CHAPTER Newborn Baby

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CHAPTER  Newborn Baby Powered By Docstoc
(Focusing on Selected Weredas in Oromia and SNNPR Regions)

Sponsored by:

Addis Ababa, Ethiopia

Undertaken by:

Miz-Hasab Research Center (MHRC)
Addis Ababa, Ethiopia

March, 2004

                                     Table of Contents

Executive Summary                                                                  1
1:     Gender and HIV/AIDS: An Overview                                            7
       1.1 Introduction                                                            7
       1.2 The Gender Context in Ethiopia                                          9

2:    Research Methodology                                                        12
      2.1 Introduction                                                             12
      2.2 Objectives                                                               12
      2.3 Target Areas                                                             12
      2.4 Target Population                                                        13
      2.5 Methods of Data Collection                                               14
              2.5.1 The survey                                                     14
             Identification of respondents                        14
             Research Questions                                   14
             Pilot Survey                                         15
             Quality Checks                                       15
              2.5.2 Focus Group Discussions                                        15
              2.5.3 In-depth interviews                                            16

3:    Background Characteristics, Knowledge of HIV/AIDS, and Routes to
      HIV Infection                                                                 17
      3.1 Demographic and Socio-economic Characteristics of the Respondents         17
      3.2 Knowledge about HIV/AIDS                                                  21
      3.3 Source of Information on HIV/AIDS                                         28
      3.4 Voluntary Counseling and Testing                                          30
      3.5 Routes to HIV Infection and their Underlying Causes                       31
             3.5.1 Cultural norms, Values and Practices that Enhance HIV Infection--32
             3.5.2 Socialization of Women and Men                                   35
             3.5.3 Types of Marriages and related Practices                         36
             3.5.4 Virginity                                                        38

4:    Sex and Sexuality                                                            40
      4.1 Sexual Expectation                                                       40
      4.2 Unmet Sexual Needs                                                       41
      4.3 Decisions about Having Sex                                               43
      4.4 Rights to Property Ownership, Work and Access to Services                48

5:    Social Capital                                                               50
      5.1 Community Structures and Networks                                        50
      5.2 NGOs and other Civil Societies                                           52
      5.3 Government                                                               56
              5.3.1 Policy Provisions                                              56
              5.3.2 Constitutional and legal rights                                57
              5.3.3 Trends in the implementation of Policy and Legal
                     Rights of Women                                               58
            Courts and Police                                     58
            Education                                             59
            Health                                                59

6:      Discussions and Way Forward                                                    61
        6.1 Discussions                                                                61
        6.2 Way Forward                                                                64

References                                                                             68

List of Tables

Table 2.1:        List of Communities and Weredas where the Study was Conducted        13
Table 2.2:        Background characteristics of key informants by sex and occupation   16
Table 3.1:        Percentage Distribution of Demographic Characteristics of
                  Respondents by Wereda                                                18
Table 3.2:        Percentage Distribution of Socio-economic Characteristics of
                  Respondents by Wereda                                                20
Table 3.3:        Percentage Distribution of Knowledge by Modes of HIV
                  Infection by Wereda                                                  26
Table 3.4:        Percentage Distribution of Knowledge of Preventive
                  Strategies by Wereda                                                 28
Table 3.5         Percentage Distribution of Level and Source of Information on
                  HIV/AIDS by Wereda                                                   30
Table 3.6:        Percentage Distribution of Perceptions and Attitudes Towards
                  Voluntary Counseling and Testing by Wereda                           31
Table 3.7:        Percentage Distribution of Knowledge on Harmful Practices that
                  Enhance the Spread of HIV/AIDS by Wereda                             32
Table3.8:         Percentage Distribution of Attitudes Towards Virginity by Wereda     39
Table 4.1:        Percentage Distribution of Gender Sexuality and HIV/AIDS by Wereda   44
Table 4.2:        Percentage Distribution of Attitude Towards
                  Gender and Sexuality by Wereda                                       45
Table 4.3:        Percentage Distribution of Perception of Risk and Attitude
                  Towards HIV Infection by Wereda                                      47
Table 4.4:        Percentage Distribution of Woman‘s Right by Wereda                   49

List of Figures

Figure 3.1: Ownership of Land by Gender in Study Areas                                 19
Figure 3.2: Educational Level by Gender in Study Areas                                 21
Figure 3.3: Literacy by Gender in Study Areas                                          21
Figure 3.4: Knowledge of Two Most Common Modes of Transmission by Wereda               24
Figure 3.5: Attitude Towards PLHA by Wereda                                            25
Figure 3.6: The Most Common Prevention Method by Wereda                                27

List of Maps

Map 1a: Location of Study Sites, SNNPR
Map 1b: Location of Study Sites, Oromia

Annexes:       Wereda and Community Profiles                       72

Annex 1:       Alaba Special Wereda, SNNPR                         72
Annex 2:       Butajira Wereda in Guraghe Zone, SNNPR              72
Annex 3:       Humbo Wereda in Welaita Zone and Mareka Wereda in
               Dawro Zone, SNNPR                                   73
Annex 4:       Wenago Wereda in Gedio Zone, SNNPR                  73
Annex 5:       Hamer Wereda in South Omo Zone, SNNPR               74
Annex 6:       Yabelo Wereda in Borena Zone, Oromia                74
Annex 7:       Yaya Gulele in Seimen Shoa, Oromia                  75
Annex 8:       Fentale in East Shoa Zone, Oromia                   75
Annex 9:       Fedis in East Haraghe Zone, Oromia                  76


Appendix 1a:   Final English Survey Questionnaire
Appendix 1b:   Final Amharic Survey Questionnaire
Appendix 2:    Final FGD Guide
Appendix 3:    Final Key Informant Interview Guide

List of Acronyms

CCF                Christian Children‘s Fund
CSA                Central Statistics Authority
CSW                Commercial Sex Workers
DHS                Demography Health Survey
EWDF               Ethiopian Women‘s Development Fund
EWLA               Ethiopians Women Lawyers Association
FDRE               Federal Democratic Republic of Ethiopia
FGAE               Family Guidance Association of Ethiopia
FGM                Female Genital Mutilation
GTF                German Technical Funds
GTZ                German Technical Cooperation
HIV/AIDS           Human Immune Virus/ Acquired Immune Deficiency Syndrome
IIRR               International Institute of Rural Reconstruction
KAP                Knowledge Attitude and Practice
KMG                Kembata Menti Gezmi
MHRC               Miz-Hasab Research Center
MOH                Ministry of Health
NCTPE              National Committee on Traditional Practices of Ethiopia
NGO                Non Governmental Organization
OSSA               Organization for Social Services for AIDS in Ethiopia
PA                 Peasant Association
PLHA               People Living with HIV and AIDS
PMTCT              Prevention of Mothers to Child Transmission
SNNPR              Southern Nations Nationalities and Peoples‘ Region
STD                Sexually Transmitted Disease
STI                Sexually Transmitted Infection
UNDP               United Nations Development Program
VCT                Voluntary Counseling and Testing
WDIP               Women‘s Development Initiatives Fund
WHO                World Health Organization

                                      Executive Summary

One of the most puzzling issues regarding HIV/AIDS is that despite the information people have
on HIV transmission and prevention, self-risk assessment remains low at the individual and
community levels. Similarly, sexual behaviors remain virtually unchanged. In countries like
Ethiopia, HIV is mainly transmitted through sexual relations. This has made it necessary to
explore the assumptions, beliefs, norms and values people have about sex and sexuality and the
ways men and women are socialized and the existing customary practices that enhance the spread
of HIV infection. It is generally believed that prevailing masculinity and femininity ideologies
underpin the sexual behaviors of men and women. Thus an in-depth study that explores these
issues is essential to suggest policy and program interventions in the fight against the spread of

This study was undertaken in 4 weredas in Oromia and 6 weredas in SNNR, selected in
consultation with the UNDP Ethiopia office and the Technical Committee for Research composed
of representatives from different agencies working on issues of HIV/AIDS and gender. HIV
prevalence rates and the diversity of cultural and occupational categories in the areas were among
the criteria of selection. A triangulation of methods including survey questionnaires, focus group
discussions and key informant interviews were used to collect primary data at the community
level. Most of the data collected were qualitative, supplemented with quantitative data.


The three main objectives of the study are as follows:

    (i)      To document and understand the basic cultural norms, values, assumptions, beliefs,
             perceptions, attitudes and practices that render women, and the community at large,
             vulnerable to HIV infection;

    (ii)     To identify existing social capital (windows of opportunity) that are accepted and
             practiced by the community at large, and to explore the potential that such capital has
             in being used to change norms and values that expose the community at large to HIV
             infection; and,

    (iii)    To suggest community-specific policy and program interventions, utilizing existing
             social capital identified in the communities, to bring about fundamental changes in
             individual and societal thinking towards gender, particularly the masculinity and
             femininity perceptions that are believed to be the major macro variables that guide
             behavioral practices of women and men.


    (i)      For the most part, Ethiopian communities remain rural and traditional, and have
             values, norms and beliefs on sex and sexuality that result in exposing community
             members, particularly women, to HIV infection.

                The practices of multiple sexual relations, including polygamy, characterize most
                 communities. This sexual relation is underpinned by the values that define
                 masculinity and femininity. Prominent among such values are extra marital
                 sexual relation, abduction, rape, multiple marriage or polygamy, sharing of wife
                 and widow inheritance.

           Many of the prevailing cultural practices were initially adopted into the ways of
            life of respective communities with the intention of ensuring social harmony and
            community survival. For instance, jala jalto, which allows both women and men
            to have multiple sexual partners outside marriage, aimed to avoid men killing
            each other for having sexual affairs with each other‘s women.

           Communities do not connect their customary sexual practices such as sharing
            wife, widow inheritance with HIV infection. The prevailing attitude, and belief is
            that HIV infection concerns only ‗other‘ people such as truck drivers or
            commercial sex workers etc. Communities still externalize the infection and try
            to associate it with external groups and cultures that are western in life style.
            Rural communities think that it is the disease of the urban communities; Muslims
            blame Christians; pastoralists blame Amharas (Christians), urban residents blame
            the youth and sex workers etc. In addition, the study shows that the customary
            practices created at a certain epoch of a community‘s social evolution remained
            insensitive to changes happening locally and globally.

(ii)    The socialization process of men and women right from birth puts men in a position
        of absolute authority over women, and women are expected to be obedient and
        submissive to men. This process puts women in a situation where they cannot use
        their abilities and know how to deal with impending problems.

           Masculinity and femininity are defined in the respective communities by the
            shared perceptions they have about the 'typical man' and 'typical woman'. A
            'typical man is defined' to be sexually conquering, courageous, assertive and
            being able to give protection. He controls his wife/wives and ensures their loyalty
            and obedience to him by inflicting fear. A 'typical woman' is submissive and
            meets the needs of her parents at home before marriage and when she marries her
            main duty is to satisfy the needs of her husband: sex wise, bearing and looking
            after children, preparing delicious food. Femininity signals submissiveness,
            delicateness, and agreeing to what a man says and always seeking protection.

           The gender bias in the communities studied is reflected in the denial of women to
            own or have access to property, services such as education and health, and access
            to information through the attendance of public gatherings. Women do not have
            the opportunity to participate in discussions at both the household and the
            community levels; they do not have the right to decide when and with whom to
            get married. Neither do they have the right to sex and sexuality within their

(iii)   The government legal structures have not yet penetrated the communities and the
        rights of women stipulated in the constitution of the country have not been realized,

           The gap between the government legal structures and customary laws of dealing
            husband and wife dispute, sexual abuse and harassment remain wide. This is
            because the communities are hardly aware of policies and constitutional laws.
            Thus, the customary law supercedes the criminal law. In all the communities it
            has been reported that even if women bring their cases to the attention of police
            and the court, they hardly see their cases come to an end. The community elders

           who are guardians of customary laws threaten such women to withdraw their
           cases and elders put a lot of pressure including social sanctions against the victim
           and her families and make them withdraw or nullify the case they presented to
           police or court. In most cases the perpetuator of the crime is protected. This is
           seen in elation to abduction, rape and husband and wife dispute.

          Men who are products of the same socialization process occupy all offices of the
           government, with the exception of the office for women's affairs. This has a
           major implication to the implementation of government programs on women and
           related issues. Some of the legal structures and courts are less sympathetic to the
           cases of women and tend to use delay tactics and advise relatives of the
           perpetuator of the crime to make use of community elders to settle the matter
           outside of the legal system.

(iv)   Generic HIV/AIDS programmes have been focusing on the behavioral aspects of
       individuals and targeting mainly “high risk groups”.

          A number of interventions have been tried to address HIV/AIDS in an attempt to
           modify individual behaviors through the promotion of condom use and adherence
           to abstinence and faithfulness to one sexual partner without taking a look at the
           underlining causes of these behaviors.

          Many HIV/AIDS programmes have been based on a paradigm, which identify
           commercial sex workers and long distance truck drivers as high-risk groups, and
           designed interventions accordingly.

          Rural communities, especially women, who don‘t fit in a ―high risk groups‖,
           have little access to information on HIV/AIDS. As a consequence, they have
           limited and sometimes wrong knowledge on HIV/AIDS.

(v)    Pastoral communities are more vulnerable to the HIV/AIDS infections. Due to their
       mobility, the access to social services and information is very limited. Furthermore,
       prevailing cultural practices are more open to multiple sexual relationship than
       sedentary communities.

(vi)   Although there are serious constraints that are culturally determined and also
       exacerbated by the lack of effective interventions on the side of the government and
       civil societies, communities offer opportunities for change. Each community has a set
       of social capital that can be used to stop harmful customary practices. The study
       showed that it is possible to effect social change and the ingredients for such a
       process are readily available in the communities. Discussions in all the communities
       revealed that:

          The communities are enthusiastic to deal with the problems that they are facing
           particularly HIV/AIDS. The communities, like any other communities, aspire to
           be healthy. People are afraid of HIV/AIDS, and would like to protect themselves
           from the infection, and hence, will appreciate additional information on
           prevention and transmission strategies. The communities are prepared to
           cooperate with government and the NGO community to change certain practices
           if such changes would make them avoid HIV infection and thus be healthy.

               There do exist cultural norms and values that could be used by government,
                NGOs and other civil organizations to bring about changes that would enhance
                the health and survival of the respective communities. Ethiopian communities
                have social structure by which they address community issues. Tribal and
                religious leaders play key role in maintaining social harmony and remain
                influential. Community based associations such as Idir, mahber, debo are social
                assets of cooperation and working together. There are community forums for
                resolving problems and disseminating information. These structures and their
                leadership can be mobilized to introduce new values and practices towards
                gender equity and eventually stop practices that expose to HIV infection directly
                or indirectly. Community leadership are being mobilized in Yabello, Alaba and
                Butajura, for example, to deal with harmful customary practices and reports show
                that major changes are occurring in these areas.

    (vii)   There is a growing sensitivity on the side of the political leadership and the civil
            societies working on HIV/AIDS that the fight against HIV/AIDS requires deeper
            understanding of the gender relations and their underpinning values in the target

               The political leadership is eager to deal with HIV/AIDS and gender issues. The
                government has placed HIV/AIDS policy in place and is trying to strengthen the
                National HIV/AIDS Prevention and Control Office with human power and
                resources, whose mandate is to mainstream HIV/AIDS along all sectors in order
                to comprehensively address it. The government is aware that gender disparities
                affect its development endeavors. It has women policy in place and has made
                provisions for gender in all its development policies such as education, health
                and economic and population policies. It is trying to revise the civil code and
                criminal code procedure to incorporate legal provisions that address gender and
                HIV/AIDS. This environment creates positive conditions for more advocacy and
                PR works on policy and program ramifications in order to have a supportive
                environment for effective response to HIV/AIDS.

               There is growing sensitivity among the civil societies and NGOs that the
                customary practices that expose people to the infection, which in essence are
                results of masculinity and femininity ideologies, have to be addressed. This
                conception is being transformed into a program in some areas visited. The work
                of KGM in Alaba, Betel in Yabelo and Progenist in Butajura are going along this
                thinking and are attracting more attention (see Social Capital Ch 5).


As a way forward (see chapter 6 for details), it is suggested that addressing the cultural norms and
values that underpin sexual practices and other customary practices that expose men and women
to HIV/AIDS infection needs to be a focal point in policy and program ramifications to make the
response to HIV/AIDS effective. The present focus on behavior without dealing with the
underpinning factors would not bring a significant result to halt the spread of the infection. Thus,

(i)     The gender dimension of policy and program ramifications has to speed up the
        realization that men and women have equal rights to property, information, services,
        sex and sexuality by reinforcing the law and the rights recognized in the national
        constitution by working closely with community and government structures and
        strengthening existing women's organizations.

(ii)    The methodology suggested in bringing policy and program ramification
        needs to be based on advocacy works and PR activities targeting policy
        makers, religious and opinion leaders, business and industry leaders, media
        mangers and agencies. Since it is mainly transmitted through unprotected sex,
        gender has to be a focal point in policy and program ramifications. Equal
        opportunities for men and women have to be the guiding principle. For the
        realization of this, it is suggested that a supportive atmosphere needs to be
        created through continuous dialogue on gender and HIV/AIDS

(iii)   The community dimension has to be based on the belief that any community is
        capable of dealing with its problems. What a community needs is to understand its
        practices and be able to relate them with HIV/AIDS such as notions of masculinity
        and femininity; recognize available good practices that lead to gender equity and
        forums for resolving conflicts, being able to continuously work with available
        community leadership, and creating the social context for transformations. Focusing
        on community conversations would create an opportunity to highlight the
        understanding that everybody, not only those falling in “high risk groups”, is at risk
        of HIV infection. This would help the securing of collective response against

(iv)    The approach to impact cultural change by any facilitative group such as
        government, NGO or otherwise has to be process based, continuous and
        methodological: building a relationship of trust, creating a sense of community
        ownership in the identification of problems and making decisions to tackle them, be
        able to assess outcomes of such decisions and plan future course of actions.

(v)     Giving attention to occupation and means of livelihood in the course of programing
        is essential. This entails identifying communities that lead sedentary life based
        mainly on farming, those that live on animal husbandry such as pastoralists as well
        as making a rural urban distinction. .

(vi)    Most HIV programs focus on urban and sedentary people. It is necessary to carry
        community based works with pastoralists by considering their mobility along with
        their livestock. Programs have to be tailored according to the way pastoralists live.
        This entails that HIV/AIDS program has to be part of programs that aim at iproving
        animal husbandry; health services have to be mobile or built along trekking routes,
        and educational programs have to consider giving residence and food assistance to
        children of pastoralists.

(vii)   The mainstreaming of HIV/AIDS in any program/project is believed to be a good
        strategy to address HIV/AIDS in the rural population. However, in the
        mainstreaming, gender and community structures have to be central for any HIV
        related activity. Although gender tends to be seen as a separate issue, it is clear that
        every activity is gender governed.

The expected outcomes of the above mentioned processes could be measured in terms of process
and product indicators. The process outcomes would see into the community transformation
through participation in identifying problems, making decisions, reinforcing decisions made, and
the level of harmony between customary laws and statutory national laws. The product outcomes
would be seen in terms of number of women directly controlling valuable resources such as land
and livestock, accessing information and services such education and health, and women
assuming leadership roles , and the reduction of harmful customary practices such as FGM,
widow inheritance, wife sharing , abduction, early marriage, and polygamous marriage.

The study all in all shows that gender remains a focal point in the fight against HIV/AIDS. The
sex and sexuality norms and the prevailing ideologies of masculinity and femininity of
communities have to be addressed in policy, programs and activities dealing with HIV/AIDS in
order to bring a quick halt to the infection. The behavioral approach being implemented by
various agencies working on HIV/AIDS to stop the spread if HIV is just like trying to dry up a
tree by pruning its leaves, without cutting the roots.

1.      Gender and HIV and AIDS: An Overview

1.1     Introduction

HIV/AIDS is spreading at an alarming rate in Ethiopia. HIV/AIDS Behavioral Surveillance
Survey (BSS), Ethiopia (2002) shows that people are informed about HIV/AIDS. However,
changes in behavioral practices remain low. Prevailing HIV/AIDS campaigns have not made a
significant impact on attitudes and practices of the target population. One of the main reasons
may be that the campaigns on HIV/AIDS focus on the direct observable behaviors without due
consideration of the cultural beliefs, ways of thinking, norms and values that guide practices
which expose the community to HIV/AIDS infection. This study attempts to link the invisible
(social norms, values, and beliefs) with the visible behaviors that expose people to HIV infection
in address to address the root causes for the rapid spread of HIV/AIDS.

To a very large extent, interventions have largely been based on models and programs, which
derive from western paradigms that are inevitably insensitive to the region's socio-economic,
cultural and demographic constraints and facilitating factors. Specifically, community perceptions
of gender and particularly the issue of masculinity, femininity, gender power relations, and how
such relations expose the community to HIV/AIDS, remain obscure rendering existing
programmes minimally sensitive and responsive to the needs of women and men as different
groups. This oversight has disadvantaged women who are largely powerless to make decisions
about protecting themselves, their partners and their children. Granted that heterosexual
transmission is the basic mode of HIV transmission in Ethiopia and the rest of the African region,
an understanding of gender constructs of sexuality, femininity and masculinity will form the
needed bedrock upon which HIV interventions can be based.

The concept ―gender‖ was first used in the 1970s as scholars who were moving away from a mere
focus on women in order to include men. Gender therefore describes those characteristics of men
and women, boys and girls that are socially and culturally determined, as opposed to those that
are biologically determined. It refers to the social and cultural meaning assigned to being female
and male. People are born female or male, but learn to be girls and boys and grow into women
and men. They are taught what the appropriate behavior and attitude, roles and responsibilities
are for them, and how they should relate to other people within and between sexes. This learned
behavior is what makes up gender identity (IIRR, 1996). Gender shapes the opportunities one is
offered in life, the roles one may play, and the kinds of relationships one may have - social norms
and values that strongly influence the spread of HIV/AIDS (UNAIDS, 1998).

