National AIDS Resource Center

On a five-day outreach program organized by JHU/CCP's AIDS Resource Center at the 3rd All Ethiopian games in Adama, issues such as the negative consequences of alcohol abuse, multiple concurrent partnerships (MCP) and effective condom use for HIV prevention were discussed. On this event, we met Sosena Sisay, a 30 year old divorcee engaged in selling coffee and other refreshments.

We caught up with her after she had taken part in the discussion groups organized in three separate tents. Although most of the topics discussed were not new to her, it was as if she was participating in the discussions due to her desire to bring about real change in her community and help her fellow compatriots truly grasp the issues being discussed and make a difference in their lives.

While Sosena is currently engaged in small business activities, she used to support herself through what she would get from men with whom she had sexual relations with. After having her baby however, instead of looking to men for support, she has started doing small businesses to take care of herself and her son.

Growing up Sosena was a bright girl, who used to get good grades and take part in extra-curricular activities, in anti-AIDS and anti-drug clubs. She used to educate her peers on the benefits of abstinence, faithfulness and using condoms. She was also well aware of the negative consequences of drugs and alcohol abuse. She, however, had not lived by what she was teaching others.

She feels that just knowing about these facts is not adequate; one has to make strong resolutions to protect oneself from HIV transmission and exposure to alcohol abuse.

When talking about the videos shown about multiple concurrent partnerships, Sosena said that, to her it was as though she could see a large part of Adama's population networked through multiple concurrent partnerships.

She fears that people may feel over-confident about using condoms and neglect the dangers of having multiple concurrent partners. Speaking from her experience, she said "I used to take the responsibility to have the men use condoms every time I had sexual encounters, so I felt very confident that I would never be exposed to HIV, what I had not taken into account was the risk of having condoms tear. I still get chills when I think about what could have happened".

Sosena started to have sexual encounters with multiple partners when she was 19 years old after having broken up with her boyfriend. At that time, people used to come to Adama from Addis Ababa for recreation and looked for young girls to hang out with. "All we had to do was take our swimming suits with us on Saturdays, and we knew that we would get picked up by someone wealthy. They would ask us to show them around Sodore, we would give them what they wanted and get back with money in our hands" said Sosena.

She said that it was considered trendy to go out with men who were wealthy and influential. At that time, she thought she was on top of the world, she had money, went to places and had lots of fun. But what bothers her today is that she has lost 10 years of her life. Although she did not acquire HIV due to her risky lifestyle, she knows now that she was playing with fire. She said she has lost her purity and confidence. It bothers her that she was like a commodity used for the satisfaction of the men she hung out with. "They haven't lost anything; they continue to live their comfortable lives. But I have lost a lot.... I quit school and have nothing now....At an age when I should be enjoying life, reaping what I had worked for in my youth, I have started working afresh..... I'm trying to change because I am not happy with this kind of life" Sosena said.

Sosena gave us an insight into what life was like for her as a youth leading a risky lifestyle and the lasting effects it had on her.

Listen to Sosena Sisay's story in her own words.

Insights into the Life of a Youth Sosena’s Story  (3.84 MB)

Hits: 40

One of the reasons that the Ethiopian National Emergency Plan for the Prevention of Mother-to-Child Transmission of HIV (PMTCT) was launched on December 04, 2011 was to scale-up the provision of PMTCT services to as many health facilities as possible because a large proportion of women who visited health facilities to access antenatal care and got HIV counseling and testing did not get PMTCT services because only a limited number of health facilities provided these services. This means that so many pregnant women who got antenatal care and knew of their HIV status couldn’t get the treatment to save their unborn from acquiring HIV.   Fozia Mohammed was one of such women. A 32 year old woman currently living with her husband in Jijiga on her third marriage with a healthy baby girl, Fozia has passed through many hardships and setbacks in her life.

When Fozia was in 9^th grade, she met her first husband who came to her home town in Kombolcha looking for a house in her neighborhood. The man, who would later become her husband, was instantly smitten by her and started to correspond with her through letters having found her school address. Although Fozia, at the beginning, did not have the heart to pursue him, her friends used to pressure her to do so, considering her lucky.

With aspirations to be independent, and a lot of pressure from her friends, Fozia, one day, ran away to Assaita, where he lived. Delighted with her decision, he asked her father’s permission to wed.  Upon receiving the permission to marry, they got married immediately.

