Saturday, May 19, 2007

ETHIOPIA: Rural HIV - time to wake up and smell the coffee

Photo: Victoria Av

The outbreak of war between Ethiopia and neighbouring Eritrea between 1998 and 2000 swelled the army's ranks to about 350,000 soldiers, who spent months at a time in border areas where commercial sex work flourished. When the fighting ended, most of these men were demobilised and returned to their rural homes to continue farming.

In Ethiopia, where 85 percent of the country's 71 million people live in the still conservative countryside, Birhanu's openness in discussing AIDS is far from the norm. "HIV is not at all common here in these rural areas," he said. "I do encourage other farmers to go for testing - I think that's important - but I've never heard of anyone who has HIV or AIDS." The ministry of health estimates rural HIV prevalence at 1.9 percent, compared with the national average of 3.5 percent.

"The government enterprise is reporting many of their staff are dying of HIV/AIDS on these coffee farms; many are dying and many are vulnerable," Gashaw said, adding that HIV was also a growing threat among smallholders. "A smallholder coffee farmer in Yirgacheffe may deny that HIV/AIDS is a problem, but the transfer of the disease from urban to rural areas is growing, and many people are dying," he said.

Low awareness means stigma and discrimination are high, with half the rural women interviewed in a 2006 demographic health survey admitting they would not want to care for a relative with HIV in their own home. As a result, many HIV-positive people remain in denial rather than seeking treatment. "The government has voiced their concerns, yet little is being done to change the situation," Gashaw noted. "The lack of studies and preventative programmes in these coffee-growing regions is very concerning."

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