These norms and values that set the standards of behavior are acquired through the socialization
process. For instance, from the time a child is born she/he is taught what roles they have to
perform based on their sex. Children get appreciation from the family and society if they behave
according to what society prescribes, on the other hand, they are condemned when they deviate
from the established norms and values (Were, 1991). In other words, society, through specific
duty bearers, is the watchdog of adherence to norms and values. However, gender roles and
obligations are dynamic and they vary over time and across class, caste, religion, ethnicity and
age groupings (UNAIDS, 1999). This variation over time is inherent in the quality of "relevance
of norms" for the survival of a particular people at a given point in time.

The dimension of human rights violation often takes on different forms for men and women.
Women suffer disproportionately from a violation of their rights based on established patterns of
discriminatory 'traditional' gender roles and expectations. For instance, women represent a

greater proportion of the informal labor force compared to men, and as a result are less likely to
enjoy the protection of legislation and policies guaranteeing their rights to safe working
conditions, equal pay for equal work, adequate standards of living, and social security. In turn, the
economic dependency of women fosters minimal access to remedial action such as lack of legal
literacy and capacity to initiate legal action to redress a violation of their rights. This situation is
exacerbated by the fact that community norms, by and large, discourage women from reporting
violations, while there is also a pervasive lack of sensitivity toward the needs of women by
officials who should redress the violations encountered by women.

Women are more vulnerable to HIV/STIs biologically, economically, socially and culturally,
compared to men (Engender Health, 2002). Biologically, women have large mucosal surface and
micro-lesions, which can occur during intercourse, may be entry points for the virus or bacteria.
In addition, the viral load in sperm is more than that of vaginal secretions. It has also been noted
that women are less likely to be treated for STIs, which have a synergistic relationship with HIV
infection. It has been shown that with STIs, women are at least four times more vulnerable to
infection than men. This situation is exacerbated by the fact that most women are exposed to
coerced sex in Ethiopia, which increases the risk for micro-lesions.

Socio cultural and economic dependence of women on men means that they cannot control when,
with whom and in what circumstances they have sex. Women are not expected to discuss or make
decisions about sexuality. From youth, some young girls, particularly in Africa, sell sex to older
economically well off men - the "sugar daddy" relationship, for pecuniary support needed for
expenses ranging from school fees to clothing, food and other valued goods. And some older
women, regardless of marital status, are forced to form stable relationships with several sexual
partners each of whom provide for specific needs as a supplement and/or the source of economic
support. Yet women cannot request, let alone insist on using a condom or any form of protection.
If they refuse sex or request condom use, they often risk abuse, as there is a suspicion of infidelity
or unfaithfulness.

The many forms of violence against women mean that sex is often coerced, a situation which
enhances HIV infection. The situational factors that provoke violence against women are vast.
They include male dominance and histories of family violence, male control of family wealth,
divorcee restrictions on women, verbal marital conflict, heavy alcohol consumption, economic
stress and unemployment; isolation of women and the family from community support,
delinquent peer associations, notions of masculinity linked to toughness and honor, rigid gender
roles, a sense of male entitlement and ownership of women, approval of physical chastisement of
women, and a cultural ethos that violence is a valid means of solving interpersonal disputes.

According to Rivers, Aggelton and Coran, [1999], surrounding and to some extent legitimizing
these inequalities are ideologies of masculinity and femininity which make it seem ‗natural‘ that
men should have the upper hand when it comes to economic decision making, opportunities for
advancement, expression of sexual desires and satisfaction of sexual needs. Masculinities are
socially constructed and exert pressure on men to behave in particular ways. However,
hegemonic masculinities are not constant and do change over time. The development of
alternative versions of masculinity can, therefore, be promoted.

Gender norms significantly affect an individual‘s risk and societal vulnerability to HIV/AIDS
because they ascribe distinct productive and reproductive roles to women and men, and because
they differentially influence women and men‘s access to such key resources as information,
education, employment, income, land, property and credit. At least three types of factors
influence individual risk towards HIV/STI: cognitive, attitudinal and behavioral. Cognitive

factors are those that relate to how and what individuals know about sex and sexuality, and their
ability to identify risk and understand information vital to risk reduction. Attitudinal factors
include people‘s feelings about situations, others and themselves. Behavioral factors are those
that emerge from the cognitive - how people act and what they do in light of what they know and
feel. The behavioral aspect of individual risk also includes the skills of individuals regarding HIV
risk and risk reduction, such as the ability to use condoms consistently and correctly and /or to
negotiate their use with a sexual partner.

Women are subjected to societal vulnerability, which stems from the confluence of socio-cultural,
economic and political factors and realities that compound individual risk by significantly
limiting individuals‘ choices and options for risk reduction. These factors include discrimination
and marginalization of certain groups of people, illiteracy and lack of educational opportunities,
poverty and income disparity, lack of work and economic opportunities, law and the legal
environment, political will to mount effective responses to the epidemic, and the state‘s
willingness to protect and promote the full range of political, economic and social human rights.

In cultures where HIV is seen as a sign of promiscuity, gender norms shape the way men and
women infected with HIV are perceived. Generally, HIV-positive women face greater
stigmatization and rejection than men. Gender norms also influence the way in which family
members experience and cope with HIV and with AIDS deaths. For example, the burden of care
often falls on females, while orphaned girls are more likely to be withdrawn from school than
their brothers. (UNAIDS, 1998). Women, as grandmothers, care of the sick, and remain heads of
orphaned households.

1.2     The Gender Context in Ethiopia

The gender context in Ethiopia is characterized by disparities in the economic, social, cultural and
political positions and conditions of women. Ethiopian women constitute 50 percent (CSA, 1999)
of the population and they disproportionately bear the burden of poverty resulting from the
stereotyped gender divisions of labor and restricted access and control over household and
national resources. Underlying these disparities are cultural norms and values that determine
activities and opportunities of men and women. Women constitute 30% of formal employment
and 98% of the informal sector. And about 90% of those employed are concentrated in low
paying jobs. In the informal sector the pattern shows that women are either self-employed or
work in family owned businesses. Indeed, a nationally representative survey undertaken by the
Central Statistical Authority (DHS, 2000) revealed that nearly half of the working women in the
survey were self-employed; 43% worked for a family member, while 9% worked for non-family
owned businesses, and 41% did not receive any form of payment. A significant number of
women are forced to live on sex work as a source of income.

The participation of women in politics is very low. In the 2000 election, women took 42 (7.7%)
of the total 547 seats. At regional level there are only 244 (12.9%), female representatives out of
1891 council members. At Wereda Councils, only (6.6%) are women out of the 70,430 council
members. At the kebele level women constitute only (13.9%) of the 928,288 elected officials.
(Shadow report prepared by Network of Ethiopian Women's Association, 2004). Only one out of
the 18 ministers is a female. At a level lower, there are five women who hold the rank of vice
minister. Presently, among the 28 ambassadors that Ethiopia has appointed to different missions
abroad, only 4 (14.3%) are women. There is no female representative of Ethiopia in International

Although attempts are being made to raise women's participation in education, it remains low.
According to the DHS 2000, only 19% of women and 40% of men are literate, while 6% of
women and 13 % of men are partially literate. There is much lower literacy level among rural
women and men than among those living in the urban areas. Literacy levels vary widely among
regions, from a high of 68% among women in Addis Ababa to a low of 9% of women in the
Somali Region. Literacy among men ranges from a high of 87% in Addis Ababa to a low of 16%
in the Somali Region Three and a half million boys and 2.16 million girls were enrolled in all
primary schools in the 1998/99 school years. Male general enrolment rate in primary school is 56
compared to 35 for females. (MOE, 1998-99).

Ethiopia is a country with several ethnic groups, over hundred, and exhibiting linguistic, cultural
and social diversity. Being a pre-industrial society, all ethnic groups in the country share most of
the harmful traditional practices that can enhance HIV infection among others. "Women, from
infancy to adulthood and children of both sexes suffer most from the effects of harmful traditional
practices, ranging from the allocation of family food resources, nutritional taboos to other
harmful practices such as female genital mutilation (FGM), early marriage or marriage by
abduction, uvulectomy, milk tooth extraction, keeping a baby out of the sun and force-feeding
fresh butter to new-born children." (NCPTE, 2003 pp. 3-4). The most common and painful
harmful practice for women is FGM which is practiced by 73 percent of Ethiopians (NCPTE,
2003). The main reason of FGM is to subdue the sexual feeling of a woman in order not to exhibit
sexual needs before marriage and after marriage.

Ethiopian women are exposed to different forms of sexual violence such as abduction, rape and
forced sex within marriage. Abduction is widely practiced with an occurrence rate of 69 percent
at a national level. (NCTPE, 1998). Marriage by abduction occurs in almost all regions of
Ethiopia; it is very high in SNNPR, followed by Oromia, Benishangul, Afar, Harari, Gambella,
Tigray, Somali, Amhara and Addis Ababa. Rape is a common occurrence in both urban and rural
areas. It is traditionally tolerated to the extent that most women who have been violated do not
report the incident. In a study conducted among adolescents from six peri urban centers in
Ethiopia, 9 percent of sexually active women reported having been raped, while 74 percent
reported sexual harassment. (OSSA and German Foundation for World Population, 1999).
Traditional beliefs and religion also belittle women. (NCTPE, 2003).

One of the major expectations from a woman is being able to produce as many children as
possible. Fertility is a guaranteeing factor for a woman to stay with her husband. The
Demographic Health Survey (DHS) of 2000 indicates that an Ethiopian woman gives birth on
the average to 5.9 children; fertility is higher in the rural areas (6.4). Consequently, maternal
mortality rate is one of the highest in the world and accounts for 25% of all deaths among women
aged 15-49. Thus, one out of four women in the reproductive ages dies from pregnancy related
causes which are exacerbated by many other factors such as harmful traditional practices, heavy
work as the result of the gender biased division of labor, and unsafe abortions which are
widespread in the country. The DHS estimates for maternal mortality are 871 while others are
around 1100 deaths per 100,000 (WHO 2001). The 1990 National Family and Fertility Survey
revealed that 34 percent of women were married before age 15. Almost all women end up being
mothers by the time they reach the age of twenty (CSA, 1990). The mean age at marriage for
women at national level is 16 years. However for Amhara, Agaw, Argobat, Kemant and Tigray
communities' commitment to marriage starts when a girl is 4-5 years old and gets married at an
early age of about 9-10 and stays for a while in the family before sexual intercourse starts.
However, it has been noted that the groom often forces the bride to have sex before she is mature;
it is common sight to see an11-year old girl being pregnant which in turn leads to complications
such as obstetric fistulae resulting in lifelong misery due to total and permanent incontinence.

Treatment for such complications is available at only one hospital in Addis Ababa that performs
over 1000 fistula operations a year. It is estimated that for every successful operation performed,
10 other young women need the treatment. (NCPTE,2003).

In some cultures like the Borena, Kereyu, and Hamer, a woman cannot ask for divorce and thus
she remains a slave of the man in those situations where there is serious abuse. In these cultures,
any rich man can marry any young girl he is interested in. If the man is too old to make sex, a
young relative is given the responsibility of making her pregnant. The names of the children born
bear the name of the legal husband, this includes those children who might be born after his
death. In communities where divorce is allowed, the process becomes tiring and finally many
women decide to leave their marriages empty handed. Consequently, many young women who
end up in divorce migrate to urban areas where they take menial jobs like being housemaids,
cleaners and commercial sex workers.

Women in Ethiopia do not have a right to sex and sexuality. Children, particularly girls, are
socialized not to discuss issues on sexuality and HIV/AIDS even with their parents including the
mother. Findings of a study on attitudes and practices of female students in a high school in
Adigrat of the Tigray region revealed that 80% of the students never discuss these issues with
their parents. Reasons given were culture, fear of being labeled as promiscuous and respect for
parents. These students also perceived AIDS as an act of the devil. (Hadas, 2001). Young women
are often exposed to sexual violence resulting in unwanted pregnancies and illegal abortions. (see
Yoseph, 1999, and Mekonnen,, 1995 and Abdella, 1992, for details on unwanted
pregnancies and illegal abortions ).Men are socialized to be sexually adventurous; consequently
exposing themselves and their sexual mates to STIs including HIV/AIDS. Women normally do
not refuse sex, if they do so they get raped. Women hardly negotiate safe sex such as use of
condoms partly due to their socialization that makes them to be ignorant of sex and to be afraid of
men. The practice of unsafe sex is common in the rural and urban areas. (see Gebre 1990, Kidan,
et. al., 1995, Kora et. al., 1998) and FGAE,1998). The prevailing sexual behaviors expose
women to HIV and the STI infection and the prevalence is 11 percent among those aged 15-19
years, and 15% among those aged 20-24. (MOH, 1998; MOH, 2000 a). A study conducted in
high schools in Addis Ababa indicated that 54 percent of sexually active youth have experienced
sex with more than one partner; 43 percent of sexually active students knew about condoms at the
time of their first sexual experience, and 82 percent of them did not use condoms (Eshetu, 1997).

Ethiopia, nevertheless, offers some opportunities to address gender disparities. The Ethiopian
Constitution of the Federal Democratic Republic of Ethiopia, (FDRE, 1995) article 35 makes
explicit provisions that recognize the rights of women to access resources, services and respect
their human rights. The Women's Policy (1993) primarily aims to institutionalize the political,
economic, and social rights of women by creating an appropriate structure in government offices
and institutions. The Education Policy (1994) addresses the issue of women's access to education
and stipulates that education has to be geared ' towards reorienting society's attitude and value
pertaining to the role and contribution of women in development.' The Cultural Policy (1997)
articles 13,14, and 15 make special reference to rights of women, elimination of biases and
prejudices against women and ensuring equal participation of women in cultural activities. The
HIV/AIDS Policy (1998) makes special reference to how gender disparity expose women to HIV
infection and stresses the need to see gender in relation to HIV/AIDS prevention and control. The
socio-economic policies do consider women as targets of development. The Federal Rural Land
Administration Proclamation N0 87/1997, Article 5 (4) states that the land administration law to
be issued by each Regional State should confirm the equal rights of men and women in respect to
the use, administration and control of land, as well as in respect to transferring and bequeathing
holding rights.

2.      Research Methodology

2.1     Introduction

Generally speaking, the study attempts to explore the underlying gender norms and values that
expose men and women to practices that expose them to HIV/AIDS. It also tries to establish the
connection between the invisible cultural norms, values and customs and the visible behavioral
practices. In addition, the study explores the social capital which can be used as resources to
bring about quick behavioral changes to prevent and control HIV infection in the respective
communities. It takes gender as the center of the study.

2.2      Objectives

Given the need to understand the direct and underlying causes to HIV infection, this study
specifically addresses three main objectives, which are:

           To document and understand the basic cultural norms, values, assumptions, beliefs,
            perceptions, attitudes and practices that render women, and the community at large,
            vulnerable to HIV infection;

           To identify existing social capital (windows of opportunity) that are accepted and
            practiced by the community at large, and to explore the potential that such capital has
            in being used to change norms and values that expose the community at large to HIV
            infection; and,

           To suggest community-specific policy and program interventions, utilizing existing
            social capital identified in the communities, to bring about fundamental changes in
            individual and societal thinking towards gender, particularly the masculinity and
            femininity perceptions that are believed to be the major macro variables that guide
            behavioral practices of women and men.

The specific objectives are:

           To assess people's knowledge, beliefs and practices about HIV/AIDS;
           To identify norms and values underlying the observed practices;
           To understand the meaning and expectations regarding masculinity and femininity,
            and how these determine sexual relations between men and women;
           To highlight sexual practices, and other practices that predispose the respective
            communities to HIV infection;
            To identify the social capital which can be utilized to change the existing norms,
            beliefs and practices in order to reduce HIV infections; and,
           Based on findings from 1-5 above, to make policy recommendations on what can be
            done to change those perceptions about gender relations that tend to pre-dispose the
            respective communities to HIV/AIDS.

2.3     Target Areas

The study was conducted in 20 communities (13 rural and 7 urban) in 10 weredas in 2 of the
largest regions of the country, SNNPR and Oromia. The selection of the weredas, done in
consultation with UNDP, was largely based on cultural diversity, HIV/AIDS prevalence, and

proximity to the ‗AIDS corridor.‘ (See Maps 1a and 1b for location of weredas in their respective
regions, see appendix)

Once the weredas and the main towns were selected, two kebeles, one from rural and urban areas
respectively, were randomly selected for the study. Table 2.1 shows the list of communities and
weredas where the study was conducted.

Table 2.1 List of Communities and Weredas where the Study was Conducted
  No      Region          Zone         Wereda            Name of       Urban/Rural
 1      SNNPR        Gurague        Miskan         Kebele 01           Urban
 2      SNNPR        Gurague        Miskan         Dobi                Rural
 3      SNNPR        Alaba          Alaba          Kebele 02           Urban
 4      SNNPR        Alaba          Alaba          Gedeba              Rural
 5      SNNPR        Welayita       Humbo          Kebele 01           Urban
 6      SNNPR        Welayita       Humbo          Abalafarecho        Rural
 7      SNNPR        Dawro          Mareka         Tercha              Urban
 8      SNNPR        Dawro          Mareka         Gosashash           Rural
 9      SNNPR        Gedio          Wenago         Dilla/Kebele 08     Urban
 10     SNNPR        Gedio          Wenago         Dilla/Chechu        Rural
 11     SNNPR        South Omo      Hammer         Dimeka              Urban
 12     SNNPR        South Omo      Hammer         Shankokelema        Rural
 13     Oromiya      Borena         Yabelo         Arare               Rural
 14     Oromiya      Borena         Yabelo         Didiyabelo          Rural
 15     Oromiya      North Shewa    Yayagulele     Debretsige/Keble 01 Urban
 16     Oromiya      North Shewa    Yayagulele     Tiregiorgis         Rural
 17     Oromiya      East Shewa     Fentale        Gola                Rural
 18     Oromiya      East Shewa     Fentale        Debti               Rural
 19     Oromiya      East Hararge   Fedis          kebele 01           Urban
 20     Oromiya      East Harrarge Fedis           Lencha              Rural

The study involved a total of twenty sites (two in each wereda) with 13 rural and 7 urban

2.4     Target Population

Cultural values and norms are the product of interactions of a complex network of different
members of the community. Some networks are perceived to be custodians of such values and
are largely responsible for the transmission of values from one generation to the other, and their
maintenance within the respective communities. Some networks are perceived as mere
receptacles who are expected to live by the expected standards. Thus, a number of target groups
were included in this study in order to capture the variable views regarding the issues at hand.
These include:

           Adult males and females;
           Headmasters/teachers at schools;
           Traditional local leaders such at the wereda and kebele levels;
           Employees of non-governmental organizations;
           Government employees in the areas of health, education, women's affairs bureaus,
            and courts

The selection of the 2,000 respondents for the survey was random based on the list of households
provided by each selected kebele. Among the 2,000 respondents 1,680 were from the 13 rural
sites while the remaining 320 were from the 7 urban sites. This was done in consideration of the
rural-urban population distribution in the country.

The selection of the participants of the key-informant interviews and FGDs was purposeful.

2.5     Methods of Data Collection

A combination of methods was used for triangulation purposes. The number of target groups
involved, and the breadth and depth of the issues to be studied necessitated this. The methods
include a survey of adults aged at least 15 years, key informant interviews who are the respective
custodians of cultural values, and focus group discussions (FGDs). A detail description of each is
provided below.

2.5.1 The survey

The survey covered a sample of 2,000 randomly selected respondents that were equally divided
between adult males and females. This sample is expected to represent the population of the 10
weredas included in the study. Identification of respondents

Within each selected kebele in a wereda, a list of households was obtained from the kebele
administration. Sample households were selected by systematic sampling where a random start
was selected and every x + nth household was sampled (n is the sampling interval which is the
total number of households in a kebele divided by the sample to be selected from the respective
kebele, 200 in this case).

As noted before, the sample comprised adults, and also males and females. It was particularly
important that once in a household, one did not interview all the eligible members since many
such members would share the same belief system, a situation that would reduce the
heterogeneity, which typifies human behavior especially at a regional level. Thus, in the selected
households, all eligible members were randomly assigned numbers, and one number was
randomly selected and interviewed. Research questions
The research questions were designed in order to capture both quantitative and qualitative data,
which would give a comprehensive view of the HIV/AIDS and gender issues. The questionnaires,
which were used to collect quantitative data, were designed to enable the research team to carry
out statistical analysis using SPSS. (See Appendix 1). CSPro was used to enter data into the
computer. A combination of open and close-ended questions, with a bias towards the latter was
used. However, granted that this area is not as well researched, it was necessary to have an open
category ―other‖ for most of the questions in order to capture those answers, which might not
have been anticipated and included in the questionnaires.

                                                                                               14 Pilot survey
The first stage of the survey was a pilot survey, which was carried out in Addis Ababa and its
surrounding villages. The pilot survey helped in the refinement of the questionnaires, and also the
data collection plans with respect to both the content of the instruments and the logistics to be
followed. Quality checks
Various mechanisms were put in place to ascertain data validity and reliability. Firstly, quality
control was maintained daily by the supervisors in the field. The researcher worked with a
supervisor. Both the researcher and the supervisor went into the field with the data collectors to
ensure that the data collectors followed instructions as given both during the training, and also in
the field by the researchers. The researcher held daily debriefing meetings before getting into the
field to reinforce procedures and quality standards. These meetings were aimed at highlighting
problems encountered, and thus identification of the relevant solutions.
The supervisor randomly drew 5 percent of the questionnaires that were filled-in daily. The
supervisors visited the homes of the randomly selected 5% interviewees for verification purposes.
Any mismatches were dealt with swiftly during the fieldwork period to ensure the quality of data.
In addition, the supervisor and researcher identified problems in the data collected, i.e. missing
data, inconsistent data, incomplete questionnaires and illegibility of handwriting. While there
were general discussions of these problems, there were also one-to-one discussions with the
respective data collectors who had to individually remedy their respective errors some of which
entailed revisiting interviewees. Lastly, the questionnaires were designed in such a manner that
some of the questions were used for consistency checks.