Several months into their marriage, Fozia got pregnant and started going to the nearest health facility for check-ups and vaccinations. Although she had visited the health center several times, no one had advised her to get HIV counseling and testing.  When the time of her delivery came, she gave birth in a hospital to a baby girl. Although, the birth of her first born had brought cheer and happiness to her family, her baby, who had just celebrated her first birthday, fell ill and was starting to show rash on her body. She also seemed to be continually tired. Although, the baby hadn’t stopped eating, she had lost a lot of weight.

Perplexed by her daughter’s illness, Fozia quickly took her to the nearest hospital. Apart from giving her some medications, they were unable to help her. Finally, the baby died from her sickness. This was a devastating loss for Fozia. She had become inconsolable. Unfortunately, this was not to be the end of her grief, not long after her daughter’s death, her husband whom she loved also fell ill and died of tuberculosis after six months.

Overwhelmed by her loss and all alone, Fozia returned to her parents’ house in Kombolcha. To forget her grief, she involved herself in traditional bands and the performing arts which helped her cope with her loss and gave her strength to go on.

Subsequently, as she was spending most of her time at her aunt’s house who introduced her to her new found interest in art, she met her second husband.

Pleased to have found a husband who will take care of her, Fozia got married in a simple traditional ceremony. Shortly afterwards, she became pregnant with her second baby. As usual, she visited the local health center and got the necessary vaccinations. However, she still did not get tested for HIV as there were no provider-initiated counseling and testing at that time. Although Fozia had given birth to her first born in a hospital, she decided to have her second at home with her mother, who was a skilled attendant. Once her second born, a baby boy, was delivered, she prayed to Allah that he would grow up to be a big boy and not die as the first one did.

With the birth of her son, Fozia was feeling compensated for her loss.  However, things were not all good in her life. Her health was declining.  Things with her husband were not peaceful. His drinking and chat chewing habits were coming between them. Sometimes he would come home drunk and beaten up.

To add insult to injury, One day, when the ailing Fozia asked her husband to give her money to pay for her medical expenses, he mistreats her and tells her to go away because she was sickly anyway. Angry and hurt, Fozia left and eventually got a divorce.

Divorced and alone for the second time, Fozia resolves to go away to Assaita and work and raise her son on her own. Several years later, however, her four year old son, in whom she had put so much hope, suddenly became unable to walk. Although, the doctors had given him medications, he was not getting better. His condition persisted for several months until another doctor recommended that he get tested for HIV. And this was how Fozia found out of her son’s HIV positive status.

Fozia hadn’t thought her son would survive. But through counseling and encouragement from the doctors, she decided to give her son the prescribed antiretroviral treatment (ART). Through medications and proper diet, her son started to show some improvements. Encouraged by the results, after six months, believing that she also must be HIV positive and must have transmitted it to her son, she decided to have her blood work done and find out her status

Her test results did not come to her as a surprise. Because she had seen her son’s recovery, she also started ART, trusting in the treatment’s efficacy. This was a turning point for Fozia. Her life drastically changed. She was feeling very hopeful for herself and for her son. Because of the benefits she had reaped from ART, she decided to educate mothers who came to the health center for antenatal care.

After some time had passed, she got introduced to her current husband who lives in Jijiga, through a friend. This time round, having learnt from her past, she visited the health center before becoming pregnant and during the entire course of her pregnancy. Finally, she was able to give birth to an HIV free baby girl, having taken the necessary precautions through a PMTCT initiative provided in her clinic.

Fozia’s story shows the missed opportunities and how much suffering one may then face with something that could have been prevented from the beginning. Had there been PMTCT initiatives in the clinics she visited, she would not have lost her first born girl, nor would her son have been born with HIV. Fozia would have not suffered so much loss. But now, due to the work being done around HIV/AIDS, ART and the scaling up of PMTCT services, Fozia and many women like her will have a brighter future ahead of them. They can have HIV free babies and lead better and healthier lives.

According to the National Guidelines for the Management of STIs jointly prepared by the Federal Ministry of Health and Federal HAPCO, sexually transmitted infections are caused by more than 30 pathogens that can be transmitted through unprotected sex. STIs may be broadly classified into ulcerative and non-ulcerative (discharge) or curable and non-curable (MoH, 2006).  While it’s easy to prevent the transmission of non-ulcerative or discharge STIs through the correct and consistent use of condoms, it’s rather difficult to prevent the transmission of ulcerative STIs, as open sores and infected parts may be found in areas where condoms cannot cover. Thus, in such cases the best prevention method is abstinence. STIs are especially more severe on women as the consequence of some STIs may result in cervical cancer, death during child birth and child infection during pregnancy or childbirth.

