Methods A cross sectional community based survey have been conducted between January 2011 to April 2011 by interview of 419 heads of the households regarding the knowledge of HIV transmission means in Accra, Ghana

Results Out of the interviewed 419 household heads,287(68.5%) were females.36%,28% and34.3% were in the age group of 40+,31–40 and15–30 respectively. The findings revealed that only21(5%)of study participants mentioned four ways of HIV transmission(unprotected sex, mother to child, sharp materials and blood transfusion).On the other hand,63(15%) mentioned any three of the above route of transmission, whereas the majority, 209(50%) and 86(20.5%) mentioned two and one means of HIV respectively. On contrary about 40(10%) of interviewed heads of house hold mentioned hardly any of the transmission means. Males were about 2.4 times more likely to mention unprotected sex as one means of transmission than females

Conclusion In general, knowledge of residents of Medina in the capital town of Ghana about HIV transmission and prevention means was low. Appropriate HIV/Aids education means ought to be tailored to residents