2.5.2   Focus group discussions (FGDs)

In order to meet the above objectives, the researchers also used focus group discussions (FGDs)
whose main goal was to collect data on assumptions, values, attitudes and beliefs that underpin
prevailing behavioral practices towards sex and sexuality. (See Appendix 2) The focus was on
the variables indicated in Wilber‘s Integral Framework describing individual (attitude, ways of
thinking, enthusiasm, feeling, commitment, integrity, skills) and collective (culture norms, shared
norms, moral norms, shared assumptions, covenants and traditions) attributes. Generally, while
quantitative data answer the ―what‖ aspect of our research question, that is what practices are
common, and at what levels of prevalence, information from FGDs answer the ―why‖ aspect, that
is, why are there such types of practices, and why are levels of prevalence that high or low.

The focus group discussions were undertaken in both regions. A total of 40 FGDs were carried
out. Each group had between 8 and 12 participants. Within the worades participants were chosen
bearing in mind that the participants must be comfortable with each other, yet they must also
represent the potentially different view points. Gender, age and position in respective
communities were used as selection factors. That is, groups were either exclusively male or
female, and influential members of the community were not included in the FGDs; they were
included in the key informant interviews.

The discussions lasted for on the average three hours, and they were conducted in public places
such as schools, rented facilities, or where the participants hold regular meetings. Most FGDs
were held outdoors especially because the weather was conducive. These locations were neutral
so as to avoid either negative or positive associations with particular settings among the
participants. In each wereda 4 FGDs, 2 for males and 2 for females were conducted.

2.5.3 In-depth interviews

As noted earlier, in-depth interviews were undertaken with the other target groups which
included: NGOs leaders, headmasters/teachers and local leadership at different levels. The in-
depth interviews were guided by structured open-ended questionnaires (See Appendix 3). A total
of 236 in-depth interviews were conducted. 78 were selected from government offices such as
health, education, wereda and kebele administration, health facilities, women's affairs bureaus,
schools and courts. Apart from the bureau of women's affairs, men represented all government
offices. 43 informants came from NGOs and 115 from community structures such as tribal,
religious leaders, elders and leaders of community associations (See Table 2.2 for details by

Table 2.2 Background Characteristics of Key Informants by Sex and Occupation
                                      Sex                       Occupation
        Wereda         N      Men         Women       Govt        NGO      Community
Meskam/Butajura        21            8          13          6          4          11
Alaba                  23           15           8          8          5          10
Humbo/Welaita          28           17          11         15         10           3
Dawro                  29           19          10          9          7          13
Wenago/Gedeo           30           17          13          6          6          18
Borena/Yabello         20           11           9          7          2          11
Hamer                  20           14           6          7          -          13
Yaya gulele/N/Shoa     17           12           5          7          1           9
Fentale (Kereyou&Etu   25           14          11          4          4          17
Fedis (E.Harareghe)    23           17           6          9          4          10
Total                 236          144          92         78         43        115

3.      Background Characteristics, Knowledge of HIV/AIDS and Routes to HIV
The findings combine data from both the quantitative survey and the qualitative sources. The
former are used largely to give an indication of the levels and prevalence of particular indicators
while qualitative data are used to explain factors underlying the observed levels, with the view of
unraveling the entry points for interventions that can reduce the spread of HIV/AIDS.

3.1     Demographic and Socio-economic Characteristics of the Respondents

As noted earlier, the survey included 2000 randomly selected respondents, 200 for each
site with a fair gender balance. It targeted males and females who were at least fifteen
years old, and their age distribution reflects that of the country. About 81 percent of the
respondents were aged between 15 and 45 years (table 3.1). However, Alaba, Hamer,
Fentele and Fedis have slightly younger populations with the proportion aged between
15-45 years being 86, 88, 87 and 90 percent respectively. On the other hand, Batjura and
Yaya Gulele have older populations with about 62 and 72 percent, respectively, of the
population aged between 15-45 years.

The majority of the respondents, about 81 percent, reported that they were married. Monogamy
was reported by 76 percent of the respondents while polygamy was reported by about 5 percent of
the respondents. Polygamy is almost universal with nine of the ten weredas reporting polygamous
marriages the highest being in Hamer (14.6%) and Alaba (7%). Yaya Gulele is the only wereda
which does not report polygamy. It is important to note at this point that the reported level of
polygamy understates the level of multiple sexual partnerships, which can be easily considered as
polygny or even polyandry. In most of the weredas, both men and women reported having extra
marital relationships, which were regular, and socially sanctioned, yet not reported as extra wives
or husbands. For instance, jalajalto is a culturally accepted sexual practice among the Borena of
Yabelo and the Kereyuo of Fentale where both a man and a woman can have other sexual
partners in addition to their regular spouses.

Among the Borena, it is acceptable that a man can ask for sex from another man's wife and
normally she agrees. In this relationship, the married man is called the jala (man lover) while the
female partner is called the jalto (woman lover). The official wife and the jalto accommodate
with each other. For example, when the official wife gives birth to a baby, especially a boy, there
is a ceremony for giving a name to a newborn baby, the ceremony is called the mogasha. The
jalto also attends the ceremony to which she brings gifts such as a bull or goat, milk of camel,
butter and honey. On her return, after spending a number of days at the jala’s home, the jala
gives the jalto a gift in exchange; the gift can be a goat or cow. This exchange of gifts makes the
jalto part of the family. Since the jalto spends some days at the jala’s home, it is possible that she
can become pregnant; however, if she has a child from that pregnancy, the child born takes the
name of her legal husband called abera.

Note that both the legal wife of the jala and the legal husband of the jalto are aware of the
relationship, and they tolerate the relationship; should the two spouses be interested in each other,
they can also engage in a sexual relationship, if not, they can be involved with other men and
women. A network of sexual relationships therefore generally characterizes these communities;
having additional sexual partners is a source of pride for both men and women. In these
communities monogamy does not necessarily preclude multiple sexual relationships. Thus, the
number of sexual relationships is a better proxy to assess the degree of exposure to HIV infection

    than type of marriage. Besides, the practice of jala jalto is fairly comparable to polygny and
    polyandry, albeit not perceived as such by the respective communities.

    The communities studied are clearly patriarchal with males dominating as heads of households.
    Males headed about 79 percent of the households interviewed. Male headship is somewhat low in
    Butajura (71.5%), Yabelo (77.5%) Fentele (76.8%) and Fedis (74.6%). Female headship is about
    13 percent; it is highest in Butajura (28%) Yaya Gulele (15.2%) and Humbo (14.6%). Single
    women are more likely to be heads of households than single men. While single males headed
    about 2 percent of households, the single women headed about 7 percent of the households.
    Single women headship is highest in Fentele (13.4%) and Fedis (17.8). Both Fentele and Fedis
    are affected by drought and men usually migrate in search for jobs; this might be a possible
    explanation for the relatively high female headship.

    Table 3.1 Percentage Distribution of Demographic Characteristics of Respondents
    by Wereda
                         special                                Butajurra/             Yaya
Age             Humbo    wereda Wenago Mareka          Hamer     Meskan Yabelo Fentele Gulele       Fedis   Total
15-19              3.0       4.0   1.5    3.5            5.5         0.5    7.1  13.0    2.5          3.5     4.4
20-24             10.7      12.6  10.8   17.8           14.6         4.5   11.1  13.0   10.1         15.6    12.1
25-29             20.8      26.3  23.1   18.3           19.1        13.5   18.2  19.5   14.1         25.1    19.8
30-34             18.3      18.2  17.9   20.8           19.6        15.0   17.7  17.0   12.1         21.1    17.8
35-39             13.2      16.7  14.4   13.4           14.1        17.0   13.6  13.0   15.2         13.1    14.4
40-44             14.7       8.6  13.3    8.9           15.1        11.5   10.1  11.0   18.2         11.1    12.2
45-49             11.2       7.6   7.2    8.4            6.0        19.0    9.6   5.5    9.1          3.0     8.7
50-54              4.1       3.5   3.6    3.0            5.5         8.5    4.0   5.5    7.6          5.0     5.0
55-59              1.5       1.0   1.5    4.0              -         4.5    5.6     -    6.6          1.0     2.6
60+                2.5       1.5   7.7    2.0            0.5         6.0    3.0   2.5    4.5          1.5     3.1
Male              55.6      49.5  42.7   42.7           52.8        51.5   45.5  41.0   50.3         54.8    48.7
Marital Status
Never married      9.1       10.0      3.5       8.3     17.6        5.5      9.5    14.0    9.0     7.0      9.4
Married, Mono.    77.3       75.0     82.8      75.6     59.3       81.9     77.5    73.0   80.4    78.9     76.2
Married, poly.     1.5        7.0      1.5       4.4     14.6        3.0      3.0     4.5      -     6.0      4.6
Divorced/separ.    3.5        2.5      4.5       4.4        -        3.5      1.5     4.0    5.0     5.0      3.4
Widowed            8.6        5.5      7.6       7.3      8.5        6.0      8.5     4.5    5.5     3.0      6.5
Adult male        79.3       81.5     83.8      80.1     81.4       71.5     77.5    76.8   78.3    74.6     78.5
Adult female      14.6       11.0     11.6      12.6      9.0       28.0     13.0     4.6   15.2     6.1     12.6
Young male         1.0        1.0      1.0       1.5      1.0        0.5      3.5     5.2    1.5     1.5      1.8
Young female       5.1        6.5      3.5       5.8      8.5          -      6.0    13.4    5.1    17.8      7.1
Orthodox           8.6       10.6     30.3      32.7        -       86.0       .5     4.0   97.0     6.6     27.7
Catholic          12.1          -        -       1.5      1.0        3.0       .5      .5     .5       -      1.9
Protestant        78.8        3.0     68.2      64.9      3.0        6.0      9.5       -    2.5      .5     23.7
Muslim               -       86.4      1.5         -        -        4.5     30.0    69.8      -    92.9     28.4
Other               .5          -        -       1.0     96.0         .5     59.5    25.6      -       -     18.3

    Educational attainment of the respondents is quite low. About 66 percent of the respondents
    reported that they had no formal education while 25 percent had primary school only (table3.2).
    Lack of education is highest in Hamer (96.5) and Yabelo (91.2); there were no respondents with
    education above secondary school in both weredas. The mean number of completed years of
    school for the sample is 2.3. Males report higher levels of education than females (fig 3.2). For

instance, while about 56 percent of males reported no education, about 75 percent of the females
reported the same. And while about 14 percent of the males reported having secondary education
or higher, only 6 percent of the females reported the same.

Consistently, literacy is very low, about 31 percent of the respondents reported that they were
literate. The lowest level of literacy was reported in Hamer, only 3 percent, and in Yabelo (7.5%).
Again, males are more literate than females (Fig. 3.3). While about 41 percent of the males
reported that they were literate, about 22 percent of their female counterparts reported the same.

The study population is largely rural. About 14 percent of the sample was from urban areas while
86 percent was from rural areas. However, the Hamer, Yabelo and Fentele respondents were
exclusively rural largely because these communities are pastoral.

Consistent with the high rural residency, the majority of the respondents reported that they had
their own land in which they cultivated crops. This was reported by about 68 percent of the
respondents. Ownership of land was lowest in Fentele, about 45 percent. This is largely explained
by the fact that people in Fentele are largely dependent on pastoral farming.

There are minimal differences in ownership of land by gender. For instance, while 72 percent of
the males reported having land, about 68 percent reported the same (See Figure3.1). And while 28
percent of males reported that they did not have their own land, about 35 percent of the females
reported the same. The key informants and focus group discussions revealed that women are the
major participants in terms of working in the fields. Thus, most women would report their
husband‘s land as theirs. However, during divorce or separation women do not share land or

            Figure 3.1: Ownership of Land by Gender in Study Areas (N=1,998)


               80        72.4

                                                           35.3                T otal


                            Percent Yes                Percent No

However, decisions on crops to be grown and sold are not commensurately made by women.
About 45 percent of the respondents reported that males make decisions on crops to be grown.
The Hamer are the most likely (55%) to report male dominance in decision-making. Another 45
percent reported that both the wife and the husband decide on the crops to be grown. This
egalitarian decision-making is consistently lowest in Hamer (32.7%). Decisions on crops to be
sold are more equal than decisions on crops to be grown. This is largely because women are the

 ones largely involved in assessing the food requirements for the family. While about 29 percent
 of the respondents reported that decisions on crops to be sold are made by men, about 59 percent
 reported that both spouses make decisions on what is to be sold. Respondents from Hamer and
 Fentele were the least likely to report egalitarian decision-making on crops to be sold; about 47
 and 44 percent reported so, respectively.

 Respondents were also asked about their possession of other consumer goods such as cars,
 bicycles, refrigerators and television. These goods were almost non-existent in the sample
 studied. The only amenities and goods, which were reported by at least by 10 percent of the
 respondents, were access to electricity and possession of a radio. However, only 12 percent of
 the respondents reported having access to electricity; this comprises urban residents only as
 evinced by the lack of access to electricity in the exclusively rural communities of Mareka,
 Hamar, and Yabelo. Ownership of radio was reported by 38 percent of the respondents.
 Ownership of radio was lowest in Hamer (2.5%), Yabelo (22.1% and Fentele (27.5%).

 Table 3.2        Percentage Distribution of Socio-economic Characteristics of Respondents by
                          special                             Butajurza/                  Yaya
Education       Humbo     wereda    Wenago Mareka    Hamer     Meskan Yabelo      Fentele Gulele     Fedis   Total
No educ.          35.4       60.5    43.1     45.4    96.5        64.2     91.2    83.0     73.2      64.3    65.7
1st cycle Prim.   11.3       11.4    19.0      9.8     2.0        16.8      6.2     8.0      8.1       9.7    10.1
2nd cycle Prim.    31.3      18.4    27.7     22.9     0.5        11.0      2.1     8.0      5.1      18.4    14.5
Secondary          11.8       3.2     2.6      8.8     1.0         2.3      0.5     1.0      4.5       5.6     4.2
Above seco.        10.3       6.5     7.7     13.2       -         5.8        -       -      9.1       2.0     5.5

Literate           57.6      37.0    51.5     52.7      2.5       29.6      7.5    13.0     25.6      30.8    30.8

Own land           68.7      74.5    74.7     67.0    78.4        74.0     56.8    44.5     71.9      73.9    68.4
Decision on
crops grown
Husband            36.8      41.6    48.0     40.1    55.1        39.9     46.9    47.2     44.8      46.9    44.7
Wife               10.3       4.7     7.4     13.9    10.3         8.8      7.1     7.9      5.6       4.1     8.0
Both0              47.8      48.3    43.2     44.5    32.7        49.3     43.4    42.7     48.3      48.3    44.9
Others             13.8      27.6     6.9      6.9     1.9         2.0      1.8     2.2      1.4       0.7     2.1
Decision on
crops sold
Husband            25.0      37.6    20.3     24.1    39.7        22.3     25.7    39.3     20.3      32.7    28.5
Wife                9.6       4.0     8.1     12.4    11.5         8.1      8.0     6.7      5.6       4.1     7.8
Both               60.3      51.0    69.6     61.3    47.4        60.1     63.7    43.8     64.3      61.9    58.7
Others              4.4       7.4     2.0      2.2     1.3         9.5      1.8    10.1      9.8       1.4     4.8
Own Elect.         19.2      19.0    47.5        -       -        17.5        -     0.5     10.1       1.5    11.5
Radio              49.5      44.5    55.6     44.2      2.5       43.0     22.1    27.5     34.2      57.3    38.0

 These findings generally suggest that these populations are largely rural. Multiple sexual
 relationships are rampant and socially sanctioned. Literacy and access to media is also very low
 which renders interventions via print and electronic media untenable.

In the sedentary communities namely Alaba, Humbo, Dawro, Gedeo, Yaya gulele, and Fedis, the
major occupation is farming followed by livestock raising. They also engage in activities like
selling wood and charcoal, and petty trade such as selling agricultural produce. Alaba is noted for
its pepper market. Kat is also grown in Alaba, Gedeo and Fedis and remains also source of
income. Coffee is a major source of income in Gedeo. In the pastoralist communities namely
Borena, Hamer, and Fentale communities, animal husbandry is the main source of income.
Women also sell charcoal and wood to support their families.

             Figure 3.2: Educational Level by Gender in Study Areas (N=1,939)


           80                                         75.3
                                                                                   No Education
           60        55.5
                                                                                   1st Cycle Primary
                                                                                   2nd Cycle Primary
                                 19.1                                              Above Secondary
           20               12
                                         6.1 7.4              8.3 10.4
                                                                         2.4 3.7
                                 M ale                          Female

                     Figure 3.3: Literacy by Gender in Study Areas (N=1,996)



                60                                                                             M ale
                                          40.5                                                 Female
                40                                                        30.8                 Total

                                                   Literacy Rate

3.2     Knowledge about HIV/AIDS

Findings from key informants and FGDs show that people have heard of HIV/AIDS, and it is
universally understood as a sexually transmitted disease. Respondents also mention sharpened
metal objects like razors and needles as possible routes of infection. Very few know about mother
to child transmission. Respondents report faithfulness as a preventive strategy against HIV
infection. There are misconceptions on routes and origin of infection, too. Some think that raw

eggs, flies, casual physical contact with PLHA can transmit the infection. Many of the people
believe that HIV is the result of the anger of God. However, all agree that people are not serious
in avoiding HIV infection particularly when it comes to sex with more than one partner.

The communities visited mostly see HIV as an external factor and fail to associate it with their
customary practices of sex and sexuality. Some ethnic groups like the Hamers and Borenas think
that HIV is a disease of the Amharas (Christians). The rural residents take it as a disease of the
urban population and they do not think that they are at risk. Some think that it is a disease of sex
workers and the ill-mannered youth; some deny the existence of HIV.

HIV/AIDS is widespread in all the weredas visited, although figures are not made available.
Circumstantial evidence shows that people are dying of diseases whose symptoms are consistent
with those of HIV/AIDS. In places like Alaba, Butajura, Gedio, Alaba, Welaita, Fentale Fedis,
prevailing cultural and commercial activities play significant roles in the rapid spread of the
infection. Sex with multiple partners is common. According to the wereda HIV office of Alaba,
many people have died and many more are showing symptoms of HIV/AIDS. During the
harvesting season of pepper, which is November to December, people, including sex workers,
inundate the area and sex is freely practiced, he added.

 In Butajura many youngsters, women and men, have been reported to have died of AIDS. There
are parents who are reported to have died of HIV/AIDS and children are being orphaned. Many
are suspected to be living with the virus, but no official figures have been released. According to
the wereda HIV/AIDS secretariat, out of 570 people who got tested voluntarily in order to get
HIV clearance for marriage in year 2003, (330 men and 240 women) 46 were positive (27
women, and 19 men). An urban woman remarked: "Many men get exposed during the time of
harvesting pepper. They get money and enjoy their time by going to towns and returning home
with HIV." Prevalence in Welaita is estimated at 10% (Sodo Health Center). "Sexual intercourse
is the main mode of transmission. Sex in Welaita is free; young boys start sex early, but do not
know about condoms." [Humbo health officer]. Humbo is the worst hit by HIV/AIDS. Out of
seventy who were voluntarily tested, 41 (59%) tested positive for HIV.

HIV/AIDS is an epidemic in Gedio/Wenago wereda. According to the medical director of Dilla,
HIV/AIDS has been spreading fast especially in the last two to four years, and it is the third top
disease and fourth killer disease in the in the wereda.

         There is high spread of HIV/AIDS in the wereda more than any other
         place in the SNPPR; this is largely due to many hotels, and sex workers
         that come from different parts of the country. It is on the main high way
         and many truck drivers and merchants pass nights in Dilla; migrants from
         the countryside come to work; there is also high unemployment among the
         youth (Health Officer).

Out of 70 people tested, 30 (43%) were found to be HIV positive in one month, five of them had
already died at the time of the survey; this was reported by PMTCT head for the hospital who
proceeded to remark:

         348 women took blood test in the PMTCT and only 43 husbands came to
         take the test. Wives fear to disclose their test results to their husbands and
         it is difficult to force men to come and take the test. The PMTCT program
         depends on the cooperation of wives and husbands. If breast-feeding is to

         be replaced by other sources of food the husband must know and agree to
         it. In this area men practice multiple sexual relationships. In the tests
         conducted a woman was found to be negative but her husband was
         positive. Positive women try to give other excuses such as undergoing
         dental treatment instead of admitting sexual relationships as the source of

In Yaya Gulele people die showing physical symptoms of AIDS illness. In Fiche hospital 73
blood tests were taken in one month and nine (12%) were positive, 4 women and 5 men. TB is
common, so is pneumonia. At the time of the survey there were 20 AIDS patients in the hospital,
13 were women. Abebech Gobena, a local NGO, has been supporting 22 PLHA, three of them
had already passed away. Now there are nine women and six men getting full care and support.
The Kereyou and Etu in Fentale experience high levels of HIV infection. According to HIV/AIDS
center for information, out of 800 people who got tested, 600 (75%) were HIV positive at
Metahra sugar factory. These tests were undertaken three years ago. In Fedis people have died
showing symptoms of HIV/AIDS. Because of the presence of the army and draught, HIV/AIDS is
said to have spread widely and fast in the area. Promiscuity is part of life and is thus tolerated.