Although the Ethiopian government has come up with a National guideline to treat and care for STIs by using syndromic approach – an approach that uses a set of symptoms to treat possible cases of STIs  by giving medications believed to be the appropriate treatment, STIs that do not show sufficient symptoms with potentially fatal consequences may be left undetected.  Such an approach, albeit best in a resource limited country as Ethiopia, where availability of fully equipped laboratories are very limited and skilled health care practitioners are hard to come by, it may not treat or address a lot of people’s problems with asymptomatic STIs.

Furthermore, because the presence of STIs, especially ulcerative STIs, exacerbates the risk of acquiring HIV, as the open sores and cuts provide easy access for the HIV virus to pass into the blood stream in cases of unprotected sexual intercourse, early diagnosis is important to prevent HIV acquisition.

According to a WHO factsheet published in August 2011, “the presence of untreated STIs (both those which cause ulcers [and] those which do not) increase the risk of both acquisition and transmission of HIV by a factor of up to 10. Thus, prompt treatment of STIs is important to reduce the risk of HIV infection” (WHO, 2011).

Therefore, in sero-discordant relationships, where one partner is HIV positive and has other STIs, the chances of transmitting HIV to their uninfected partner increases, if the STI is not treated promptly. The same is true, for the HIV negative partner who has an untreated sexually transmitted infection.

To see how much testing for STIs embarrasses people, we spoke to one college student in Addis Ababa. *Zeinab is a twenty year old college student who has been going out with her boyfriend for a couple of years, whom she plans to marry. Although, Zeinab is still a virgin, she has had several intimate moments with her boyfriend without having actual sexual intercourse. Because of this, Zeinab used to feel that she would be safe from all STIs and, thus, did not see the need to seek medical help. It wasn’t until Zeinab decides to volunteer in an organization that works in the area of HIV/AIDS that she finds out she may be at risk of acquiring STIs. Because she has no symptoms and most STI tests use the syndromic approach, she does not know how to get tested or what to tell the doctors. Embarrassed and worried, she’s waiting for the time when she gets married and has the freedom to ask for all possible tests.

Although, Zeinab has already decided to marry her boyfriend and is HIV negative at the time being, she nonetheless feels that talking about STIs and getting tested is difficult in such a traditional society as ours. She also feels that although much is being done about HIV on various media, there is hardly anything on STIs and on how to prevent them.

Adolescents who start sexual intercourse at an early age are at higher risk of acquiring STIs because they are not in a good position to negotiate for safer sex and due to the increased number of sexual partners they will have in their lifetime.

With this in mind, more awareness raising work needs to be done in schools, colleges and youth clubs to inform the more susceptible population on the dangers of STIs, how STIs are transmitted and on how to prevent them.

*Names in this article have been changed to protect identity.

Sero-discordance is a term used to describe the sero status of couples where one partner is HIV positive and the other is HIV negative. Sero-discordant couples could be married, pre-marital or cohabiting.

A case study conducted in selected health centers in Dessie found that, couples’ sero-discordance was mostly due to frequent history of travel, short or long term departure from partner and partners’ history of STI and alcohol abuse, even though there may be other reasons at country level.

According to the 2005 Ethiopian Demographic and Health Survey (EDHS), from 2,674 couples tested for HIV, 98% of the cohabiting couples were concordant negative, while 1.8% of the 2.1% were discordant. This shows that, 1.8% of negative partners in sero-discordant relationships are at high risk of contracting the HIV virus unless the necessary measures are taken to avert infection. Worldwide, it is estimated that only half of the 33 million people living with HIV/AIDS know their HIV status, which demonstrates the great need to scale up couples’ HIV counseling and testing.

On the one hand, although individual testing can inform the sero-status of an individual, high risk of HIV infection or sero-conversion is still a looming threat for individuals in sexual partnerships, unless both parties are tested together.  While it’s relatively easy to find pre-marital couples going to HIV counseling and testing (HCT), especially before nuptials, it’s not very common for married or cohabiting couples going to HCT centers together unless one falls ill or has been exposed to risky behavior.

