Population Council Research that makes a difference

HIV prevalence in urban Ethiopia is 7.7% (9.3% among women and 6.2% among men). Peak HIV prevalance is among ever-married women in their 30s. Because Ethiopia is a traditional country, with most women experiencing sexual initiation within marriage, it's likely that a substantial number of these women may be infected by their husbands. Few programs address marital HIV risk—which includes risk from lack of condom use and infidelity—nor do they address women's limited power and decisionmaking—including ways to increase partner communication and safer sexual behaviors.

Building upon existing programmatic experience in rural Ethiopia, Council researchers will attempt to address the HIV risks faced by many women within the context of their regular, marital partnerships through the project Kalkidan (Amharic for "Keeping the Promise"). This community-based initiative for husbands and wives will take place in low-income areas of urban Ethiopia. Council researchers will develop a gender-sensitive and context-appropriate approach to help women remain HIV-negative. The project will be implemented in slum areas of three Ethiopian cities—Addis Ababa, Bahir Dar, and Mekelle—where rates of HIV infection are high.

In partnership with regional HIV/AIDS prevention and control offices (HAPCO), the sub city, and local kebele administrations, a total of 72 respected local leaders (36 women and 36 men) will be recruited from the communities as adult mentors. Mentors will be trained on a specially designed curriculum that includes topics such as caring and supportive relationships, communication, alcohol and violence, HIV transmission and prevention, couples' counseling and testing, PMTCT, family planning, condom use, and maternal and child health care. Mentors will identify eligible participants—married men and women between the ages of 18 and 49—via a house-to-house survey. Eligible participants will be invited to join single-sex groups that will meet weekly in local kebele community halls for four months, and both sexes will be brought together monthly for collective discussion and problem-solving.

Results will include enhanced couple communication, promotion of HIV prevention, reduced stigma and violence, and increased demand for HIV information and services—which will contribute to maintaining women's HIV-negative status.

This project is funded by the Positive Action for Children Fund.