There is stigma and discrimination against people who are suspected to be HIV positive in all the
communities. People assume that only promiscuous and immoral persons get the disease; this is
more serious when it comes to women. Women, especially the young, get thrown out of home
should they be HIV positive. In Welaita, people associate HIV/AIDS with sex workers and road
construction workers. Housewives are to some extent considered not responsible for the spread of
HIV/AIDS. Men are tolerated. Guragehs, for example, are intolerant of women who practice sex
work. Guraghes blame their men more than women for bringing HIV to the household. This is
because men practice multiple sexual relationships. Guraghe men are mobile since they often go
to towns for long periods of time looking for jobs. Although there is still denial and stigma
attached to HIV/AIDS, the communities studied show some knowledge, albeit incomplete, about

Survey data show that the majority of the respondents (96%) do not have a local name for
HIV/AIDS, and thus use the term HIV/AIDS. Knowledge about the modes of infection is still not
universal. The two most commonly reported modes of HIV infection are sex and use of sharp
infected objects (See Figure 3.4. table 3.3). Knowledge on sexual transmission is almost universal
having been reported by about 96 percent of the respondents. Proportions reporting sexual
transmission range from 89 percent in Butajera to 99 percent in Yabelo and Fedis. About 75
percent of the respondents reported use of infected sharp objects as a mode of HIV transmission

     Figure 3.4: Knowledge of Two Most Common Modes of Transmission by Wereda

                                                                                99        98.5            99
          100 96.5            97        98                                                       95.5             95.6
                                                90.2       93.5

                                                                                     92     87.5
                       82.3                                                                                                    Sexual
             60                                                                                                         75.3
                                                                 46                                                            Sharing Sharp
                                   56                                                                         86.4             Objects
             40                                                            55




























The reporting of sharp objects as a mode of transmission ranges from 25 percent in Hamer to 92
and 93 percent in Yabelo and Mareka respectively. Infection through blood was reported by 33
percent of the respondents while parent-to-child transmission (PTCT) was reported by 44 percent
of the respondents. Blood transfusion was reported by only 4 percent of the respondents. Again,
Hamer and Yabelo display the least knowledge of modes of HIV infection.

The biggest challenge about HIV/AIDS is for people to know that an asymptomatic person can be
HIV positive. This knowledge is quite low in this population. Less than a third of the respondents,
30 percent, reported that a healthy looking person could transmit HIV/AIDS. However, this
knowledge is very low in Hamer (10%) Yabelo (19%) and Fentele (21%). While lack of
knowledge that a healthy looking person can have the virus was reported by about 40 percent of
all the respondents, this proportion ranges from 29 percent in Wenago to 58 percent of the
respondents in Hamer. About 30 percent maintained that a healthy looking person could not have
the virus that causes AIDS. The proportion reporting that a healthy looking person cannot
transmit the virus ranges from 23 percent in Humbo to 36 percent in Fentele. And 40 percent of
the respondents reported that they do not know whether or not a healthy looking person can
transmit the HIV virus or not. The reported lack of knowledge ranges between 29 percent in
Wenago to 58 percent in Hamer.

Pregnant Mother-to-child transmission (PMTCT) was reported by about 66 percent of the
respondents with proportions ranging from 34 percent in Hamer to 77 percent in Mareka. Lack of
knowledge of this mode was reported by 28 percent of all the respondents; it ranged from 17
percent in Mareka 59 percent in Hamer. And lack of knowledge of PMTCT was reported by 28
percent of all the respondents while 6 percent maintained that a mother could not transmit the
virus to the baby. Of those who knew about PMTCT, about 60 percent reported that the virus can
be transmitted during pregnancy, while 52 percent reported that the virus can be transmitted
during delivery. Seventy nine percent reported that the virus can be transmitted during

Asked about the chances of PMTCT by HIV positive mothers, about 53 percent maintained that
HIV positive mothers would always pass the virus to their babies; 32 percent reported that
transmission was not guaranteed. Knowledge on the possibility of a virgin being infected is
moderate, with about 53 percent reporting that a virgin can be infected. However, note that the
proportion correctly reporting that a virgin can be infected ranges from 26 percent in Hamer to 74
percent in Mareka. And blood contamination was the mode of infection commonly cited for
virgins. This was reported by about 73 percent of the respondents; this proportion ranges from 64
percent in Fentele to 92 percent in Humbo.

A typical reaction to HIV infection is blame, which in turn negatively impacts on disclosure.
Data also show that there is a tendency of apportioning blame to the opposite sex, and men are
more likely to be blamed for infecting partner than women. For instance, about 72 percent of the
respondents reported that men are more likely to infect women. This proportion ranges from 59
percent in Fedis to about 80 percent in Yabelo. The reason for blaming men is that they are
unfaithful which was reported by about 61 percent of the respondents. Again, the reported
unfaithfulness of men ranges from 43 percent in Fedis to 82 percent in Alaba. About 48 percent
of the respondents reported that women are more likely to infect men. Again, unfaithfulness was
reported as the reason for this attitude. The proportion reporting that women are unfaithful
ranged from 51 percent in Hamer to 74 percent in Fentele.

Qualitative data also show that blame is a common reaction to HIV infection. For instance, the
youth are generally blamed for being sexually irresponsible. People maintain that unmarried
youth are vulnerable to the virus because they frequent bars, chew kat and do not use condoms. It
is further noted that people who are engaged in business and move from place to place, alcohol
drinkers and chat users are more exposed to the virus. Note that both women and men chew kat.

HIV related stigma is a problem. In Alaba, people still fear sharing food with a suspected person.
For instance, women do not invite a PLHA to a coffee ceremony. PLHAs are largely seen as
promiscuous, immoral and as prostitutes (See Figure 3.5).

        Figure 3.5: Attitude Toward PLHA by Wereda

                                                                      They are promiscuous
            30                                                        They are immoral
                                                                      They are prostitutes


                           M o

                            Fe e

                           W a

                           M r

                        ay a le
                           lw o













                 sp Hu







In Dawro people are not interested to talk about HIV/AIDS since it is related with sex. A case in
point is when Action AID invited the community to discuss HIV/AIDS; only few people attended
the meeting. Dawro people blame foreign religions such as the Pentecostal Church for creating
conducive conditions for free sex among the youth who often spend nights away from home

     under the pretext of separation for prayers (religious programs). Generally, there is a strong
     negative attitude towards the new churches. Gedeo residents blame the youth, commercial sex
     workers and returnee soldiers for spreading the infection.

     Table 3.3 Percentage Distribution of Knowledge on Modes of HIV Infection by Wereda
                              special                      Butajurza/                       Yaya
    Education           Humbo wereda    Wenago Mareka Hamer Meskan Yabelo           Fentele Gulele Fedis Total
Blood                    30.3    41.0     39.4    36.8   15.5       55.0     27.6    31.5    24.1 30.7       33.2
Sexual                   96.5    97.0     98.0    90.2   93.5       89.0     99.0    98.5    95.5 99.0       95.6
PMTCT                    43.4    42.5     57.6    50.5   24.5       46.0     34.4    43.5    49.2 50.3       44.2
Sharing sharp objects    82.3    56.0     71.2    92.6   46.0       55.0     92.0    87.5    83.4 86.4       75.3
Blood transfusion         6.1     4.5      3.0     3.9    0.5        7.0      2.5     2.0     3.0 4.5         3.7
Healthy looking
person could have
Yes                      38.9    30.0     35.4    32.8   10.0       38.5     18.6    21.0    33.7 36.7       29.5
No                       23.2    28.5     35.4    35.3   32.0       25.5     31.7    35.5    27.6 28.1       30.3
Don't Know               37.9    41.5     29.3    31.9   58.0       36.0     49.7    43.5    38.7 35.2       40.2
PMTCT Possible
Yes                      75.8    70.5     76.3    77.0   34.0       70.5     51.3    70.5    66.8 64.8       65.7
No                        5.1     6.5      4.5     6.4    7.5        4.5      7.5     4.5     7.0 5.5         5.9
Don't Know               19.2    23.0     19.2    16.7   58.5       25.0     41.2    25.0    26.1 29.6       28.3
During pregnancy
Yes                      56.1    59.6     67.5    65.2   73.5       74.3     66.7    53.2    47.0 48.4       60.6
No                       24.3    22.1     25.2    21.9   17.6        7.9     23.5     3.6    20.5 4.7        17.2
Don't Know               19.6    18.4      7.3    12.9    8.8       17.9      9.8    43.2    32.6 46.9       22.2
During delivery
Yes                      43.5    46.0     58.9    58.3   61.8       55.7     69.3    49.3    47.3 38.0       52.1
No                       29.3    22.6     23.8    25.0   14.7       11.4      9.9     5.1    11.5 12.4       17.2
Don't Know               27.2    31.4     17.2    16.7   23.5       32.9     20.8    45.7    41.2 49.6       30.7
By breastfeeding
Yes                      86.6    85.5     70.9    78.2   66.2       75.2     61.4    85.7    78.2 92.2       79.0
No                        4.0     2.2     14.6    10.9   17.6        7.8     18.8     1.4     5.3 2.3         7.8
Don't Know                9.4    12.3     14.6    10.9   16.2       17.0     19.8    12.9    16.5 5.4        13.2
How often
Always                   49.0    42.9     49.0    50.3   61.8       56.0     50.5    52.5    64.9 64.3       53.5
Sometimes                39.5    46.4     39.7    33.1   23.5       31.9     30.1    27.0    17.2 24.8       32.0
Don't Know               11.6    10.7     11.3    16.6   14.7       12.1     19.4    20.6    17.9 10.9       14.4
Attitude towards
gender and sex
Men infect woman         73.2    67.8     62.6    78.4   70.0       78.0     79.5    76.4    75.5     59.3   72.1
Men unfaithful           74.5    81.5     71.8    64.4   44.3       65.4     50.9    57.2    55.6     43.2   60.9
Woman infect men         60.9    52.3     46.0    56.9   43.0       43.5     38.0    38.7    52.5     49.7   48.1
Women unfaithful         71.1    63.5     72.5    69.8   50.6       69.0     73.7    74.0    59.0     60.6   66.3
Attitude towards
Virgin can be
infected                 66.2    47.7     57.1    73.5   25.5       57.0     36.0    51.8    51.5 59.8       52.6
Through blood
contamination            92.4    85.3     80.5    88.7   60.8       83.3     68.1    64.1    82.5 66.4       79.1

The most common public health strategies for the prevention of HIV infection are: abstinence,
faithful monogamy with one uninfected partner, reduction of sexual partners, condom use and
treatment of sexually transmitted diseases. The most commonly reported preventive measure
against HIV/AIDS by the respondents is faithful monogamy, which is reported by 78 percent of
the respondents. (See Figure 3.6). The proportions reporting faithful monogamy as a strategy
ranges from 60 percent in Butajera to 85 percent in Humbo. Nonuse of infected sharp objects was
reported by about 63 percent of the respondents. Condom use is reported by only 23 percent of
the respondents. Note that the proportion reporting condom use ranges from 7 percent in Hamer
to 29 percent in Humbo. Abstinence was reported by about 26 percent of the respondents.

                Figure 3.6: The Most Common Prevention Method by Wereda

                       85.3          84                        83.4          84.9
                              81.8                                                  81
                                          76.6                        77.4               78.3

                                                                                                One to one
                 40                                                                             relationshiop



                          bo eda ago eka me r kan bel e ta le le le edis ot al
                      um wer
                    H l         e n ar Ha             es Ya Fen Gu   F   T
                               W    M              /M              a
                       e cia
                                                za            Y ay
                    sp                      jur
                aba                   B uta

It is important to note that abstinence is generally prescribed for females (to be discussed latter).
Another preventive strategy, which was mentioned, is the avoidance of casual sex. This was
reported by about 24 percent of the respondents. What is particularly difficult is the fact that
socially sanctioned multiple sexual relationships tend to be regular and thus having an inherent
element of trust, one of the most important underlying factor to non-condom use. The socially
sanctioned relationships are also not considered risky for HIV infection; this calls for a
redefinition of risky sexual relationships to include all sexual relationships beyond one uninfected

Table 3.4 Percentage Distribution of Knowledge on Preventive Strategies by Wereda
                        special                   Butajurza/             Yaya
                  Humbo wereda Wenago Mareka Hamer Meskan Yabelo Fentele Gulele Fedis Total                N
A person can
do to avoid
getting AIDS
Yes                92.9   88.4   91.4    92.1    74.0       84.0    84.5    84.0    83.0 87.4         86.2 1997
Don't Know          5.6    9.5    7.1     5.4    20.0       10.0    15.5    15.5    17.0 11.6         11.7
Use condoms        29.3   25.6   22.7    34.6     6.8       36.3     8.3    11.9    19.9 28.7         22.8 1722
partners            4.9    8.5   11.6     6.9     4.1        8.9     4.1     8.3       - 0.6           5.9 1722
No casual sex      31.0   22.2   35.4    28.2    17.6       20.8    33.1    19.6    15.7 13.2         23.9 1722
One to one
Relationship       85.3   81.8   84.0    76.6    66.9       59.5    83.4    77.4    84.9 81.0         78.3 1722
Abstinence         25.0   25.6   27.1    29.3    11.5       38.1    17.2    31.0    28.9 22.4         25.8 1722
injections with
needles            58.2   34.1   66.9    75.0    60.1       33.3    90.5    67.9    67.5 76.4         63.1 1722
Avoid blood
transfusion        16.3   20.5   12.7    16.0    13.5       23.2    17.8     8.9    14.5   9.2        15.3 1722
Treat STIs          0.5      -    1.1     1.1       -          -     0.6       -       -   0.6         0.4 1722

 3.3     Source of Information on HIV/AIDS

There are different sources that people use to get information on HIV/AIDS, these include health
providers, family planning agents, anti AIDS Clubs, kebele and wereda administration, schools,
media, particularly the radio, religious institutions such as churches, mosques; NGOs like
Progenist in Butajura, FGAE and KEM in Alaba, World Vision in Humbo, Action AID in Dawro,
Medane ACTS in Wenago, Care and Betel in Yabello, CCF and Gudina Tomsa, OSSA, Save the
Children in Fantale, and Mentchin for Mentchinin in Fedis. Community meetings, gatherings,
weddings, coffee and community based associations such as Idir, mahber, and debo ( forms of
community associations for cooperation), ogote (community assembly in Alaba).

Rumor and suspicion on physical syndromes are ways of knowing about a person who is ill of
AIDS. Cracked lips, diarrhea, weight lose, thin hair and body sores are the reported symptoms of
AIDS; any person who shows these signs is suspected and labeled an 'AIDS victim'. A person
who dies after the death of his/her sexual partner, or a person who does not get married after
taking pre marital blood tests is suspected for having the virus. Note this remark by one woman in

          One woman came after staying long away from this village. When she
          returned she had wounds on her face and her hair was thin. Everybody
          avoided her; many people did not even shake hands with her. This woman
          died within a short time. Another one who showed similar signs and was
          also isolated and he died within a short time; his brother washed the body
          without any assistance.

Note that all these cases were not known through self-diagnosis but through inference and
rumormongering. Access to information varies by sex, residence, and religion. Rural men and
women have less access to information than urban residents. Women have less access to
information than men. Muslim women have less access to information than Christian women. In
pastoralist societies like Borena, Hamer and Kereyou women are not expected to participate in
meetings. In Hammer women are not allowed to attend public meetings. Note this remark by a
Hamer man:

         Women are not critical thinkers like men; for example, if a woman is
         invited to a meeting there will be no peace in the audience because women
         are usually very talkative. Moreover, women are cruel and should not be
         given the power to make decisions.

The marginalization of women is so instutionalized that it permeates all aspects of life. For
instance, women are not allowed to attend most of the public meetings with their husbands.

Disclosure of sero-status, however, remains a problem. The general belief is that disclosing a
sexually transmitted disease is shameful. For this reason, it is difficult to speak openly with
PLHA. People even hide infections like gonorrhea. Men do not tell their wives when they get
infected with STIs. The men usually get treated for STIs; however, their wives may not be treated
properly. Note this story from Wenago:

         A certain men tested positive while the wife tested negative. The couple
         was advised to stop sex and return for another test; however, the husband
         insisted that the results should not be disclosed. It was reported that the
         woman had given birth since the first visit but the couple has not returned
         for the second test. It is possible that eventually the woman would be
         infected.[Head of PMTCT, Dilla]

The urban and rural people more or less share similar attitudes, knowledge and practice as far as
HIV/AIDS is concerned. While urban people recognize, to a certain extent, condoms as a way of
avoiding the infection, rural people remain against it. They are inclined to traditional ways of
protection or healing. Some perceive condoms as responsible for the spread of HIV/AIDS. Some
maintained that that holly water can cure AIDS patients and they cite cases of AIDS who have
been healed with holly water.

The majority of respondents, 67 percent, reported that men are more informed about issues of sex,
sexuality and HIV/AIDS (table 3.5). However, the majority of respondents, 75 percent,
maintained that people needed more information on HIV/AIDS. Asked about their sources of
information, it was clear that there is no systematic source of information on HIV/ AIDS, which
reaches most of the people in the communities studied. For instance, proportions reporting any
source of information ranged from only 7 percent for school to 31 percent for health providers.

The family is the least preferred source of information with less than one percent of the
respondents reporting preference of the family as a preferred source of information. Health
providers were the most commonly reported preferred source of information; this was reported by
about 37 percent of the respondents.

Table 3.5     Percentage Distribution of Level and Source of Information on HIV/AIDS by
                         special                   Butajurza/                        Yaya
                   Humbo wereda Wenago Mareka Hamer Meskan Yabelo                  Gulele Fedis Total
                                                                             Fentele                       N
Men more
informed             57.6   66.0    66.7    68.6   73.0       70.0    68.5    67.8   70.9   60.4    67.0   1995
Need more info.      72.7   59.0    79.8    84.3   80.5       52.0    78.5    79.4   78.4   86.3    75.1   1995
Source of
Peers                13.1   14.5    16.7    14.7   20.0       30.5    18.5    19.1   17.6   17.3    18.2   1995
Neighbors             2.5   12.0     3.5     6.4   15.0       14.5    12.5     3.5   12.6    7.6     9.0   1995
Overhearing          10.6   14.0    21.2    11.3   48.0       13.0    39.0    44.7   49.2   36.0    28.7   1995
Health providers     38.4   27.0    40.9    50.5   35.5       12.0    31.5    21.6   29.1   18.8    30.6   1995
School                8.6    5.0    11.6    15.7      -        2.5     3.5    11.1    4.5    9.1     7.2   1995
Spouse               17.7   34.5    10.6    12.3    0.5       27.5     6.5     2.5    4.5    8.6    12.5   1995
Media                48.5   27.0    53.5    41.2    1.5       28.5    34.5    31.2   34.7   60.4    36.0   1995

Prefered Source
of Information
Peers                12.1   23.5    11.7    10.8   20.0       21.0    19.1    17.8   17.6   16.2    17.0    338
Family                1.0      -     0.5       -    0.5        1.5       -     0.5      -          - 0.4      8
Neighbors             5.0    2.0       -     1.0    2.0        2.0       -     1.0    0.5          - 0.9     18
Overhearing           1.5    0.5     1.0     1.5   11.0        2.5     1.0     5.1    8.5    8.1     4.1     81
Spouse               13.1   22.5     9.6     6.9    0.5       23.5     4.0     1.5    2.0    4.5     8.8    176
Health providers     43.9   28.5    31.5    53.4   54.0       18.0    35.7    37.6   47.7   20.7    37.1    740
School                3.0    3.0     4.1     2.9      -        1.5     0.5     6.6    3.0    2.0     2.7     53
Media                20.7   14.5    36.5    20.1    1.0       22.0    18.1    15.2   19.6   45.5    21.3    424
Other                 4.0    5.5     5.1     3.4   11.0        8.0    21.6    14.7    1.0   3.0      7.7    154

3.4      Voluntary Counseling and Testing

In all the communities‘ attitude towards testing is positive. VCT is highly supported and is made
a requirement for marriage in Butajura, and similar attempts are being made in Alaba, Welaita
and Gedio. Respondents noted that it is good to know one's sero-status. 71 percent of the
respondents in the survey reported that they would like to be tested for HIV (Table 3.6).
Proportions reporting this desire to be tested range from 53 percent in Butajera to 78 percent in
Mareka. The most important reason given for wanting to be tested which was given by 87 percent
of the respondents is that they would like to be sure of their suspicions. About 16 percent would
like to live more positively. The majority of the respondents who would like to be tested, 75
percent, also reported that they would share the results of the test with someone. And the
majority, 75 percent, would share the results with a spouse, while 41 percent would share results
with family.

The majority of those who would not share results, 80 percent, reported that they were afraid of
being neglected, stigmatized or marginalized. Some of the respondents were afraid of being
judged or labeled.

Table 3.6 Percentage Distributions of Perceptions and Attitudes Towards Voluntary
Counseling and Testing by Wereda
                            Alaba                      Butajur
                            special                    za/Mesk                Yaya
                      Humbo wereda Wenago Mareka Hamer    an   Yabelo Fentele Gulele Fedis Total            N
Want to be tested       71.7   74.5   74.7    77.5    72.0    52.5    73.0    74.7     69.8   65.8   70.6   1996

To know for sure        88.7   92.6   85.1    94.9    78.5    91.4    89.0    82.4     83.5   87.0   87.3   1410
To live better          16.2   13.4   18.2    10.1    19.4     9.5    11.6    16.2     20.1   21.4   15.7   1410
To know before
getting married          0.7    3.4    2.7     1.3     8.3     1.0     5.5     5.4      2.9    2.3    3.4   1410
To get treatment         5.6   10.7    3.4     8.9     8.3    13.3     3.4     5.4      5.8    3.8    6.7   1410
Share results           55.1   64.0   66.2    61.8    63.0    40.0    56.0    59.1     66.3   59.3   59.1   1996
Person to Share
Partner/spouse          75.2   75.8   80.9    80.2    61.1    82.5    75.9    68.6     73.7   74.6   74.6   1181
Father and mother       18.3   13.3   17.6    24.6    28.6    13.8    21.4    13.6      6.0   10.2   16.8   1181
Family                  47.7   41.4   36.6    38.9    42.9    65.0    49.1    27.1     35.3   32.2   40.6   1181
Neighbors               30.3   25.8   35.1    30.2    36.5    25.0    41.1    33.1     22.6   26.3   30.7   1181
Friends                 14.7   14.8   32.8    16.7    15.1    18.8     5.4    23.7     11.3   22.9   17.7   1181
Reasons for not
Fear of neglect,
isolation avoidance     77.0   92.9   89.4    93.1    73.3    82.4    98.1    61.0     59.5   69.6   80.4   562
Fear of verbally
abuse, teasing          16.2   21.4    6.4    19.0       -    16.5     5.6      3.4       -   1.8    10.5   562
I wouldn't receive
any care & support      17.6   10.7   14.9    10.3    10.0    14.3     9.3    20.3     35.1   19.6   15.8   562
People would think
that I am bad/
immoral                 21.6   17.9   42.6    17.2    16.7     9.9    16.7    16.9     18.9   21.4   19.2   562
People would think
that I am
promiscuous              5.4    3.6    2.1     3.4    10.0    11.0     5.6        -       -    1.8    4.6   562

3.5      Routes to HIV Infection and their Underlying Causes

Survey data also show that there are several practices, which are differentially practiced in the
respective weradas (table 3.7). HTPs, which were reported in all the werades are female
circumcision, polygamy, widow inheritance (levirate), rape and abduction. Female circumcision
was reported by about 59 percent of all respondents, and this proportion ranges from 20 percent
in Butajera to 81 percent in Fedis. Polygamy was reported by about 48 percent of all the
respondents, the proportion ranges from 7 percent in Yaya Gule to 74 percent in Wenago. Widow
inheritance (levirate) was reported by about 42 percent of all the respondents.