Because many couples do not come together for HIV counseling and testing, HCT counselors find it difficult to give comprehensive care, treatment and support to both partners and whole family units. This is especially true in urban areas where HIV Counseling and Testing refusal is higher than in rural areas, as found out by EDHS, 2005.

An informal discussion with a VCT counselor at Zewditu Hospital showed that, reasons individuals in partnerships who get tested for HIV do not want to disclose their status to their partner or bring partner to HCT centers are because: they don’t want to seem unfaithful, are afraid of separation or divorce and say they trust partner and do not need to have partner tested, among others.

One may ask why couples need to get HIV counseling and testing. Can it be helped if one is HIV positive and the other is not? Or is there any way to prevent infection among discordant couples?

According to a scientific study conducted by the United States National Institute of Health, an HIV positive person’s effective adherence to antiretrovirals (ARV) can reduce the transmission of HIV to their uninfected partner by 96% (WHO/UNAIDS joint press release, 2011).  This means that as soon as sero-discordant couples know of their status, they can start ARV treatment to significantly reduce the concentration of HIV in the bloodstream and genital secretions thereby reducing HIV transmission. According to World Health Organization, “Proof of concept that antiretroviral drugs decrease HIV transmission comes from the prevention of mother to child transmission of HIV.”

Nevertheless, because, antiretroviral treatment (ART) for HIV prevention is not 100%, it’s recommended that it be used along with a package of prevention and treatment interventions, such as the proper and consistent use of condoms and voluntary male circumcision among discordant couples to effectively and substantially reduce transmission.

Having said this, however, the debate whether or not to start ART when CD4 count is greater than 350 is still ongoing. In the Ethiopian context, WHO guidelines for the initiation of ARV treatment is set at CD4 count of ≤350 or at clinical stage 3. Thus, sero-negative persons with sero-positive partners who start ART in line with WHO’s guidelines can significantly reduce HIV transmission to their partners given that they also use condoms consistently and correctly along with other prevention packages.

Such findings, as stipulated by a WHO/UNAIDS joint press release “will not only empower people to get tested for HIV, but also to disclose their HIV status, discuss HIV prevention options with their partners and access essential HIV services. It will also significantly contribute to reducing the stigma and discrimination surrounding HIV.”

Thus, while it is encouraging that, in the 2008/2009 Ethiopian fiscal year, 31,831 Health Extension Workers were deployed to villages across the country to improve access and equity in the delivery of essential health services (Progress Report 2010, FHAPCO) including, the prevention, care and treatment of HIV/AIDS, which translates to a substantial number of couples living in villages getting HIV counseling and testing services in their homes, there’s still a great need to scale-up couples’ HIV counseling and testing in urban areas to achieve the global vision of zero new HIV infection, zero AIDS related deaths and zero discrimination.

 

In Ethiopia, different alcoholic drinks are consumed, from the traditionally prepared beer and honey mead wine to industrially produced beer, wine, distilled spirits etc. Drinking alcohol is very much part of the Ethiopian culture. Apart from it being a way to unwind and socialize with friends, it is usually a big part of wedding celebrations, social gatherings, holidays and other festivities.

When alcoholic drinks are abused, apart from having both short and long term direct negative health effects, it can also affect behavior negatively and expose drinkers to unwanted sexual risk taking.

In the urban and metropolitan cities of Ethiopia, a wide range of both modern and traditional bars are available selling from low-priced drinks with unknown alcoholic content to high end wine and distilled alcoholic beverages. In the absence of effective implementation of alcohol prohibitory laws for minors in the country, both under age youths and adults can go into any bar of their choice and drink as much as they desire, as long as they can pay for it. This puts underage adolescents in a vulnerable position exposing them to risky sexual encounters and other undesirable consequences.

In Ethiopia, youths, after their 12^th grade matriculation which is usually around the age of 18, join different universities and stay at campus dormitories or in nearby rented houses for the duration of their studies. During this time, because there is minimal or no parental oversight, there is a chance for them to be engaged in drinking bouts and binges from time to time.

Eskinder and Nahom, who are currently in their first year of postgraduate education, started to binge drink while they were in their sophomore year. Eskinder, a social studies postgraduate student who came from Awassa to join Addis Ababa University five years ago, recalls that when he first joined, he didn’t have friends and was new to many things. He was, thus, very much focused on his studies and spent much of his freshman year studying.

