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Northeast African Studies 7.1 (2000) 1-11
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HIV/AIDS has become the most important health problem in Ethiopia and a threat to the social and economic fabric of the nation. The rapid spread and severity of the epidemic and its effects on society were examined by Kebede and colleagues (2000). The bibliography by Converse and colleagues (2003) contains more than 900 references to published articles and unpublished reports on HIV/AIDS in Ethiopia, reflecting the strong response since the late 1990s from public health officials, international organizations, local nongovernment organizations (NGOs), civil society, and researchers to the epidemic.
Despite increasing efforts to plan and implement interventions to control the further spread of HIV, research has focused mainly on clinical, laboratory, and epidemiological problems. The more holistic approach to the search for causal webs and appropriate responses that the social sciences and interdisciplinary fields with social science and biomedical perspectives and methodologies can provide has received little attention (Inhorn and Brown 1997; Kawachi 2002; Mayer 2000). Neglected areas include knowledge, perceptions, and risk behavior of rural people in parts of Ethiopia not covered by anti-HIV/AIDS programs; aspects of the relationship between sexuality, HIV/AIDS risk, and preventive behavior; epidemiological and behavioral aspects of opportunistic infections; the suitability of community-based organizations and programs in HIV/AIDS prevention, control, and patient care; coping behavior of AIDS patients and perceptions of their caregivers; and the occurrence of HIV infection and AIDS among Ethiopians in the Diaspora. [End Page 1]
The 13 papers contained in this and the following issue of NEAS (7.2), mostly by Ethiopian anthropologists, psychologists, and epidemiologists, begin to address some of these issues and to suggest directions for improved interventions. The contributions are directed not only at researchers but also, because of the new information many of them contain, at health planners and administrators of HIV/AIDS programs. They represent the first compendium of articles on HIV/AIDS in Ethiopia involving social and behavioral scientists, including five papers written by biomedical researchers using the social science perspective or coauthored with researchers from the social and behavioral science community—in itself a major step forward in mobilizing all resources to fight HIV/AIDS. Given the sensitive nature of the topics relating to sexually transmitted and terminal illnesses, it is significant that most of the papers use anthropological methods, seeking to present the viewpoints of those most directly concerned. To facilitate a wide distribution of this special issue, especially in Ethiopia, they will be available electronically by subscription to Project Muse (http://muse.jhu.edu).
The seven papers in this first issue examine the diffusion of the epidemic in Ethiopia and risk factors within the socioeconomic, cultural, and political context; present two models of risk and preventive behavior; explore the relationship between sexuality and HIV risk; and analyze behavioral and cultural aspects of sexually transmitted diseases (STDs) and the epidemiological relationship between tuberculosis and HIV/AIDS. At the end of this issue we describe crosscutting issues, draw conclusions, and identify new findings about the interrelationship between HIV transmission and prevention/mitigation efforts. Limitations of the papers and further research needs are identified in the second issue.
The review by Helmut Kloos and Damen Haile Mariam discusses the diffusion of the HIV/AIDS epidemic and the major driving forces behind it, risk behavior, and problems of AIDS patient support and care, as well as the impact of the epidemic on Ethiopian society and prospects of prevention and control in relation to socioeconomic, cultural, and political factors. A review of the still fragmentary epidemiological data indicates that the virus first spread primarily through commercial sex workers, soldiers, and truck drivers among towns and [End Page 2] is increasingly infecting the general population in both urban and rural areas, a pattern also seen in other hyperendemic sub-Saharan countries.
An examination of the HIV/AIDS knowledge/behavior gap, negative attitudes, gender inequities, and harmful practices points out the intransigence of the epidemic. Although the decline of both risky behavior and HIV infection rates in...