The reporting of levirate ranges from 10 percent in Yaya Gulele to 56 percent in Fentele.
Abduction, a practice where a young man can forcefully take a girl to be his wife without her
consent, or the young lady runs away to be married without the consent of her parents, is reported
by 31 percent of the respondents; this proportion ranges from 4 percent in Fedis to 67 percent in
Yaya Gulele.

While the other harmful practices are reported by a small proportion of all the respondents, it is
important to note that such practices are intense in those woradas where they are practiced, and
they pause a serious threat of HIV transmission to the respective populations. For instance, while
warsa a practice where the young brother inherits the widow of an older brother, is reported by
about 25 percent of all the respondents, the proportion ranges from zero percent in Yaya Gulele to
a high of 89 percent of the respondents in Hamer. On the other hand, while Jala Jalto, a practice
where both men and women can have extra sexual relationships, is reported by about 20 percent
of all the respondents, it is reported by about 88 and 65 percent of the respondents in Yabelo and
Fentele; it is also practiced to some extent in Hamer and Yaya Gulele.

Table 3.7 Percentage Distribution of Knowledge on Harmful Practices that Enhance the
Spread of HIV/AIDS
                         Alaba                      Butajurr
                         special                       a/                 Yaya
                   Humbo wereda Wenago Mareka Hamer Meskan Yabelo Fentele Gulele             Fedis    Total    N
Jalla                1.5    15.0     0.5     2.0       -       -    24.5      4.5       -        -      4.8   1995
Young brother
has sex with his
elder brother's
wife                15.7    18.5    14.6    12.3    88.5    10.5    35.0    49.7        -     9.1     25.4    1995
Abduction           29.3    14.5    22.7    38.2    34.5    26.0    26.0    50.8     66.8     4.1     31.3    1995
Polygamy            55.1    52.0    73.7    61.8    45.0    54.0    28.5    49.7      6.5    49.7     47.6    1995
Wife sharing         9.1     9.0    14.1     9.8    10.5    12.0     7.5    21.1        -     4.1      9.7    1995
inheritance         28.8    45.0    36.9    36.3    48.5    47.0    29.0    55.8     10.1    79.7     41.7    1995
circumcision        31.8    28.0    46.5    49.0    27.0    20.2    53.5    75.4     78.9    81.7     49.2    1993
Uvula cutting       12.1     4.4    16.4    14.7       -       -     0.5     8.5     15.1    38.6     12.3    1776
Wipe my tears        1.0     1.5       -     2.0       -     4.5     3.5     2.5        -     4.1      1.9    1995
Lucky man            0.5       -       -       -     0.5       -     0.5     4.5        -       -      0.6    1995
Jalaf Jalto          1.0     5.5       -       -    18.5     2.5    87.5    65.3     15.6     1.0     19.7    1995

Data from key informants and FGDs corroborate findings from quantitative data. Indeed the
spread of HIV/AIDS is fueled by the deeply rooted cultural norms and values and customary
practices on sex and sexuality, and by the social and economic marginalization of women
throughout the country. This observations match with earlier research works done on HIV/AIDS
related stigma and discrimination in Ethiopia (see Banteyerga, Hailom ,2003). The ensuing
discussion attempts to summarize the respective practices, which enhance the spread of
HIV/AIDS. This section will give few detailed descriptions of a few practices while other
detailed discussions on the respective tribes is in the appendices.

3.5.1 Cultural norms, values and practices that enhance HIV infection

The concept of masculinity and femininity in the communities studied share common values and
norms either explicitly or implicitly. In the Christian and Islamic communities it is observed that
sex before marriage and outside marriage is forbidden. And within marriage, faithfulness is
expected. However, there are deviations from these standards, these deviations are determined by
existing cultural norms and values.

First, masculinity gets meaning in the sexual conquest of women. A man has to prove his
masculinity by practicing sex before marriage, sex at his will in marriage and sex outside of
marriage. Femininity gets it's meaning in women‘s lose of sexual rights and absolute obedience to
a man during sexual intercourse, food service, and child management. Both masculinity and
femininity get their base in property rights where a man owns the most valued resources, land and
livestock in rural communities and major businesses in towns. On the other hand, women have
limited access to household resources.

Upon divorce, a woman is forced to leave home without any property; it is only in situations
where the man is kind enough, and often upon the request of elders, that the man may give his
divorced wife a token which she might be able to survive on only for a few days. The only way a
divorced woman can survive is to find another man to whom she will sacrifice all her sexual and
human rights. At marriage, a woman is said to have been sold to a man.

As shown by the quantitative data, polygamy is widespread. The qualitative data show that
Muslims in Alaba, Guraghe, Fentale (Etu) and Oromo Hararghe practice polygamy explicitly, and
extra marital sex in hiding. Islam supports polygamy and faithfulness within such unions. Rural
communities, irrespective of religion, practice polygamous marriages openly. Islamic
communities maintain that their religion allows them to marry up to four wives. In Kereyou even
the youngest man in the community would have a minimum of two wives; as soon as his first
wife is pregnant he looks for another wife. A man, as long as he can afford to pay the bride price,
can marry as many women as wants. However, in polygamous marriages sexuality remains an
issue. Note the following remark:

                  Men marry many wives and the wives get irritated and some take
                  revenge by having sexual relationships with other men in hiding. If
                  a woman is sexually dissatisfied she insists on divorce but does not
                  openly discuss it with her husband. Sex is a gift from God and no
                  body can discuss it, it is maintained. If families recognize a
                  problem related to sexual intercourse they consult a kalecha (a
                  man with spiritual power) who invariably advises the people that
                  there is a curse in the family and prescribes some ceremonies to
                  be conducted to rid the curse. [Dawro, urban, woman, aged 98.].

There are many reasons given for polygamy. This includes people‘s desire to increase the number
of their descendants while making sure that all women had husbands given that many men died
during inter tribal conflicts. Christians, as observed in Christian communities like Welaita and
Gedio, and Ormomos, practice extramarital sex openly or in hiding in the form of wushima
(lover). This practice is prevalent in Amhara and Tigray communities, although most of them are
followers of the Ethiopian Orthodox Church, which stands for faithful monogamy.

It is interesting however, to note that there are Sheiks who argue that the conditions set by the
Koran on marrying more than one wives are hard to meet. They maintain that it is difficult to treat
two or more wives emotionally and materially equally as the Koran requires. They argue that not
being able to meet even the psychological and material needs of one woman prohibits a man from
marrying thereby imposing fasting (abstinence by men) by men. They further contend that
allowing men to marry up to four wives is an excuse to maintain practices that used to exist in pre
Islam, an adaptation of religion to fit traditional culture.

Another practice which enhances polygamy is the marrying of widows. Warsa is another form of
marriage, which happens widely in Oromia and SNNPR. It is the inheritance of a widow by a

young brother or relative, and sometimes the father of the deceased man. The aim is mostly to
protect the property and children of the deceased man. The underlying story for the introduction
of wife inheritance is that a widow got married to a man outside of the blood family. The man
misused the property of the deceased man and the inherited wife. The man was also accused of
causing the death of a baby of the deceased man by tying the tip of the penis with a horsetail hair
in order to prevent the young boy from urinating in bed.

On hearing this story, the elders explained the behavior of the man by saying that he was not a
blood relation of the boy hence the lack of feeling or love for the boy. On this logic they
introduced the practice of Warsa. Hiricho and Rege are two forms of wife inheritance in Aaba.
Hircho is when a young brother of the deceased husband inherits the widow of his brother.
Actually a young brother occasionally makes love to his brother‘s wife even when he is alive; the
woman does not refuse and the husband does not get angry. Rege is also wife inheritance on the
basis of blood relation with the deceased husband, not a brother. In warsa the woman's consent is
not required; it is taken for granted, and if she refuses she gets kicked out of the house empty
handed. Older women are usually not inherited sexually, but they are not allowed to marry any
other man.

Emba madrekya (drying tears) is a rarely used form of marriage. This practice exists in all the
communities in SNNPR and Oromo. This happens when a man marries his late wife‘s young
sister. This happens especially in those situations where the relationship between the families is
strong. Maintenance of such strong relationships is thus achieved through husband inheritance. In
Alaba when a wife dies the husband asks the family to send him one of the late wife‘s young
sisters for a wife, this is called ribina. Embeto is when a man can ask the hand of his sister in law
if his wife dies; this is in Kereyou.

There is stigma and discrimination against PLHA specially women. This inhibits people from
making use of VCT and PMTCT services to enhance prevention care and support services. VCT
services like Borena, Hamer, Fedis, Dawro are not available. Thin people are suspected and
people say would run away from such people not to be infected. Many people fear that HIV
transmits through causal contacts like shaking hands, sleeping and eating together with an HIV
positive person. There are also people who believe that HIV transmits through mosquito bites.

Traditional beliefs of sexually transmitted diseases make people not use condoms and medical
treatment on time. People resort to traditional methods of treating sexually transmitted infections.

There are people who do not believe in the existence of HIV. ―Since our culture allows us to have
many sexual partners, we all would have died if sexual intercourse had been the route to
HIV/AIDS infection.‖ {Man, rural site Borena]. Jala jalto is a culturally accepted sexual
relationship where a man and a woman can have other sexual partners on top of their regular
spouses. It is accepted that a man can ask for sex from another man's wife and normally she

Rape and abduction of women are criminal activities, which enhance the spread of HIV/AIDS.
Often young girls, who are under age, are abducted by older men who rape the young women,
and force them into marriage-three forms of breaching a young woman's rights. These cases are
often settled by community elders and are not taken to police or court; if a person attempts to use
the police and court, the woman and her family are often pressured into withdrawing the case
from the courts and accede to the forced marriage. If she appears before the court, the woman is
often forced to testify that she was a willing party to the abduction; such a testimony will render
the abductor inocent.

In addition to these practices there is rampant use of sharp objects which also enhance the spread
of HIV/AIDS. For instance, in traditional birthing practices use unsterilized needles and sharing
of equipment are common. Female circumcision is another cultural practice in which sharp
objects are used. Borenas think that all females should be circumcised to minimize their sexual
desire and keep them clean. If she is not circumcised, no body wants to marry her. One Borena
elder says, " If the clitoris is not cut it grows and becomes like a horn and makes sexual relation
with a man difficult."

According to an informant from the office of wereda women's affairs, there are three types of
FGM in Fedis. The first one is called sunna, which is the cutting of the clitoris; the second one is
called arbi which is cutting the clitoris and the tip of the labia minoras; and the third one is called
hoda, which is the cutting of the clitoris, the labia minoras and the stitching. After the mutilation,
the legs are tied tightly together for a month till there is adhesion leaving a small opening for
urination. At marriage, woman is cut open by a knife and the husband is expected to have sex
with the woman until the opening has healed enough to avoid adhesions. The main purpose of
FGM is to control the sexuality of the woman.

Coupled with these practices are high levels of STIs and poor treatment especially because of
limited health facilities. A key informant and health professional remarks:

          The medical service here is very poor. For example this clinic is ill
          quipped and staffed and is serving 40,000 people. As a result people are
          forced to use harmful traditional practices of treating patients. Sometimes
          people walk or carry a patient over 12 hours to reach the clinic, which is
          of little help. Yesterday a woman died of placenta rapture and there was
          no way to help her. Sex is a major activity here; both men and women are
          sex oriented. Today even under aged men and women have sex and ask
          their parents to endorse their marriage. Many young men and women start
          education and are bright in school but get married early and stop their
          education and become farmers, traders and the like. People depend on
          food aid and sex is plenty and they say,' let it rain in Canada and not in
          Ethiopia.' Alcohol drinking is not a problem; but men chew a lot of kat.
          This affects their sexual potency and leads to quarrels between men and
          their wives. Contaminated materials are used for circumcision thereby
          exposing children to infection. Menschen fur, Menschen has been trying
          to stop FGM, but religious leaders were opposed to it.

3.5.2 Socialization of women and men

In the communities studied, the birth of a male baby is invariably received with extreme joy and
happiness, the joy which is far greater than that expressed for a girl baby. For instance, most
communities celebrate and they ululate at the birth of child. However, the ululations for a boy are
twice as many as those for a girl. It is generally believed that women are biologically incomplete
as reflected in their physical weakness. A girl is perceived as property and a source of problems
since she can be raped or impregnated. On the other hand, a boy is considered a continuation of
the family lineage and a natural heir of the family property, which includes livestock and land.
However, pastoralist communities like the Hamer value women , for they bring them bride

In these communities, women are socialized to serve men. They are also socialized to be
obedient, home oriented, submissive and good at house keeping, preparing food, cooking,
collecting wood and fetching water, giving birth and looking after children, while assisting the
husband on the farm. A woman‘s labor is not valued, it is only perceived as supportive of her
main role, reproduction. Women are expected to view sex only in terms of reproduction; they are
expected to please their husbands sexually desires while they are assumed to have no sexual
needs nor rights of their own. Women just have to be sexually submissive and docile.

Women, especially Muslims, are not expected to seek information. If they are students they are
expected to reach home on time. They are also expected to be decent in their way of clothing and
talking, they are not allowed to learn Koran and go to Mosque at night. They are not allowed to
have much communication with many people rather they should be shy. Cultivation of female
submissiveness and docility are a common goal achieved through different means.

Women are considered emotionally and mentally weak regardless of their level of education.
Women are not expected to demand for information or make an argument apart from listening to
what husbands tell them to do. For example a Guraghe woman is not expected to discuss with her
husband on family matters.

Women are socialized to be dependent on men, and thus are not expected to own or demand
property. The girl child is deprived, from infancy, of the very resources and skills she needs to be
an equally productive member of society. The girl child is given less food while the boy child
has enough food as he eats together with the father who often gets enough food. The girl child is
also deprived of similar opportunities for school with the boy child.

On the other hand, men are expected to farm, look after cattle, attend community meetings and
play a leadership role in the community across all societies. They are also expected to be
breadwinners, who are able to supply the family with all household requirements. In addition, a
man is expected to be courageous, to be a risk taker and sexually controlling his wife/wives. For
instance, in Hamer a good husband is a person who supplies his family with food, owns many
goats and heads of cattle and beehives, kills his enemies, hunts wild animals and controls his

Men are socialized to claim and own property, and to have absolute decision-making power. They
are socialized to be sexually demanding and aggressive. Men are also expected to seek
information by attending community gatherings. For example men attend tribal, family and
community meetings. Men are allowed to go out of the home and play, attend religious services
even at night. Young men are favored to go to schools and learn. They have no fear and inhibition
in their movements.

3.5.3 Types of marriages and related practices

Theoretically one might assume that once one is married the chances of getting infected are slim;
however, there are various types of marriages some of which expose women to HIV infection
right from the beginning.

Marriage in Ethiopian communities is mostly family arranged. Family's elders, without the
consent of their children, decide on who and when their respective sons and daughters should
marry. In family arranged marriage, wealth is an important selection criterion for women. Parents
require bride price and they expect daughters to attract rich men. This is why some men,
regardless of age, marry many women across all age groups, including very young girls. In some

communities like the Borena, Kereyou and Hamer, marriage must be between people from the
same tribe.

Marriage is accompanied by the exchange of money and other resources usually called bride
price, and the price varies from one ethnic group to the other. Bride price varies from a minimum
of Birr 500 in Guraghe to a maximum of up to Birr 20 000 in Alaba. In addition to the money
different groups demand cattle, clothes including shoes, gold, umbrellas, blankets, and honey.
Generally, the bride price has been commercialized to the extent that it generally signifies that the
groom has bought the bride who becomes his property.

In some communities like the Guraghe, Alaba, and Welaita, young men have the opportunity to
identify potential wives. The celebration festivals such as Meskel, which are done in such
communities, pave way for the selection of mates. The kat ceremony in Alaba also gives men the
chance to select a mate. A young man buys kat and along with his friends can chew it in the
house where he intends to select his bride. Albans believe that any person carrying kat should be
treated very well. At the end of the chewing, the young man ties a rope on one of the pillars in the
house indicating that he wants to marry one of the daughters. Parents of the man would
subsequently send elders who would ask for the hand of the selected young woman. The
negotiation starts and the bride price becomes a critical factor for agreeing or disagreeing to give
the daughter away.

There are also ways of arranging marriages which avoid the payment of bride price as a
prerequisite. Among the Alaba, there is a marital practice called herna, an arrangement where a
couple decides to stay together without the knowledge of their parents. Subsequently, the man
sends elders to the girl's family to accept the marriage without a wedding; this is done in order to
avoid bride price. In situations where a girl is married without the involvement of the parents in
the decision-making, the woman is looked down upon since she would have deviated from the
norm. There is yet another marital arrangement in Yaya Gule called Asena where a girl goes to
the parents of the man she likes and sits next to a pillar in the room and the man allows her to live
with him.

There are some situations where the Kalicha (spiritul leader) dictates the husband to women,
including young girls, and more than often such young girls marry much older men. A kalicha is
the spiritual leader for the animists. He bases his leadership often on witchcraft and superstition.
He may prescribe a man to have sex with a girl/woman regardless of age and status. Sometimes
by order of the Kalicha, girls as young as 5 years of age are given to men as old as 60-70 years.

A kelelcha can also intervene in marriage arrangement. AKelecha is a spiritual leader \who
carries a piece of metal believed to have been sent from heaven. The kelelcha is very much
respected and his advice is taken for granted. Note this remark by a Yaya Gulele urban man:

           But a man who couldn’t pay bride price negotiates with the bride’s
          parents by sending elderly people accompanied by a kelelecha In this case
          the parents accept his proposal of marrying to their daughter without
          bride price and even cover all the expenses of wedding because people
          greatly fear the Kelelecha.

In all the communities women marry at a young age normally under 15 years. The age at
marriage ranges form a minimum of about 12 years for Gedio and Menja women to a maximum
of 18 years for Dawro. If women pass the maximum age limit for marriage, the community
stigmatizes them to the extent of giving them names such as komoker, which means unwanted. If

a woman reaches the age of twenty before marriage she becomes an embarrassment to the family
and her parents would opt to marry her to any man who can afford the price. Many young girls
end up being married to old men as second, third, or fourth wives. Divorce is discouraged
irrespective of the repressive behavior of the husband. If a woman gets divorced she is forced by
her relatives to find another husband, for keeping a divorced woman at home is a shame.

While men get married after getting sexual experience with other women, virginity of girls at
marriage, except among the Hamer, is demanded and the groom has to show the virginity of his
bride by deflowering her on the wedding night. If the bride is not a virgin she is not acceptable as
a wife.

          " If a groom does not find the bride a virgin, he beats her and forces her to go
          back to her parents. Virginity is announced the very day of marriage and a
          piece of cloth is socked in blood as evidence that the bride kept her virginity till
          marriage." [Dawro, urban, old woman aged 98.].

Borena and Kereyous are very serious about their demand for virginity and men are not expected
to have sex with virgins before they are married. If a man takes the virginity of a girl before
marriage, he is severely punished and is excommunicated from his community. Before the
wedding day a woman is tested for virginity. If she is not virgin, she discloses the person who
took her virginity. On deflowering a bride, Kereyous sing a song called Robile, which appreciates
the strength, success and loyalty of the bride.

3.5.4     Virginity

Survey data support qualitative data. The study clearly demonstrated that communities are
characterized by asymmetrical heterosexual relationships typified by the valorization of sexuality,
the seductiveness of males, and the passive nature of females who should serve men sexually. On
the other hand, the majority of respondents, 75 percent, maintained that a woman must be a virgin
if she is to be married (Table 3.8). This compares to only 38 percent of the respondents who
maintain the same for men.

However, this demand for female virginity is variable, it is lowest in the Hamer where 34 percent
of the respondents responded in the affirmative that women must be virgins, and highest is in
Fentele where about 90 percent of the respondents maintain that women must be virgins to be
married. The most common reasons for the need for women to be virgins upon marriage were that
virginity signifies purity and strength. This was reported by 43 percent of the respondents. On the
other hand, virginity for males was largely perceived to mean innocence on the part of the male;
this was reported by about 45 percent of the respondents. Another 43 percent reported that male
virginity means cleanliness and health. This compares to 32 percent of the respondents who
reported the same for females.