However, in sophomore year, everything changed, Eskinder said. “We started hanging out with senior students around the basketball court. And they would tell us about their nights, and how fun they were. They would then invite us to hang out with them in the evening. Although we did not like it the first time, we slowly got used to the lifestyle and got sucked in.”

College youths at this age are eager to experience all kinds of things with a great desire to belong and conform to popular campus culture. Unless strengthened to resist peer pressure, there is a real danger for them to be exposed to risky sexual behavior from alcohol intoxication. This, not only, can derail them from their goals, but it can also expose them to unwanted pregnancies, HIV infection and other STIs.

Eskinder said “sometimes I would be asleep in my dorm and would get a phone call from friends at around 10:00 pm, asking me to join them for drinks; I would get up from bed to join them.” They sometimes would be partying until over midnight, by which time campus gates would close, forcing them to jump in through the fence. Nahom said he once had an accident trying to jump in through the fence.

He said, as university students, they almost never drank moderately, they drank to get intoxicated. “Think about it, why would you drink something so bitter if you’re not going to get drunk” was what Nahom said.

When talking about how often they drank, Nahom said “it’s like a wave coming to take you away,  a group of friends find you, may be walking  on the road,  and just take you to go out and have drinks with them, without any prior plans.”

They would go out for drinks whenever they had the money. Nahom said “we always went out with girls to drink”. One of the things they regret about drinking was that drinking caused them to lose their inhibitions when it comes to sexual encounters, sometimes making them lose control, even if it’s with their girlfriends. Nahom said although he always uses condoms, he has had sex without protection on few occasions, because his girl friend didn’t want to use condoms and because it was harder to negotiate for safer sex while intoxicated. “It’s difficult to negotiate for safer sex and use condoms in the heat of the moment while intoxicated” said Nahom.

Although there is evidence that alcohol has physiological suppressive effects on sexual arousal for both men and women, there is also co-occurring evidence that acute alcohol consumption depresses one’s ability to make quick and proper judgments and causes loss of inhibition. According to a study    “when men consciously intend to suppress arousal in the face of erotic stimulation, alcohol reduces their effectiveness in doing so” (George W, 2000). Especially when faced with a counter prompt not to engage in risky sexual behavior or use condoms, persons under the influence find it difficult to inhibit risky sexual behavior and make proper judgments.  This is because alcohol makes drinkers lose the proper sense of evaluating risk and negative consequences causing them to concentrate more on immediate events than distant ones. Such an effect is called alcohol myopia. This makes acute alcohol drinkers shortsighted during intoxication and likely to engage in unsafe or unwise sexual practices due to loss of ability to appraise distant effects.

Both, Eskinder and Nahom, regret having had to drink so much to the extent of losing their focus in their studies and being exposed to risky sexual encounters.

Since excessive drinking exposes the youth to serious health risks and undesired consequences, it’s crucial to increase youths’ self-efficacy to control their drinking from early on. Furthermore, it could be useful for responsible bodies to come up with effective ways of enforcing alcohol prohibiting laws for minors, while employing other means to curtail excessive drinking by the youth.

 

Are young women with upper income and better levels of education making use of the life saving condom?

A study conducted by the CDC states that “Latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV.” For centuries male condoms have been in use to prevent pregnancy and sexually transmitted diseases (STDs). Although, there are different types of condoms, such as those made from latex, polyurethane and lamb intestine, the most widely used in Ethiopia is the male latex condom.

Estifanos Teshome, a healthy-looking vivacious character living with HIV, told us that when he first started to have sexual intercourse at the age of 11, not much was known about condoms or HIV/AIDS. He said someone who wanted to buy condoms, found in pharmacies at the time, was considered as a promiscuous person. Not only that “At that time, if a woman asked a man to use a condom, the man will think that it’s because she has an STI or HIV. No one would trust her or would want to have any relations with her. In those days, the general opinion was that condoms were for promiscuous persons and those who had STIs.”

He argues that even today, this perception has not changed much. “I work in a health center in the area of HIV/AIDS, I see people look at those who come to take condoms suspiciously as though they were doing something wrong, as if they were promiscuous. It’s still frowned upon.”

The 2005 DHS shows that the level of knowledge for prevention methods of HIV/AIDS such as abstinence and faithfulness is relatively high as compared to knowledge of condoms and its role in the prevention of HIV transmission. It states that only  “around four in ten women and six in ten men are aware that using a condom during sexual encounters can reduce HIV/AIDS transmission” (DHS,2005).

Estifanos told us that although he knew about the benefits of condoms, he did not like to use it because he thought putting it on was too troublesome and did not like its smell and oiliness.  “Even today, if I were to dress well and had money to spend, I can convince ladies to go out with me. I can easily persuade them to have sex without a condom, you see, nowadays women’s focus is not so much on negotiating for safer sex, they just want to be with someone with money,” said Estifanos.

Interestingly, however, based on the 2008 Health Impact Evaluation, although one may think that young women in the lowest wealth quintile would engage in risky sexual behavior, young women with secondary and above education and those in the highest wealth quintile engage in risky sexual behavior more than those in the lowest.  This is despite the fact that the level of comprehensive knowledge about HIV increases with education and wealth status (2008 Health Impact Evaluation).

On the other hand, Kelemu Belete, a 20 year-old boy who debuted sexual intercourse at the age of 15, told us that although he has never had sex without a condom, he has a female friend who has had sex without a condom with a partner who told her that because he looks healthy, she should trust him to have unprotected sex.

 “Even though she had the awareness about condoms and HIV, she was forced to have unprotected sex maybe because she felt too embarrassed to persuade him to use one,” Kelemu said.

The 2008 Health Impact Evaluation shows that only 53.2% of women know that it is possible for a healthy-looking person to have the HIV virus.

 In a patriarchal society as ours, where the level of women’s empowerment in making decisions about their own health is very low and where only 15 percent of currently married women make sole decisions regarding their own health care (DHS, 2005), the responsibility for the prevention of HIV through the use of condoms largely lies on men.

On the other hand, though, as the trend shows, if the women who are educated, those in the higher wealth quintile and those in better position to negotiate for safer sex engage in risky sexual behavior, then it’s necessary that a strong and definite behavior change that would make sexual intercourse without using condoms consistently and correctly unacceptable be brought about.

*Names of individuals in this article have been changed.

This true story is about an HIV positive pregnant mother who told us her fascinating story while she was waiting to get antenatal care.

This mother, who was engaged in housework in Dubai about twenty years ago, was told by her employers to give blood for HIV testing. During that time, since the notion of having housemaids tested for HIV was not new, it did not come to her as a surprise. So, she goes with her employers and gives her blood as requested.

However, what transpired when her test results came was nothing like she had expected.  Men wearing masks and dressed in protective clothing come with the police and knock on her door. When she looks through the peephole, she sees the men standing with her employers. Not thinking much of it, she opens the door for them. Once inside, the men notify her that they had come to take her away and recommend she has something to eat first. Perplexed, she thinks someone from her family may have passed and they had come to tell her the merdo – bad news. After she has finished eating, they take her into a closed van and check her into a facility where people like her were held awaiting their deportation. She could not understand what was happening. When she looks at her employers, she sees the wife crying. However, she does not tell her the reason.

After she arrives at the facility, she sees a big poster in the room that reads HIV+ with a red ribbon on it. That is when she realized she was HIV positive and was being deported as a result. No one gave her counseling before or after her test. Devastated by the news and by the way she found out, she resolves never to tell anyone believing she would be stigmatized and ostracized. Her thought was to go to her country and die there.

When she arrives in Ethiopia, there was a popular song that went something like ….”I am finished”… a fitting song, she thought, because in her mind she was finished as well.

As time went by, however, when she sees she was doing well she resolves to work and make a living. Having heard that an HIV positive person should eat well for better health, she decides the best place to do that would be if she worked as a housemaid.  Once employed in housework, she tells her employers she can’t prepare raw foods, with the pretext that she was allergic, in fear of transmitting the virus to them. In this way, she worked and lived with the virus for 16 years without having the need to take antiretroviral treatment.

This woman is now married and about to have her second child. She told us that her firstborn was HIV free because she had taken all the necessary precautions. She met her husband when he was very sick after having lost his girlfriend to AIDS. When they met, he had lost all hope of living; he was distraught and not working. Afterwards though, his life has taken a complete turn.  She told us, he now works and leads a good and positive life.

Although this woman had not gotten any counseling or support, she was able to lead a positive life. After having known her status, she did not give up. She went on to have her diploma and Bachelor of Arts degree in Management.  She now says “being HIV positive doesn’t mean it’s the end of your life, you can definitely live”.