Table 3.8 Percentage Distribution of Attitudes Towards Virginity by Wereda
                         special                      Butajurra/             Yaya
                 Humbo   wereda Wenago Mareka Hamer    Meskan Yabelo Fentele Gulele   Fedis   Total    N
Woman must
be virgin        78.8     85.5   69.2   81.9   33.7      76.0   94.5    89.9   69.3   73.7    75.3    1995
Meaning of
Purity           27.6     25.7   29.9   35.9   62.7      43.4   53.4    48.6   61.6   52.1    42.9    1502
Honesty          17.9     14.6   35.0   28.1   41.8      34.9   23.8     7.3   10.9   12.3    21.3    1502
Innocence        46.8     55.0   54.0   40.1   22.4      50.0   41.8    44.1   58.7   54.1    47.7    1502
healthy          53.2     40.4   30.7   40.7   35.8      12.5   38.6    17.9   26.8   24.7    32.2    1502
Chastity         23.1     24.6   31.4   24.6    3.0       7.9   28.0    29.6   25.4   17.8    22.8    1502
Man must be
virgin           52.0     50.0   50.0   51.5   10.1      58.5   38.5    18.1   29.6   23.2    38.2    1995
Meaning of
male Virginity
Purity           16.5     14.0   22.2   23.8   40.0      28.2   39.0    13.9   47.5   17.4    24.9    762
Honesty          21.4     12.0   29.3   35.2   15.0      37.6   18.2       -    5.1   17.4    22.6    762
Innocence        42.7     58.0   50.5   39.0   10.0      53.0   33.8    38.9   50.8   41.3    45.4    762
healthy          54.4     43.0   40.4   39.0   75.0      17.1   48.1    52.8   49.2   52.2    42.5    762
Chastity         20.4     26.0   21.2   21.0      -       7.7   26.0    36.1   35.6   15.2    21.0    762

4.      Sex and Sexuality

Sex and sexuality has remained a private matter in Ethiopian traditional communities. However,
the advent of HIV/AIDS, which is mainly transmitted through sexual intercourse, has made the
understanding of sex and sexuality norms and values to be necessary. The survey, in-depth
interviews with key informants and FGDs have shown that people are ready to talk on this matter,
unlike the usual belief. In the survey people have responded to questions on sex and sexuality, of
course with some degree of shyness only to open up the first question, so also in the in-depth and
FGDs. We used women to interview women and men to interview men in the survey. We used
highly trained and experienced women researchers and the principal investigators in interviewing
key informants and facilitating FGDs. The key skill in dealing with interviews and discussions on
sex and sexuality is the facilitators should take sex and sexuality as a usual human behavior.
Previous research works on stigma enabled the Center's research staff to handle this area with
ease and efficiency.

Sex remains a central biological and social need for human beings. However, sex and sexuality is
usually perceived in terms of reproduction from a woman's perspective. The enjoyment part is
often considered taboo and thus cannot be discussed openly even between spouses. Although
there is this culture of silence surrounding sex and sexuality, both males and females have sexual
needs and desires which if unmet, often result in frustration, extra-marital sexual relationships,
and sometimes divorce. What are the sexual needs desires and expectations of the populations

4.1     Sexual Expectations

All the communities studied require a woman to look sexually attractive to a man. Women
understand that they have to attract men to if they are to get a husband. Women are to keep their
husbands from being attracted to other women by preparing delicious food, wearing nice clothes
and looking attractive all the time. And men are attracted to women by their physical appearance:
the shape of their breasts, body, eyes, hairstyle, and facial looks. For instance, in Welaita a
woman‘s body is expected to be slim, soft and beautiful while a man‘s body is preferred to be tall,
strong, healthy and medium weight. Men take hot milk with ginger and with different herbs to
strengthen their sexual ability.

Women are not expected to express any sexual desire one way or the other. Men decide when and
how to have sex. If a woman refuses to comply with the sexual needs of the man, she gets beaten
or suspected of developing love relations with other man. She may be even kicked out of her
home. A female informant (Butajura, urban) remarked:

         Because I refused to have sex, my husband refused to give me money for
         household needs; he told me that I could get money from my extra sexual
         partner; thinking that I have another sexual partner.

All key informants maintained that a woman would be suspected of infidelity and eventually gets
beaten if she shows sexual desire.

         Talking about sex is taboo. It is called' fuka,' which means impolite and
         makes the person who talks about it a devious person. And children are
         not allowed even to watch sexual movies. If a man expresses his sexual
         likes, his wife might feel that he has sexual affairs with another woman.
         [Alaba,Woman, rural].

4.2     Unmet Sexual Needs

Women complain that their sexual needs are hardly met by their husbands. Most men have more
than one wives, or have girlfriends in addition their wives, thus they find it hard to meet their
wives' sexual needs. In most communities, masculinity is seen by the ability of a man to
impregnate a woman. Sexual satisfaction of a woman is not considered. For instance, women
reported that they hardly experience orgasm with their husbands. Men think that if women were
allowed to ask for sex it would be difficult to meet their needs. A religious leader and key
informant [Alba, urban, man] explains:

          A man does not need sex daily but a woman does, if she is allowed to ask
          for sex, she would like to have sex daily. If a woman wants sex she can
          indirectly communicate by making herself attractive, asking children to go
          to bed, and by preparing her husband a special dinner. There is a story
          about this. Once upon a time a husband asked his wife to tell him when she
          wants to have sex. She said she would do so by preparing a small bread
          and putting it on top of his regular dinner. The small bread would be fresh
          and hot. On the basis of this communication the woman started preparing
          the additional small bread every evening. The farmer thought that his wife
          would not demand on a daily basis. One day he came from the farm
          extremely tired. And as he sat dawn and asked his children what his wife
          had prepared for dinner, the children told him that they saw her preparing
          the small bread. On hearing this, the man left home telling them that he
          had a relative who was ill and would pass the night with him. He was
          avoiding showing his wife that he could not meet her sexual needs.

Women also feel impeded to ask for sex by cultural expectations. Most women expressed that
they have to tolerate their lack of sexual satisfaction for the rest of their marital life. Note this
remark from a female representative at a regional council in Fedis:

          It is difficult to openly ask my husband about sex and tell him that he is not
          meeting my sexual needs. This is indeed a problem. If the husband is not
          interested in one of his wives, during her turn he sleeps and tells her that
          he is sick but does sex with the one he is in love with. In a way he denies
          her the chance to be pregnant and have a baby. Fedis men live on food
          assistance. Let alone to satisfy four wives they cannot satisfy a single
          woman. They chew 'kat' and sleep. They simply marry more than one
          woman on the pretext that 'sheria' permits them to do so. When a husband
          fails to make love to his wife it is a sign of hatred. This leads to conflict
          and finally to divorce. Many women are chased out of their homes because
          of sexual matters. Men become aggressive and they do not want anybody
          to know of their sexual weaknesses. Many wives leave their homes end up
          being laborers, sex workers and get exposed to STI and HIV/AIDS.

The problem with sex and sexuality as noted earlier is that couples do not discuss it. However, if
men do not get sexually satisfied in marriage they usually go to other women even if they know
that they would be exposed to STIs including HIV. In some cases women also look for sexual
partners in secret. Here is what a health officer explained to the research team:

         Three women came to me to ask for advice. Their problem was sexual
         impotence of their husbands. The husbands are merchants and they chew
         'kat' during the evenings. One woman complained that her husband inserts
         his penis for few seconds and ejaculates, and turns his back and sleeps;
         another one complained that he rarely makes love to her and the other one
         said that her husband almost stopped making love. On hearing this I
         advised them on how they could make their husbands stop chewing 'kat' in
         the evening by being close to them and directing their attention towards
         sex. The two women succeeded and finally brought their husbands to the
         clinic and introduced them to me. They explained what happened to their
         husbands. I also explained to the men that they have to love their wives
         and meet their sexual needs and stop chewing 'kat' in the evening. The
         other one did not succeed and finally decided to have another lover who is
         young and physically tough. She reported to me that she is enjoying sex
         with that man. She said that she would not mind dying of AIDS so long as
         she continues to enjoy sex with that man. [Welaita, man]

Some women nevertheless, ask for divorce on the grounds that they do not match sexually with
their husbands. In the wereda courts a significant number of women appear in court with cases of
sexual problems. According to the wereda court of Wenago, many women site article 640 of the
civil code to get divorced.

In most communities sex is not encouraged during late pregnancy. This is the time for the
husband to look for another woman – second wives or a prostitute. A man would talk with pride
about his experience with another woman. It is shameful for woman, including a sex worker, to
talk about sexual affairs with a man. Sex workers in Dilla reported that most of their clients are
married men who complain that their wives do not satisfy them sexually, some complain of ill
health of their wives while others maintain that they are looking for different types of sexual

Religious leaders have different views regarding sex and sexuality. Muslim leaders accept that
one man cannot meet the sex needs of all four women. Religious leaders insist that if a woman
makes love to another man who is not her husband she should be killed. They say that Sheria
accepts discussion of sexual issues between couples. The leaders maintained that a woman can
tell her husband frankly about her sexual needs or she can appeal to kadi' and she can be allowed
to divorce since one of the reasons for divorce in the kadi court is sexual dissatisfaction.
Religious leaders maintain that sexual intercourse has to be done gently and softly. The Sheria
law does not allow forceful and painful sex. The kadi orders men and women to have romance
and harmonious sex and men must be on top of their wives during intercourse.

The inequality of sexual relationships between men and women is corroborated by quantitative
data. For instance, about 76 percent of the respondents reported the imbalance of sexual
relationships (table 4.1). This perception is highest in Humbo where 83 percent of the
respondents reported so, and lowest in Yaya Gulele where about 69 percent of the respondents
reported so. Yaya Gulele is predominantly a Christian community and closer to the capital city,
which has more relaxed rules regarding sex and sexuality.

Sexual relationships are different in many aspects of the male- female relationship. For instance,
about 83 percent of the respondents reported that men enjoy sex more than females, while 81
percent reported that men tend to want sex more than females. Another 65 percent maintained
that women are largely passive while men are pro-active in sexual relationships. It is interesting

to note that about 79 percent reported that love and closeness is more important than sexual
pleasure. Yet the two seem mutually reinforcing. And the respondents go on to report that women
want pleasure in sex just like men. This was reported by about 74 percent of the respondents. On
the other hand, the majority of the respondents, 76 percent, report that men are more interested in
sexual performance than being emotionally close. And 65 percent of the respondents maintained
that sex tends to stop when a man has orgasm irrespective of whether or not the woman herself
has experienced orgasm. About 60 percent of the respondents reported that it is more acceptable
for man to be experienced in sex than women.

It is generally believed that little has changed over the years as 67 percent of the respondents
reported that there is still variability between boys and girls in terms of how they speak about sex
and sexuality. And only a third of the respondents maintained that relationships between men and
women are more egalitarian between men and women now than twenty years ago. And the
majority of the respondents, 65 percent, reported that young women are often pressurized to have
sex even if they do not want to. Yet the young women are also reported by about 60 percent of
the respondents, to be more concerned about the consequences of sex than young men.
Respondents also maintained that women are keener to please their partners sexually than males.
This was reported by about 61 percent of the respondents. In addition, women were reported by
81 percent of the respondents to be more interested in love relationships more than sex in their
relationships. Consistently women were reported to be more concerned than men about
pregnancy and other infections by 59 percent of the respondents. And 46 percent of the
respondents maintained that men are not confident about using a condom.

4.3     Decisions about Having Sex

Again, the respondents maintain that men decide what happens in sexual relationships than
women. About 50 percent maintained that men control what happens during sex (table 4.2). Only
10 percent reported that women, as wives, decide when to have sex. Note that even in those
communities where it is tolerated to have other sexual partners in addition to the spouse like the
Hamer, wives have no decision making power on when they can have sex. About 65 percent of
the men maintained that they are the ones to decide when to have sex. About 44 percent of all the
respondents maintained that it is culturally unacceptable for women to demand sex.

Women were also reported to be less likely to decide with whom to have sex than men. Only 24
percent of the respondents reported that women are expected to choose their sexual partners.
About 70 percent of the respondents maintained that women have no power to choose their sexual
partner. On the other hand, about 96 percent of the respondents maintained that men decide with
whom to have sex. In the key informant interview and FGDs it was shown that young men can
suggest their mates as the case is in SNNPR; they can abduct women of their likes and send
elders to the family of the abducted woman. It was also maintained that men could have sex with
their wives any time they want to. This was reported by 81 percent of the respondents. And 63
percent maintained that this was culturally acceptable while 54 percent reported that men‘s sexual
needs must be met. Only 10 percent of the respondents reported that women have sex with their
husbands when they want to. And 88 percent of the respondents maintained that it is deviant
behavior for women to express their sexual desires.

        Table 4.1 Percentage Distribution of Gender Sexuality and HIV/AIDS
                                    Alaba                        Butajurr
                                    special                      a/                      Yaya
                              Humbo wereda Wenago Mareka Hamer   Meskan Yabelo   Fentele Gulele   Fedis   Total   N
Sexual r/ship b/n men and
women are not equal           83.3   74.4   79.3   81.8   79.5   75.5   74.0     75.4     69.0    71.1     76.4   1994
Men enjoy sex more
than women do                 90.4   85.9   85.9   81.3   79.0   85.0   87.5     78.9     77.0    81.7     83.2   1994
The best sex involves
sexual intercourse            84.3   70.1   83.8   77.3   81.0   61.0   78.5     77.9     77.0    82.2     77.3   1992
Men want more sexual
intercourse than women        84.8   84.9   79.8   77.3   77.0   87.9   78.4     75.9     78.0    81.2     80.5   1992
In sexual r/ship men are
active, women are passive     72.2   69.2   68.7   67.5   52.0   70.0   61.5     65.8     53.5    68.5     64.9   1993
In r/ship love & closeness
are more important than
sexual pleasure               88.9   78.9   85.9   75.4   75.5   76.4   72.0     76.4     78.0    78.2     78.5   1993
Women want pleasure
from sex, as much as men      75.6   74.4   83.3   68.0   72.5   67.5   66.8     75.1     76.5    75.9     73.5   1981
Men are more interested
in sexual performance         71.2   77.9   82.8   73.9   74.5   76.0   71.5     75.9     76.5    79.1     75.9   1993
Sex tends to stop when
man has orgasm, even if
the women has                 65.7   63.3   65.2   59.6   56.0   73.0   55.0     68.7     64.5    76.6     64.7   1993
It is acceptable for man to
be sexually experienced
than for a women              62.6   64.3   59.1   55.2   63.0   70.4   55.5     50.0     59.6    63.6     60.3   1985
Young women talk about
sex and love in different
ways from young men           68.7   68.8   72.7   61.6   72.5   57.3   61.5     64.8     71.0    72.1     67.1   1993
Young men have just as
many anxieties about sex
as young women                49.0   22.6   48.5   36.5   52.0   16.1   25.5     34.7     34.5    39.1     35.8   1993
R/ship b/n men and
women are more equal
now than 20 years ago         35.4   33.7   40.4   36.9   29.5   34.0   35.5     25.1     39.5    34.5     34.5   1994
Young women are often
pressured to have sex
when they don‘t want to       68.2   70.4   58.1   57.1   63.5   69.5   62.5     67.8     62.0    67.0     64.6   1994
Young women are more
worried about the
consequences of sex than
young men are                 49.0   63.3   63.1   59.1   67.0   75.5   58.0     55.3     56.5    52.8     60.0   1994
Women are keener to
please their partner
sexually ,than to seek
their own pleasure            62.1   64.8   60.6   53.7   55.5   65.0   54.5     58.6     62.0    70.6     60.7   1993
Woman are more
interested in the love
relationship men more
in the physical sex           86.9   82.4   85.9   86.0   70.5   87.5   85.0     77.8     75.5    74.6     81.2   1990
Women often go into
relations with men
without clear sexual
agenda                        54.5   48.5   61.1   54.0   57.5   63.0   46.7     48.5     60.5    58.1     55.3   1989
Women are concerned
more about unwanted
pregnancy and STIs            48.5   62.8   65.7   61.5   57.0   75.5   56.5     55.3     56.5    53.5     59.3   1992
Many men don‘t feel
confident using condoms       55.6   43.2   57.6   59.5   38.5   51.5   33.7     38.4     37.5    39.4     45.5   1990

            Yet asked what men could do if they suspected their wives to have a sexual affair with another
            man, about 53 percent of the respondents maintained that the woman would be beaten while 39
            percent reported that the woman would be divorced. On the other hand, about 45 percent of the
            respondents maintained that a woman would do nothing if she suspected her husband of having
            an affair with another woman. Twenty five percent and 23 percent reported that the woman
            would ask for divorce or report to the relatives, respectively.

            Respondents were also asked if a woman could ask for safe sex. Only 25 percent reported that
            women could ask for safe sex while about 48 percent reported that men could ask for safe sex.
            The majority of the respondents, 71 percent, maintained that a man would force his wife to have
            sex even if she does not want to.

            Table 4.2 Percentage Distribution of Attitude Towards Gender and Sexuality
                                 special                        Butajurra/               Yaya
                           Humbo wereda Wenago Mareka   Hamer   Meskan Yabelo    Fentele Gulele   Fedis Total    N
Men tend to control what
happens in sex more than
women do                   41.9   35.0   50.0   46.8    51.5    42.0    38.5     44.4     49.5    48.7    44.9   1991
Woman decide when to
have sex as a wife         9.1    6.0    17.2   16.2    5.5     10.0    5.5      6.8      9.5     12.6    9.8    874
Reason for not
Husband may disagree       7.4    15.9   16.1   11.9    18.8    19.4    7.9      2.2      1.6     3.4     10.4   684
Husband is the one to
decide                     29.6   45.1   51.6   47.8    65.6    43.3    39.5     42.0     51.6    56.9    47.1   682
I am ashamed to ask
husband                    25.9   26.8   30.6   29.9    31.3    19.4    59.2     37.5     32.8    39.7    33.7   682
I don't expect that from
wife                       24.6   29.4   13.2   12.2    20.0    50.7    20.6     18.2     16.7    19.3    23.4   627
I am the one to decide     49.2   33.8   71.7   61.0    91.4    38.4    81.0     76.4     78.3    73.5    65.2   627
It is culturally
unacceptable               36.1   54.4   41.5   34.1    32.9    45.2    33.3     41.8     23.3    28.9    37.2   627
Women aren't expected
to choose sexual partner   36.0   32.2   35.7   18.3    23.3    31.6    22.8     15.6     16.8    15.3    24.1   1124
Women have no power
to choose their partner    52.3   53.7   56.1   62.2    79.5    54.7    70.7     83.0     85.1    84.7    69.8   1124
Men decide with who to
have sex                   94.4   94.0   94.9   93.6    97.0    92.5    100.0    99.0     99.0    96.0    96.0   1993
men have power to
choose partners            43.9   45.2   52.1   61.6    83.0    50.3    73.0     82.9     74.7    80.6    65.0   1914
Men have sex with wife
any time they want         77.3   75.0   82.8   85.7    96.5    80.5    91.0     73.3     70.5    78.9    81.2   1993
It is culturally
acceptable                 52.9   63.3   67.1   60.3    77.7    61.5    74.7     59.4     59.6    51.6    63.4   1618
Men's sexual needs
must be met                48.4   42.7   56.7   47.7    60.6    29.8    64.3     63.6     61.0    58.6    53.5   1618
Woman must serve her
husband                    13.7   14.7   14.0   14.9    6.2     14.9    4.9      8.4      5.7     15.9    11.2   1618
Woman has sex with
husband any time           14.6   4.5    17.2   13.3    12.0    11.0    8.0      3.0      7.0     11.1    10.2   1996
Reason for not having
sex anytime
It is a deviant behavior
for women to show
sexual desire              90.2   88.6   91.7   87.1    95.7    93.2    94.6     78.0     87.4    75.7    88.1   1676

If a man suspects wife
Beat the woman           40.9   56.0   38.9    26.6      87.0    24.0     53.0      83.9    65.5     58.3    53.4   1997
Divorce her              54.5   49.0   43.9    53.2      9.5     66.5     32.0      17.1    23.5     39.7    38.9   1997
Kicks her out of house   29.3   33.5   26.8    22.2      9.0     34.0     14.5      18.1    45.5     29.1    26.2   1474
If a wife suspects a
husband to have an
affair with another
Nothing                  29.8   59.0   22.2    27.1      77.5    65.5     22.0      71.9    30.0     45.2    45.0   1997
Ask for divorce          34.8   16.5   35.9    35.0      0.5     22.5     39.5      7.0     32.0     21.6    24.5   1997
Reports to relatives     28.8   18.0   32.8    28.1      11.0    16.5     26.0      14.6    27.5     26.6    23.0   1538
A woman can ask safe
sex                      32.1   15.2   28.8    41.4      18.9    27.6     20.8      9.6     32.9     17.5    24.6   1690
A man can ask safe sex   52.0   42.4   45.9    60.8      47.2    58.1     50.6      36.8    46.4     34.9    47.7   1718
Husband may force sex    50.3   56.8   71.0    50.0      96.3    41.0     83.6      87.1    84.2     79.4    70.5   1553

            These findings suggest that women are expected to satisfy men sexually, at their own expense.
            Even when women have extra-marital relationships, they are still expected not to control what
            happens in sex. Yet men are perceived to be less concerned about the consequences of sex such
            as pregnancy and HIV infection. Given these asymmetrical and multiple sexual relationships, one
            wonders the extent to which respondents perceive their own vulnerability.

            It is important to note that respondents have a very low perception of personal vulnerability.
            Only 16 percent of the respondents reported that they had some chance of getting infected (table
            4.3). Another 31 percent could not even assess their chances of getting infected. The most
            commonly reported reason by about 78 percent of the respondents is that they did not have sex
            out of marriage.

            There is a tendency of considering the socially acceptable sexual relationships as ―normal‖ and
            therefore not dangerous. The jal jalto (Sharing of wives and husbands) practice of extra marital
            sexual relationships in Borena, Kereyou for example, is not perceived as risky behavior for
            HIV/STI. It is important to note that about 9 percent do not think that they can ever be affected
            by HIV/AIDS; thus HIV is seen as ―other‖ people‘s disease.

            Of those who perceived some chance of getting infected, the majority, 53 percent, maintained that
            they might have been infected through blood. Yet about 64 percent still maintain that their sexual
            behavior has changed since they heard of HIV/AIDS. And Consistently, the highest proportion,
            84 percent, reported that they have since stopped sharing needles. Only 13 percent reported
            having reduced the number of sexual partners while 37 percent reported abstinence as their
            behavior change. On the other hand, those who reported no change in behavior since they heard
            of HIV/AIDS maintain that they did not see the need to change because they are married.

            Asked what they would do if they suspected that they were HIV positive, the majority of the
            respondents, 80 percent, maintained that they would get tested. Most of the respondents, 88
            percent, reported that they would be tested in government health facilities.