This happy pregnant woman is now getting all the medical help she needs to have an HIV free child for the second time. She told us she lives better than any healthy person. She said “I eat and drink well. I’m healthy and I can live a good life. “Enquliliche!” - A term used to make others envious.

What an impressive and inspiring woman. It was very refreshing to find someone so positive and optimistic about life.  Being HIV positive, as the lady said is not the end of the world. If your outlook is right, you can accomplish a great deal and lead a happy and fulfilling life.

September 10, 2011 (Addis Ababa, Ethiopia): The 7^th National HIV Counseling and Testing Day event was kicked off today with a rally on the streets of Addis on a theme of Parents testing to Prevent the transmission of HIV from the mother to child.

Parents, pregnant women, youth, officials and representatives from partner organizations marched carrying messages and testimonials that encourage parents to know their HIV status in order to prevent transmission from mother-to-child along with the Ethiopian ground force’s March band.  The rally ended at Gandhi Hospital with the inauguration of a billboard promoting the theme.

On his welcoming speech Dr. Dereje Alemayehu, Medical Director of Gandhi Hospital, said as Gandhi being one of the main maternity hospitals, around 25-30 pregnant mothers visit the hospital daily. In the fiscal year 2003 E.C, from the projected number of 2,660 mothers coming for testing a total of 3,296 mothers actually got counseling and testing, meeting the hospital’s goal by more than 100%.  There, however, needs to be a collaborative effort to make the coming generation HIV free.

A report from the Federal HIV/AIDS  Prevention and Control indicates currently more than 90,000 pregnant women are living with HIV and every year 14,000 babies are born from HIV positive mothers among which only 10% are using PMTCT service. 

CDC Ethiopia’s Program Officer, Dr. Tekeste Kebede, also remarked the benefits of knowing ones HIV status earlier  to be able to  start the treatment on time and to also give birth to HIV free babies. He also spoke how CDC and other partners have been striving to  make HIV Counseling and Testing accessible to pregnant mothers and their partners.

Women should take the lead to have HIV counseling and testing to bring HIV free babies into the world and to raise the awareness of women everywhere to have antenatal, delivery and postnatal care for healthy motherhood, said  W/ro Meseret Abdi, Addis Ababa Women’s Association, Deputy Director.

The event stresses on the importance of testing together for the prevention of mother-to-child HIV transmission as opposed to mothers only to ensure that both parents are protecting their child. AAHAPCO organized the event in collaboration with its partners.

In support of this campaign a variety of communication materials were produced and will be distributed nationally encouraging parents to know their status were produced by the AIDS Resource Center. Television and Radio spots were also transmitted and promotional messages were posted on local newspapers to reach different parts of the society.

A panel discussion based on the current theme was also conducted with different prominent organizations working in the field through Fana Broadcasting Corporate.  Participants discussed reasons why service providers have to initiate HCT to expecting mothers and the need for increasing male involvement in the service.

Community and religious leaders will also carry the messages to their communities and followers stressing on parents knowing their HIV status to secure the wellbeing of their communities. So far there have been around 9.4 million people who have got HIV Counselling Services in Ethiopia.

In similar development recently Zewditu Memorial and Minilik II hospitals have launched an HIV counselling and testing service for the hearing impaired in response to the shortage of access to HCT services to the disabled.

HCT programs encourage parents to know their HIV status when they are expecting a baby and for parents who are HIV positive to access treatment for preventing the transmission of HIV to their child. It also increases knowledge about availability and accessibility of treatment.

 

Contact:
Frehiwot Yilma, AIDS Resource Center
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Tel:  +251 11 550 3584  Extension 1129
Fax: +251 11 550 3749

Addis Ababa, 09 September 2011 - An HIV positive 16 year old Girum Abdosh, who hopes to become a professional dancer, told his story with tears advocating for HIV counseling and testing in order to prevent the transmission of HIV from mother to child. 

On a half-day panel discussion organized by Addis Ababa HAPCO in collaboration with NASTAD, Ethiopia and Addis Ababa Women’s Association, Girum gave a testimony of how he got HIV from his mother. He told the audience how much suffering he had passed through as a child before starting the treatment.

Saying no child should pass through what he passed through, Girum pointed out the need for parents to be tested and get the necessary care for the sake of their children. When asked, Girum said he wished to have better health and better living.