            These results show that respondents have a very low perception of vulnerability. Some even
            think HIV/AIDS is a disease which cannot affect them; it is a disease for other people. Marriage
            seems to be a risky relationship for HIV infection since it gives people the false impression of
            safety. In addition, married people would like to live under the false assumption or even fallacy
            of unquestionable trustworthiness, which undermines any chances of negotiating safe sex within

      Table 4.3 Percentage Distribution of Perception of Risk and Attitude Towards HIV
      Infection by Wereda
                                Alaba                      Butajurr
                                special                       a/                 Yaya
                          Humbo wereda Wenago Mareka Hamer Meskan Yabelo Fentele Gulele   Fedis    Total      N
What are your
chances of getting
Some chance                15.2   22.5   14.1   19.6   17.0   16.0    7.5   21.2   12.1     9.6        15.5   1995
Don't know                 20.7   28.0   27.8   26.0   47.0   29.5   36.5   30.8   37.7    27.3        31.1
Reason for no
Follow religious rules     40.2    5.1   24.3   18.9      -    4.6    0.9    1.1      -     0.8        10.6   1065
No sex outside
marriage                   77.2   73.7   80.0   79.3   79.2   82.6   77.7   71.6   70.0    83.2        77.7   1065
No sex                     12.6   19.2   11.3   10.8    9.7   11.9   18.8   23.2   22.0     8.8        14.6   1065
AIDS cannot infect
me                          4.7    8.1   16.5   20.7   11.1    2.8   15.2      -   10.0     3.2         9.2   1065
Reason for chance
Can get infected
blood                      60.0   62.2   53.6   62.5   35.3   59.4   46.7   33.3   58.3    57.9        52.8    309
Has your sexual
behavior changed
since you heard of
HIV/AIDS                   70.2   60.0   72.2   67.6   62.5   34.5   67.0   67.2   72.9    66.2        64.0   1995
Behavioral change
Reduced number of
partners                    5.0   15.8    9.8    7.2   22.4   15.9    9.7   18.8   15.9    15.3        13.3   1277
Abstaining from sex        43.9   35.8   37.1   36.2   47.2   39.1   47.8   30.8   31.0    23.7        37.1   1277
Stopped sharing
needles                    87.1   76.7   87.4   88.4   57.6   65.2   94.8   82.0   91.7    94.7        83.8   1277
Reasons for not
I am married               61.5   75.0   50.0   55.0   68.2   76.7   70.4   50.8   57.1    47.0        62.8    646
I am in a
monogamous r/ship          25.0   32.4   36.0   36.7    6.1   35.0   39.6   27.9   49.0    59.1        34.4    645
Don't think I am at
risk                       17.3   13.2   16.0   15.0   25.8    5.0    1.9   31.1   26.5    30.3        17.2    645
Steps taken if
Get tested                 84.3   81.0   85.9   82.8   64.5   73.5   83.0   79.4   81.9    81.4        79.8   1997
Worry                       7.1   10.5    3.5    2.9    9.5   19.0    6.0    6.0    7.0     6.5         7.8   1997
Fearful of other's
reaction                    4.0    5.5    1.5    4.4    5.0    6.0    4.0    3.0    4.5     4.0         4.2   1997
Where tested
center                     95.5   80.0   97.0   95.6   65.0   95.5   90.0   81.4   90.5    87.4        87.8   1997
Private clinic/hospital     5.6    4.5    4.0    5.9      -   13.5    0.5      -      -     3.5         3.8   1997

4.4 Rights to Property Ownership, Work and Access to Services

The most valued material resources in the community are land and livestock, and in the urban
areas private houses, business shops and vehicles. Men control these materials because women do
not inherit wealth from their parents and women assume that whatever wealth their husbands
have belongs to them; although upon divorce women leave the households empty handed.

As noted earlier, women are socialized, and expected to serve men, reproduce and take care of the
children and husband within the confines of their homes. Survey data corroborate these
perceptions. The majority of the respondents, 56 percent, reported that men do not want their
wives to work outside the home (table 4.1). The most important reason for such a position is that
men are afraid that their wives would have sex with men that they work with. This was reported
by about 68 percent of the respondents. About 58 percent reported that most men tell their wives
that they would cover all the family needs which renders their work unnecessary. Thirty eight
percent maintained that women are expected to take care of the home including children.

Because women are part and parcel of the culture and are in fact heavily involved in the
socialization of the children, they too, hold similar views with men. For instance, about 55
percent of the respondents reported that the women would not do anything if their husbands
prohibited them from working. About 25 percent reported that women would report to family
members for intervention should they be prohibited from working. About 87 percent of the
respondents reported that the communities have mechanisms for helping women who are abused.
Community elders were reported by about 76 percent of the respondents while the government
legal system was reported by about 28 percent. Given that the community legal system is
patriarchal, it too is oppressive of women.

As has been pointed out in the qualitative data, the traditional family system gives excessive
rights to man and the traditional structures justify these rights at the expense of the woman. The
modern police and court system is still operated by men and is very much dissociated from the
community and its procedures require longer time to reach decisions. In this sense it can hardly
address the legal rights of women.

The community has some mechanisms to protect women so long as they obey the traditional roles
ascribed to them. if the husband is not able to feed the family, elders intervene and advise him to
meet these responsibilities of feeding and clothing the family members; if he is mistreating the
wife such as beating and insulting, she can complain to family elders. However, there is no way a
woman to ask for safe sex, share land and livestock which the help of elders in a community.
However, transforming the community leadership to play a role in addressing gender disparity
can be a viable strategy. Alaba and Yabello are cases to cite as examples, in this respect.

The qualitative data also show that women hardly access information. They are not allowed to
attend public meetings, which are the main sources of information. Women are busy at home and
rarely attend to media programs such as the radio. They hardly discuss on matters that affect their
life. All is left to the husband and what the husband says is taken for granted.

When compared to boys, less girls attend schools and most of them discontinue their education.
They are forced to help their mothers and stay at home. They are forced to discontinue their
education and marry early.

   Although many women suffer from different diseases, they hardly receive medical care. Many of
   them die from diseases that can be easily treated. They very much rely on traditional healers and
   many die during delivery. Many women hardly get treated for STI and continue to suffer from it.

   Table 4.4 Percentage Distribution of Woman’s Right by Wereda
                              special                   Butajurra/             Yaya
                        Humbo wereda Wenago Mareka Hamer Meskan Yabelo Fentele Gulele       Fedis    Total      N
Most men don't want
wife to work outside
home                     70.7   64.5   59.1   68.8   61.5    71.5    56.5    49.0    22.0    32.2        55.6   1995
Afraid wives would
have sex with other
men                      56.4   51.9   79.5   57.6   74.8    60.8    82.3    73.2    90.9    89.1        68.4   1109
Wants to control
them by making them
dependent                 3.6    9.3    6.8    4.3    1.6    14.7     0.9    10.3     9.1    12.5         6.9   1109
Culturally women are
not expected to work
outside the home         25.0   25.6   20.5   33.8   35.8    15.4    20.4    27.8    22.7     7.8        24.3   1109
Women are expected
to take care of the
home and children        48.6   55.0   37.6   54.0   25.2    23.1    41.6    32.0    25.0    21.9        38.3   1109
Men are expected
to be breadwinners       11.4    7.0   19.7   20.9    0.8    16.8    11.5     9.3     6.8    15.6        12.4   1109
Husband has enough
source of income         64.3   56.6   64.1   62.6   21.1    45.5    43.4    11.3    20.5    43.8        46.3   1109
I will cover for your
needs                    63.6   45.7   62.4   67.6   53.7    42.0    56.6    59.8    84.1    62.5        57.7   1109

Women’s Reaction
Accept                   57.1   56.5   55.1   55.4   60.0    65.0    48.0    48.5    53.5    53.8        55.3   1995
Run away from the
home                     24.2   25.0   16.2   24.8    3.0    26.0    18.0     4.0     6.0    10.6        15.8   1995
Report to family
members                  15.7   11.5   23.7   13.9   32.5    16.0    37.5    40.9    30.5    23.6        24.6   1995
Ask for divorce          11.1   10.5   10.1   10.9      -     9.0     6.0     0.5     9.0    14.1         8.1   1995
Community have
mechanisms to
protect women from
abuse                    89.4   88.0   94.4   93.6   81.5    50.0    97.0    87.9    92.5    98.0        87.2   1994
Family elder
intervene                27.1   15.3   48.1   25.9   50.3    48.0    37.6     5.2     5.4    14.4        26.7   1740
Community elders
intervene                69.5   77.8   54.5   74.1   79.8    62.0    84.0    94.3    85.9    72.8        76.0   1740
Government legal
system                   46.9   19.3   39.6   42.3    0.6    31.0    21.1    13.8    31.4    29.7        27.8   1740

   These results tend to show that women's subordination to men is true in all aspects of life, the
   reproductive and productive arenas. Because women are part and parcel of the communities in
   which they live, they are socialized to be part of the oppressive system; inadvertently, women
   participate in their own suppression.

5.      Social Capital

The study revealed that there is social capital that each community offers in the fight against
HIV/AIDS, and specifically in addressing gender and HIV/AIDS. This capital includes the
community structures of leadership and networking, the NGOs and other civil societies involved
in HIV related activities and the government policies and structures which already deal with
issues of human rights, gender, HTPs, economic empowerment reproductive health and health in

5.1 Community Structures and Networks

Ethiopian communities have social structures and networks for exchanging information and
collectively dealing with social problems. The study on the selected communities namely
Guraghe, Alban, Welita, Dawro, Gedeo and Hamer in SNNPR and the Oromo communities such
as the Borena, Etu, Kereyou, Yaya Gulele and Fedis show the existence of social structures and
networks that regulate the social, economic and political life of such communities. These
structures, although very much used to maintain the social norms, values and customary practices
prevailing in each community with the aim of maintaining social harmony, can be used to create
values and norms appropriate to deal with gender and HIV/AIDS. In this section we will try to
highlight this by giving some examples from the communities studied.

 The geda system is the most elaborate and democratic social system that Ethiopia offers. Geda
leaders are elected every eight years. Abageda is the head of the geda system and is the ultimate
leader; what he says is final. Hayo is a decision making body chaired by the fete. Refusal to
accept decisions made by the fete is punishable by excommunication. The members of hayo are
elders that have influence on the community. Kura is a meeting where some community problems
get resolved peacefully. All matters above the hayo are decided by the abageda. There are people
that work with the Abageda and assist him in decision-making. The abegada decides on higher
issues involving homicide. Gume-aldelu is a congress of geda representatives held every eight
years at a place called Aldelu. In this congress new leaders are elected and major decisions are
also made. The community automatically accepts such decisions. It is apparent that within this
system every new idea has to be sanctioned by the geda, this includes the fight against
HIV/AIDS. Note this remark form the president of the Borena Zoinal Court:

         There are customary practices that expose Borena to HIV infection such as
         multiple marriages, having extra marital affairs, widow inheritance and
         FGM. To eradicate these practices the modern law is not that helpful and
         would not make a difference. But if the Geda leaders realize all these
         practices as harmful and if they order the community not to practice them,
         people will abandon them The Geda leaders are more acceptable than the
         government leaders in Borena. Thus, there is need for collaboration between
         the Geda leaders and government if the law was to be effectively

The geda leadership, fortunately, is committed to the well being of its community. The system
and the leadership can be mobilized to deal with harmful practices such as jalajalto, early
marriage, multiple marriages, commercialization of bride wealth and FGM that expose Borenas
and Kereyous to HIV infection. Betel, a local NGO, is using this structure to deal with jalajalto.
The abagedas have recognized that jalajalto is a customary practice introduced to avoid fights
between men over women. The abegadas are expected to condemn and stop this practice in the
next meeting to be held soon at Aldelu.

Among the Oromo of North Showa the dominant structures are the abaweda and abakelelcha..
Abawada is an accepted chief whose position is unquestioned and is inherited within the ruling
family line. The abawada can be used to mobilize people against HIV/AIDS and harmful
traditional practices. The abawada has been used to influence families to send their daughters to
school and this campaign was successful. Aba Kelecha is an accepted spiritual leader whose
responsibility is to keep a piece of metal called kelecha, which is believed to have originated in
heaven. Whatever the abakelecha says is accepted without question. No one can go against the
instruction of an abakelecha. If there is a serious case the abakelecha is asked to mediate between
the families so that they can resolve the case amicably. Oromos in this region believe that if
abakelecha curses, the family root gets destroyed. The abakelechas can also be used to mobilize
people to abandon using harmful practices. Such influential people readily accept recognition
given to them by authority, particularly the government.

The institutions of Beti and Berje still influence the Hamer people in their thinking and behavior.
Beti is a local leader and under him there are local elders. Beti has the ultimate power. He gives
final decisions and has the authority to overrule the decision of elders. People respect the Beti to
the extent that they do not want to disappoint him because they fear that he can curse and inflict
suffering on them. In fact, people follow his instructions without questioning to the extent that
people who commit crimes such as homicide can ask for his protection successfully. He presides
over the reconciliation ceremony, which ends up peacefully with the killer compensating the
family of the deceased by giving several heads of cattle. The compensation to be paid depends on
the wealth of the killer; sometimes they settle the case by taking the daughter of the killer to be a
wife of one members of the family of the deceased. Berje is the creator, God, and the elders are
believed to have authority bestowed upon them by berje. Old people are respected and are
supposedly protected by berje. Hamers believe that berje listens to what elders say, consequently
they try to get the blessing of old people. It is thus important to use these institutions to mobilize
people against practices that directly or indirectly facilitate HIV infection. Hamer elders maintain
that they are ready to work with the government as long as it is for their good. If the government
seriously takes the problem of HIV/AIDS through the elders and other respected local authorities
to the people, campaigns against HIV/AIDS would be more effective.

 Among the Fedis Oromos, the Damina is important institution. It involves tribal leaders who
make decisions on all social matters affecting their communities. The abagenda who is the
community leader, is a focal person in community mobilization. The women‘s affairs and the
wereda court are trying to work with members of Damina in dealing with harmful traditional
practices such FGM, early marriage, abduction and rape.

All communities studied have fora to disseminate information, discuss community matters and
mobilize communities. For example agote and gogata (meeting of elders) are widely accepted
fora for addressing community and intertribal problems and conflicts in Alaba. The practice of
Goma (members of a tribe contributing money to be paid to a family of a deceased man as a
compensation), Lefigne (people working together during harvest, home building, wedding
ceremony), derama (money contribution done instantly to help a needy) and Mesko (when a
person dies a visitor gives only one birr as a contribution) can be used to promote IEC/BCC
interventions as well as care and support to PLHA.

Idir (a community association where members contribute money for covering funeral services)
and Equib (a local association for saving and crediting money) are widely used by rural and urban
communities. Local associations like Akuma (when women gather during mourning and help each
other), Wujot (where women contribute money to give to the needy person first), Gulo (a form of

association that women as well men use when working together) Jella (a kind of cooperation
done during weddings where people help materially to make the wedding ceremony successful)
and gargasa (working together during farming) can be used for social mobilization and BCC
activities. In all communities there are traditions of networking and cooperation to perform a task.
Gedio women, for example, sing 'aluleyo begisido' which means the sun has risen and let's go and
bring grass for roofing the house of our friend. This community cohesion is a strong social capital
for social change.

Care and support is a feature of every community. Communities care for the sick and elderly,
help the poor. In Borena, for example, the community contributes and gives heads of cattle to
their poor relatives; they support the sick and the poor. Gofgonoba is an association for helping
the needy. Borenas like children and have a culture of supporting orphans called gudefecha.
Hamers have a tradition of helping each other called gelsho. They share whatever they have with
their relatives and cannot afford to see their relative going hungry.

Ethiopia, being a traditional society, religion has tremendous influence on the people. The
religious structures, both Islam and Christian, as well as other traditional belief systems such as
wakefata in Borena and Kereyou, foster care and support to those in need. Muslim and Christian
religious leaders are involved in HIV prevention, control and care and support activities. The
religious gatherings are being used to teach followers on HIV/AIDS. In Alaba, attempts are being
made to use the mosque and the Muslim leadership to mobilize the people to stop harmful
practices such as taking alcoholic drinks, extramarital sex, underage marriage, sexual violence
including rape and abduction. Religious gatherings like when celebrating remedan and arafat are
used to pass messages on HIV/AIDS. During such holidays, men and women assemble to pray. In
Dilla, Kale Hiwot Church promotes peer education to help people understand ways of preventing
and controlling HIV/AIDS. It has made blood test for HIV mandatory for all its members seeking
marriage certificates. Mekane Eyesus church, Dembosk Catholic Organization, the Ethiopian
Orthodox Church and the Mosque also teach about HIV/AIDS and advice their members to
protect themselves from the pandemic. Muslim leaders in Fantale are teaching the Etus in Fantale
to stop FGM and widow in heritance.

         In Islam there is no circumcision of women. We are trying to stop all forms of
         circumcision. There is wife inheritance, but the prophet Mohamed said the
         brother has to look after the children not inherit the woman. Warsa came in
         order to protect the property of the deceased husband, but the prophet
         Mohamed is against this. Marriage has to be based on love. [Secretary of the
         kadi, Fentale.].

5.2     NGOs and other Civil Societies

NGOs and other civil societies work closely with communities. Some NGOs have taken steps to
deal with community norms, values and beliefs that expose man and women to HIV infection.
They have started using the community structures and leaders to scrap off such practices. The
focus on community leadership has been tried in Alba by KGM and in Borena by Betel, both
local NGOs supported by UNDP. The results of the community conversations have helped people
to question their practices and take decisions against harmful customary practices. The approach
followed by these local NGOs is highlighted in the subsequent paragraphs.

Kambata Women‘s Self help Association in Alba and Betel in Yabello are promoting behavioral
change through dialogue, reflection and decision making. The communities that they are working

with are empowered to identify problems prevailing in the communities and discuss them
thoroughly. Facilitators are nominated from the target communities and are given training on
dealing with community issues. This approach makes the conversations to continue both in
formal gatherings and in the neighborhood, they help create community consensus for decision-
making. In the process community leaders, government representatives such as the office of
HIV/AIDS and other NGOs get involved. This has made the BCC activities to be grounded on
what the people do and can easily see. According to key informants, the impact of KMG in Alaba
is tremendous.

      Women have started demanding that suspected husbands get tested. A case in point is
       that a rich Muslim who has already two wives and wanted to marry to another one. The
       two wives refused saying that the third wife could be HIV positive. Haji was consulted
       and asked all of them to be tested. The husband and the third wife were tested and
       became negative.
      Community based associations are mobilized to address HIV/AIDS. Idirs provide food
       and clothing for PLHA. Iqubs are also giving loans to members for income generating
       activities. Anti- AIDS clubs are distributing condoms in bars and schools.
      Attempts are being made to stop female circumcision; discussions are being conducted on
       this. Young women are refusing to be circumcised.
      Community conversations are discouraging alcoholic drinks in gatherings and people
       have started abstaining from such acts. The mosque is passing messages that Muslims
       should not drink after selling their crops.
      Blood tests on HIV before marriage is introduced and many are making use of VCT
       services which are available in the town. Many youngsters go in groups; it is becoming
       fashionable to get tested- a change in culture. Some of those who live with the virus are
       disclosing and collaborating with the community in giving education on HIV/AIDS.
      Abduction and rape cases are declining as a result of the education being given.
      The major impact of KGM is in the idirs. In Alaba there are more than 34 idirs that are
       registered. 14 of these have included HIV/AIDS. They have formulated guidelines and
       laws for dealing with the pandemic. 18 practices that expose people to HIV infection
       have been identified and are being included in the idir governing laws; these include: (1)
       no marriage without blood test for HIV; religious institutions, other organizations,
       government bodies including anti HIV/AIDS clubs should not allow marriage without
       blood test; (2) stop wife sharing during marriage with best men; (3) stop ‗festal‘ medical
       practitioners ( village doctors that put their medical equipment in a plastic bag and move
       from house to house, such as giving injection, circumcision and the like), (4) stop ‗ribina’
       replacement of deceased wife by her sister; (5) stop night dances; (6) take blood test for
       HIV before marrying be it the first or subsequent marriage; religious and community
       leaders should examine the economic standing of couples and HIV/AIDS matters before
       allowing marriage to an additional wife; (7) stop wife inheritance—women are not goods
       to be inherited and when a woman is widowed she can marry any person she likes; (8)
       stop ‗herina’; (9) stop FGM; (10) Stop ‗Tilosh‘ (bride wealth); (11) stop under age
       marriage; (12) stop herechu-- wife inheritance; (13) stop weldera ( marrying sister in
       law in place of a deceased wife); (14) Stop unequal marriage-age; (15) stop rape; (16)
       stop abduction; (17) stop cutting of tonsil and removing of teeth root (18) stop stigma and
       discrimination against PLHA.
      Religious leaders are collaborating. According to Shek Merjan Seid Meki, the harmful
       traditional practices have no basis in Islam.

Other civil societies are also initiated by the activities of KGM. Women‘s associations are
sensitizing the community on women‘s rights such as the right to sharing properties during
divorce. According to the woman affairs officer, women are being organized under democratic
association of women and are trying to use this association to advocate for women rights and
reverse gender disparities. The objective of the association is to stop all harmful traditional
practices, open employment opportunities for women, encourage families to send their daughters
to school and keep them in school until they get skilled and avoid early marriages while
promoting reproductive health care. She feels that women are motivated to fight for their rights.
However, the women‘s affairs office has limitations. It still has no budget to run its activities.

Biruh Tesfa, HIV/AIDS secretariat and kebele, give financial support to PLHA and HIV
suspected people. Anti AIDS clubs give counseling services to people who get sick and they test
their blood for HIV. These organizations also give home-based care services to people who are
severely sick with the AIDS. A respondent also gave evidence of two women who disclosed their
HIV positive status to anti AIDS club under KMG and have been getting financial support from
the Kebele.