This half-day conference which was mainly organized to raise awareness on the prevention of HIV transmission from mother-to-child and healthy pregnant mothers as a whole by promoting antenatal, delivery and postnatal care commenced with a welcoming address.  Ato Taddesse Atlabachew, Head of Addis Ababa HAPCO, gave a speech about how the efforts to combat the spread of HIV/AIDS in the past were not as effective since endeavors were not inclusive of the community’s participation. 

In light of this, he said, it was necessary to formulate policies that included the participation of the community and that of institutions at various levels. Accordingly, several activities have been carried out in Addis Ababa to prevent and control HIV/AIDS. Such as the establishment of VCT centers in various places, community based activities against HIV/AIDS, giving support and care to people living with HIV/AIDS and orphans, giving accessible health services to people living with HIV/AIDS, distribution of condoms etc.

Then Wro Bizualem Gebeyehu, director of Addis Ababa Women’s Association, told the audience how the Association has been trying to raise the awareness of various executive bodies and stakeholders to work towards reducing the number of mothers dying due to delivery and to eliminate the number of babies born with HIV. Wro Bizualem, in her speech, pointed out the importance of couples’ testing vis-à-vis mothers’ testing and the need to promote couples’ testing in the upcoming VCT day celebrations.

Following this, two HIV positive mothers went out on stage with their daughters to testify how they were able to give birth to HIV free girls.  Then, Dr. Tadesse, Addis Ababa Health Bureau’s representative, gave a comprehensive presentation about the need for HTC and PMTCT with detailed information on the Ethiopian context.

The conference was concluded, after Wro. Yemwodish’s, president of Ethiopian Poets Association, poem recital entitled “mother” and a dance show by AAWA’s band.

01 September 2011 - A free voluntary counseling and testing service for the hearing impaired was launched today, September 1, 2011, at the Zewditu Memorial Hospital, Addis Ababa. This disability-friendly VCT center will start its work with two community counselors who can effectively communicate and give free counseling services to the hearing impaired. This event was attended by Ato Tadesse Atlabachew, Head of Addis Ababa HAPCO, Dr. Carmela Abate, Coordinator, PEPFAR Ethiopia and Ato Habtamu Kebebe, Director, Ethiopian National Association for the Deaf and other stakeholders.  After a series of speeches a small poem was read followed by a short drama sketching the special needs of the hearing impaired.

The event started with Dr. Samrawit Reisom, Zewditu’s VCT Coordinator, giving a welcoming address. Then, Ato Tadesse Atlabachew followed, by outlining Addis Ababa HAPCO’s efforts to incorporate the special needs of the disabled in anti-HIV/AIDS activities. He listed what the Office has been doing in the past two years in relation to HIV and disability. Among which were the training of health care practitioners in sign language and those who know sign language in voluntary counseling and testing.  He said that AAHAPCO’s efforts to give anti-HIV/AIDS services to the physically disabled should be seen as an endeavor which goes hand-in-hand with the government’s five year plan for growth and transformation. He further stated that the Office’s main purpose for carrying out disability friendly anti-HIV/AIDS activities is not only because they are entitled to these services but also because anti-HIV/AIDS activities that do not incorporate their special needs cannot be complete ones.

The ceremony was then followed by Ato Habtamu Kebebe giving a speech about the needs of the hearing impaired in relation to HIV counseling and testing. He pointed out how the hearing impaired had difficulty getting counseling and testing because translators were not allowed to translate so as not to violate clients’ confidentiality. Now that community counselors from the hearing impaired have been trained this community will be served in their own language. He concluded by making a call to other health centers to duplicate what has been initiated at Zewditu that more population may be served.

Dr. Carmela Abate also made a short remark on how WHO and the National Guidelines on HIV Counseling and Testing alike recognize the special needs of the physically disabled. This need, however, which encompasses 17% of the population, had not been addressed before. She expressed her pleasure that PEPFAR had been involved in supporting Handicap International to raise the awareness of service providers to address the special needs of the physically disabled.  After Dr. Carmela said that 7 million people should not be written off because their special needs had not been considered she congratulated all for their concerted efforts and closed her remark.

Zewditu’s VCT center, based on Sr. Almaz Nedi’s presentation, is a health integrated center that provides free same day counseling and testing throughout the week except on Sundays. Since it started its operation in 2002, the center has given services to a total of 25,113 couples and 80,623 individual clients. The VCT center seeks not only to bring behavioral change, give care to people with HIV/AIDS and promote VCT in the community; it also seeks to replicate its best practices to other health centers.