An NGO called Betel, is operating in Yabelo town, Yubdo obdo, Genya, Dharitan, Eluaya-arero,
Didahara, Surupa, and Adgalchet within a range of 50 k.m from Yabelo town. It has trained 25
men and 25 women to work as facilitators for change which will stop practices that expose people
to HIV infection. The approach involves kebele leaders, tribal leaders, religious leaders, women
social workers and youth leaders. Social assets include idirs, women associations, influential
individuals like tribal leaders and local chiefs such as aba alawoch. In each kebele there are 3-4
community facilitators who are recruited form the community who speak the language of the
people, grown in the culture and selected by the community. Betel is taking two urban kebeles
and 8 Peasant associations as entry points. In turn, these people teach the community on the
harmful practices whenever there is an opportunity such as ceremonies, gatherings. When the
community understands the problems addressed and is ready to make decisions, the issue gets
discussed at the abegeda general meeting called Gumugayo. The community discussions were
taking place during the time of the research. The approach entails the selection of 25 men and 25
women to work with Betel by the community. These selected men and women get introduced to
each other and establish a working relationship of trust. They work together to identify the
problems of the community; the problems include water, malaria, HIV/AIDS, hunger etc. They
forward the ideas that they have to solve the problems to the community. For example, they
suggested ways of preventing HIV infection and the discussions lead to the linking of HIV
infection to customary practices like jala jalto.

Progenist is a local NGO in Butajura, Guraghe zone. It is promoting the rights of women by
involving the community, the government such as health, police, justice institutions, schools,
HIV/AIDS clubs and other NGOs. Progenist's activities focus on HIV/AIDS, legal rights of
women, harmful traditional practices and the empowerment of women with economic activities.
These activities have had an impact. There are indications even at the legal level, that the law can
be reinforced if judges and police collaborate.

        Women complaining against multiple marriages are on the increase; so are
        cases related to sexual incompatibility. Cases related to wife and husband
        incompatibility have increased from 137 in 1994 to 186 in 1995. The sentence
        regarding multiple marriages is up to six-month, and for abduction it is up to
        eight years of imprisonment, rape up to 12 years of jail depending on the age of
        the raped woman. Moreover, HIV blood test is conducted to check if there is HIV

        in the blood of the culprit. In case this is proved to be true then the criminal is
        accused for infecting the woman with a deadly disease. The time to process cases
        is being shortened. A committee of family elders formed from both sides sees
        divorce case and that gets accountable to the court. If it is a civil case related to
        family livelihood, the court gives an order so that the man gives a certain
        percentage of his income to the family till it gets resolved. When divorce happens
        if the woman applies for rights to get a share of the land and decides to stay with
        her children, she can get some land. In most cases when women get divorced they
        opt to look for another husband and express their desire to have more children
        rather than staying at home without being married.. [Court registrar, Butajera]

A Muslim religious leader and a member of Progenist advocates that it is not acceptable to have
more than one wife in Islam, for the husband cannot equally meet the needs of the four wives.
Islam has created conditions that make it difficult for a person to marry more than one woman.
Islam does not support FGM and other traditional practices that expose people to HIV infection.
Any marriage, whether it is the first or second time, has to be preceded by HIV blood test and no
marriage is confirmed unless the couple produces authentic HIV blood test certificate. Note this
remark from a Muslim religious leader and member of Progrenist:

         We are teaching that both men and women are equal and have equal rights to
         all services and property. Sexual satisfaction must be for both. A man has
         responsibility to meet the sexual needs of his wife and he has to understand
         his wife’s sexual needs. However, people do not discuss this openly. If a
         woman shows sexual desire, the husband may suspect her that she might have
         a relationship with other man. Harmful traditional practices mostly exist in
         the rural areas. In towns people are stopping from doing such practices and
         we think that through education people can stop harmful practices such as
         FGM, wife inheritance and multiple marriage. Regarding marriage, the law
         needs to be strengthened. Those who create problems in the name of religion
         and culture are selfish and only promote their interest.

FGAE, Word Vision and Wisdom Micro Finance are involved in Welita FGAE‘s activities
include public awareness creation, Voluntary Testing and Counseling (VCT), youth focused
activities such as training on HIV/AIDS prevention and transmission, assertiveness, life skills,
prevention against rape, peer education skills, and preventing HTPs such as FGM, early marriage,
abduction, issues related to reproductive health and, gender issues. World Vision works closely
with religious, community leaders, clubs and government organizations to change the attitude of
people towards HIV/AIDS and gender. The organization distributes food and strengthens
HIV/AIDS clubs by giving training and materials to be given to PLHA. According to the World
Vision, Welita people are cooperative and listen carefully to new information. Wisdom Micro
finance institution gives loans and provides education on HTP in relation to HIV/AIDS. In Dilla
(Wenagho), for example, Medane ACTS a local NGO, gives family planning and HIV/AIDS
education, focusing on schools. It supports HIV/AIDS clubs with materials such as stationery and
promotes peer education in Kebeles. It supports orphans and aged people and it gives care to

Abebech Gobena is a local NGO operating in Fiche. It has started giving care and support to
PLHA in addition to other educational activities. Nine women and six men get care and support.
The organization has educational activities such as conducting awareness raising workshops,
training of trainers (TOT) on HIV prevention education, peer education, training of home based
care workers, care and support to15 PLHA 38 orphans, 27 pre and post counseling services, 50

people were recruited voluntarily to work in anti HIV/AIDS clubs, 46 were recruited to work in
idir and youth clubs, 2 bill boards were prepared, and 100 IEC capes and shirts were distributed.

Christian Children Fund (CCF) and the Organization for Social Services for AIDS (OSSA) are
active in HIV related works in Fantale. CCF focuses on HIV/AIDS education, gives training to
anti HIV/AIDS clubs in collaboration with the wereda and OSSA. It supports girls attending
schools by giving them educational materials. It is now planning to establish a resource center for
HIV/AIDS. OSSA focuses on the highway areas to educate the people on HIV/AIDS.

The Information Center on HIV/AIDS at Metahara, supported by Save the Children, USA, gives
counseling, IEC services to residents; it also distributes condoms. It refers people to hospitals for
STI and HIV tests. It conducts awareness-raising activities in schools, kebeles and public
gatherings. It gives advice to truck drivers and sex workers on HIVransmission and prevention.
The Gudina Tumsa Foundation, founded in memory of the late Reverend Gudina, is involved on
IEC. It has opened a school from 1-8 with a student population of about 400 of which 176 are
girls. In order to bring about self-reliance in women, the Foundation distributes goats to eligible
women. 25 women have been organized to open a shop with some seed money provided by
NGOs such as the Christian AID. A grinding mill has been established to help woman to generate
income which enhances their self worth. The effect of such interventions are (i) men and women
are now sitting together in meetings; (ii) there is resistance to allow old men marrying young girls
(iii) some men are now assisting in construction of iron-corrugated houses (iv) there is decline in
wife sharing, widow inheritance and abduction.

Civil societies, NGOs, youth and women associations, and anti HIV/AIDS clubs are
enthusiastically working across the region to raise awareness on HIV/AIDS in both urban and
rural communities. Community conversations have proved to be effective vehicles for change at
community level; they can be replicated in other communities to address gender and HIV/AIDS.

5.3     Government

In Ethiopia, there are policy, constitution, and legal bases for addressing gender disparities.
Moreover, implementing structures have been formed from the Council of Ministers down to
kebele level.

5.3.1 Policy provisions

The government has promulgated several policies, which directly or indirectly, address the issue
of gender. The following paragraphs highlight some of the most relevant policies.

The Women's Policy (1993) primarily aims to institutionalize the political, economic, and social
rights of women by creating an appropriate structure in government offices and institutions. The
aim is to make public policies and interventions gender-sensitive and ensure equitable
development for all Ethiopian men and women. It recognizes the current status of women, and the
need to address women's rights in all socio cultural aspects.

The Education Policy (1994) addresses the issue of women's access to education, and stipulates
that education has to be geared ' towards reorienting society's attitude and values pertaining to the
role and contribution of women in development.' In the overall strategies of the policy, gender
issues are addressed through giving attention to gender issues in the curricula, reviewing the text
books, extending financial assistance for education to women, and giving special attention to
women's participation in the recruitment, training and assignment of teachers. The policy

recognizes the low level of girl's school enrollment especially in the rural areas due to factors
such as school distance and security concerns, lack of privacy in the school sanitation facilities in
some cases, the limited number of role models for women in the classroom and school
management and cultural factors that reinforce patterns of work for girls in the home, and early
marriage. Actions with a view to addressing the problem include, among others, constructing new
schools, helping families afford school fees, and encouraging communities to educate their girl
child. Other means to enhance gender sensitivity include increasing the number of female
teachers and preparing teaching materials that are free of gender biases.
The Cultural policy (1997) articles 13,14, and 15 make special reference to rights of women,
elimination of biases and prejudices against women and the need to ensure equal participation of
women in cultural activities. The HIV/AIDS Policy (1998) makes special reference to how gender
disparities expose women to HIV infection, and stresses the need to see gender in relation to
HIV/AIDS prevention and control.

The Health, Population and HIV/AIDS Policies have given emphasis to gender and the need to
give special attention to the health of women. Issues on reproductive health and rights are dealt
with in the health and population policy. The vulnerability of women to HIV infection due to
their social and economic status is highlighted.

5.3.2 Constitutional and legal rights

Ethiopia has a constitution with provisions on women‘s political, economic, social and human
rights. The Constitution of the Federal Democratic Republic of Ethiopia is the supreme law of the
country. Furthermore, Ethiopia has six major legal codes out of which the criminal code and civil
procedures directly apply to gender and HIV/AIDS. Although both codes need considerable
revision to be consistent with the constitution, there are provisions that deal with harmful
practices that courts can apply.

The Ethiopian Constitution of the Federal Democratic Republic of Ethiopia, article 35 (1995) recognizes rights of
women and stipulates the following articles:

    1.   Women shall, in all the enjoyment of rights and protections provided for by this constitution, have equal
         rights with men.
    2.   Women have equal rights with men in marriage as prescribed by this constitution.
    3.   The historical legacy of inequality and discrimination suffered by women in Ethiopia taken into account,
         women, in order to remedy this legacy, are entitled to affirmative measures. The purpose of such measures
         shall be to provide special attention to women so as to enable them to compete and participate on the basis of
         equality with men in political, social and economic life as well as in public and private institutions.
    4.   The state shall enforce the rights of women to eliminate the influences of harmful customs. Laws, customs,
         and practices that oppress or cause bodily or mental harm to women are prohibited.
    5.   (a) Women have a right to maternity leave with full pay. The duration of maternity leave shall be determined
         by the law taking into account the nature of the work, the health of the mother and the well being of the child
         and family. (b) Maternity leave may, in accordance with the provision of law, include prenatal leave with full
    6.   Women have the right to full consultation in the formulation of national development policies, the designing
         and execution of projects, and particularly in the case of projects affecting the interests of women.
    7.   Women have the right to acquire, administer, control, use and transfer property, in parti cular, transfer,
         administration and control of land. They shall also enjoy equal treatment in the inheritance of property.
    8.   Women shall have a right to equality of employment, promotion, pay, and the transfer of pension's
    9.   To prevent harm arising from pregnancy and childbirth and in order to safeguard their health, women have
         the right of access to family planning, education, information and capacity.

The Federal Rural Land Administration Proclamation N0 87/1997, Article 5 (4) states that the
land administration law to be issued by each Regional State should confirm the equal rights of
men and women in respect to the use, administration and control of land, as well as in respect of
transferring and bequeathing holding rights. The proclamation further provides that women
should be allowed to use hired labor on their holding or otherwise make similar arrangements
[article 6 (3)]. For the purposes of assigning holding rights and carrying out distribution of
holdings, regional states are to lay down a system that is transparent and fair, and allow for the
participation of peasants, especially women.

There are activities that attempt to economically empower women and protect them from HIV
infection. The Ethiopian Women Development Fund (EWDP) and the Women's Development
Initiative Project (WDIP) are good examples. The EWDP came into being because of studies
conducted under the WDIP. This initiative targeted around 16,000 women selected from four
regions. Civil societies like the Association of Women's Lawyers, the Coalition of Women
against HIV/AIDS, which includes women in key government positions, including the wife of the
Prime Minister, are examples that can be of great help in addressing gender and HIV/AIDS at the
level of policy and law.

5.3 3 Trends in the implementation of policy and legal rights of women

Ethiopia is a country with about hundred different ethnic and cultural groups. In such a scenario,
policy and program implementation remains complex and slow. However, there are indicators
that the policies, programs and legal provisions regarding women would be realized especially if
placed within the respective local socio-cultural contexts. Courts and Police

There are now indications that police and courts are attempting to reinforce the laws. Women
have started reporting their cases to the legal bodies such as police and courts. In zones where the
office of women's affairs are operational, there are attempts to help women get court decisions on
crimes related to sexual violence such as rape, abduction; violation of rights related to marriage,
where a man marries another woman in addition to his first wife. For example, in the year 2001 in
Welita zone, 310 cases reported by women appeared in wereda courts: these included abduction
(129), rape (109), and marriage related (72). Out of these, 69 cases received court decisions while
the other 241 cases were still being examined at the time of this study. In the year that followed
(2002) 227 new cases were reported to the court: these included abduction (78), rape (90), and
marriage related (59) cases. 64 cases received court decisions, 163 cases were still under
examination at the time of the research (Zonal office of Women's Affairs of Welita).
There are activities to make the community understand the law. In Fedis for example, the kebele
shengo members are given training on the law and in turn, they teach the community on rights
and obligations expressed in the constitution and the civil and criminal procedure codes. The
people have started coming to court instead of approaching elders to settle matters. Damina, tribal
leaders have also started reporting criminal cases to court. Note this remark:

         Rape is common, an eight-month pregnant woman was raped and her case
         was brought to court. The criminal was sentenced to eight years
         imprisonment. A four- year old child was raped and the case is under
         examination; another nine years old girl was raped and the criminal was
         sentenced to ten years imprisonment; there is another 6-year-old girl who was

         raped and the criminal was sentenced to ten years imprisonment. Most of
         those who rape have troubled backgrounds and have negative attitudes and
         hatred towards the community in general. Cases related to multiple marriages
         are either decided by asking the man to stick to his first wife or by divorce in
         which case the woman equally shares the property they have in common.
         However, many women do not like to be divorced and feel they better stick to
         their first husband. In the case of rape or abduction, if the prosecutor asks for
         blood tests the court obliges. [Former court president of Fedis wereda]

According to the office of women‘s association in Wenago, two men who raped a woman and a
young girl have been sentenced to imprisonment of 8 and 11 years respectively. Two Kereyou
women in Fantale refused to be inherited and reported to the police. They are protected by law
and are living in their homes along with their properties. Education

Educational institutions are responding to the pandemic. Dilla College of health sciences is
assisting in VCT and PMTCT by working closely with Dilla hospital. In Butajura, Welita, Dawro,
Weago, Yabello, Fedis, Fenatle and Hamer, schools are encouraging families to send their
daughters to school and the enrollment of girls is increasing in consequence. In Fedis, according
to the education officer, class size has grown in some schools to 170 in grade two while 90-98 is a
usual class size. School enrolment of girls is on the in crease. The community has gone to the
extent of employing those who have completed grade twelve to teach primary students and assist
regular teachers. Schools are promoting women teachers to become role models for schoolgirls.

The schools have started sensitizing students to gender related harmful practices. There are
student activities on HIV/AIDS in collaboration with residents of different communities. The
number of cases related to harassment of girls has declined as a result of the education given to
both girls and boys and the strict disciplinary laws recommended by the Ministry of education.

Young schoolgirls are resisting cultural practices such as early marriage especially with old men.
The story of this Hamer girl illustrates that change is underway.

Godena Bolinlka is a Hamer girl. She was attending school at Demeca and was staying in a
government hostel. Her parents wanted her to marry an old man because he was rich and would
give them many heads of cattle and other bride wealth. She refused to go back home and marry
the old man. Because the man paid bride wealth, her parents agreed that he abducts her. Some
people tricked her and she was taken by force to the house of the old man. The old man did not
ask for sex as she arrived in his house because certain ceremonial activities had to be done first.
She became polite to him and when he loosened his security on her she disappeared and reported
to the police. She was taken to the zonal town where she is continuing with her education there.
She is now in Jinca zonal town and she is 17 years old.

Similar stories were reported among the Kereyou and Fedis communities. Health

There is widespread support for VCT and the demand is expanding. People are requiring it for
marriage. Religious leaders both Muslims and Christians support it, but believe that education
involving influential people has to be given to help people realize the advantages of VCT. In

Guraghe, over 40% of young couples get tested before marriage. Many youth come in groups of
four and five and use VCT services in Dilla, Wenago. The VCT of FGAE in Welita is active and
the number of users is increasing. The VCT centers teach the youth reproductive health,
STI/HIV/AIDS and harmful cultural practices such as rape, abduction, multiple marriages and use
of condoms. The demand for condoms among the youth is increasing. The center in Dilla for
example, distributed 2400 condoms in 20 days to youth only. About 400 men and 200 women
have been tested in the last three months. A religious leader remarked:

         We have heard of blood test and it is good. Before introducing the test it is
         necessary to teach the people using religious and community as well as tribal
         leaders. People suspect that the government wants to make people sterile by
         injecting them with toxic drugs. People may associate the test with this. We
         had a problem with TT immunization. Virginity before marriage for boys and
         girls should be encouraged because it is a good culture. And there is also
         good culture, which should be encouraged like supporting, caring and visiting
         the patients. [Religious leader, Fedis, Man].

PMTCT service is being introduced and Dilla hospital for example, is giving the services.
Women get health education, and the number of PMTCT clients is increasing. In four months in
Dilla PMTCT center only, 1446 clients became beneficiaries of PMTCT service. 348 took blood
tests and 41 were HIV positive. 341 of those who took the test were married and the 41 positive
women were also married.

The wereda administration, wereda HIV/AIDS Bureau and Health Bureau work cooperatively to
teach the community on HIV/AIDS and harmful traditional practices such as FGM. There are
committees that deal with harmful traditional practices in Butagura, Alaba, Fedia, Yaya Gulele,
and Fantale for example.

It is clear that there is demand for change which can enhance the well being of the respective
communities. Both government and local leadership are interested in facilitating such change;
however, it is necessary to continuously educate and sensitize local leadership in order to make
them feel part and parcel of the change process from its inception to its implementation.

6.      Discussions and Way Forward

6.1     Discussions

The HIV/AIDS pandemic has created a scenario where deeper understanding of the underpinning
factors that directly and indirectly contribute to the infection is necessary to put relevant policy
and programs in place to halt the spread of the infection. It is obvious that the main route of
transmission is unprotected sexual relations with multiple partners. It has been propagated in the
last twenty years that faithful monogamy, use of condom and abstinences as ways of avoiding the
infection. BSS studies including this one show that most people have this information. However,
the behavioral practice of sex and sexuality remained the same and the infection is spreading at an
alarming rate and many people are dying daily. The question that people raise is that: 'Why is that
people behave the same despite the deadly nature of the infection?'

The current study, which was undertaken in two regions, SNNPR and Oromia, tried to explore the
culturally accepted norms, values, beliefs and practices in communities and how these relate to
HIV infection. The study assumed that there are beliefs, norms and values that justify the
behavioral practices the communities take for granted as norm al but in essence expose them to
HIV/AIDS. The study in the ten weredas shows that communities have customary practices
underpinned b y sex and sexuality norms that expose them to HIV infection more than any other
external factor. Al the customary practices that have been identified in this study revolve around
gender. The prevailing gender disparities where women are denied to access resources such as
land and livestock, to access information and services such as health and education when
compares to men, the prevalence of harmful practices such FGM, abduction, widow inheritance,
sharing of wife, and multiple marriage are the major contributing factors to HIV infection.

HIV is directly related to poverty, unemployment and mobility. The study shows that many
women runaway from their homes and end up as sex workers, or do menial jobs that expose them
to HIV infection. Many women migrate from rural to urban areas because they have no means of
livelihood once they get divorced. Many men find sex cheap enough to buy and go back home
with the virus. Housewives cannot demand use of condom or blood test because they would be
chased away from home or beaten or insulted. It is crystal clear that the pre-condition for
effective HIV/AIDS prevention and control in the two regions, and the rest of Ethiopia, is the
aggressive redressing of the socio-economic and cultural disparities that determine gender
disparities as a policy and program strategy to bring about quick behavioral change in men and
women to stop HIV/AIDS from spreading.

HIV/AIDS has made it absolutely necessary for communities to start revisiting the way they
socialize men and women are socialized by families and commuities. In Ethiopian communities,
including those in SNNPR and Oromia, women are socialized (i) to be obedient and serve their
husbands; (ii) to be good at house keeping and looking after children, working in the home; (iii)
not to claim property and to be dependent on men for their economic needs; (iv) not to exhibit
sexual desires in any way; (v not to challenge and be assertive. On the other hand, men are
socialized (i) to be good at farming and animal husbandry, working outside the home; (ii) to
assume authority and leadership in the family and the community; (iii) to own property and have
absolute decision-making power over property, on the other hand; (iii) to seek information by
attending meetings; (iv) and assume community leadership; (v) to exhibit masculinity through
aggression and violence. For a community including a family, a man symbolizes respect and
continuity of a clan or tribe; and a woman symbolizes as someone to be given and serve others,
and sometimes as source of embracement if she does not get married or becomes pregnant before

marriage. This attitude is exhibited at birth and all the way to marriage. Most communities ululate
fewer times for girls than for boys. Women that give birth to male babies are more respected than
those that give birth to female babies. On marriage families basically sell their daughters and
receive bride wealth. The girl child is given less food while the boy child has enough food as he
eats together with the father who often gets the best and most food. The girl child is also deprived
of equal opportunities for school with the boy child. In some communities like Alba, Borena,
Kereyou and Hamer, women are denied basic human right particularly sexual right. Women in
these communities are shared by men. The practice of jalajalto in Borena and kereyou, the
practices of jala in Alaba and the sex relation in the evangadi dance in Hamer are evidences that
reflect that women are perceived as sex objects. As a result of sex networking STI is widespread
in these communities particularly gonorrhea. Although there may be variations among
communities, customary practices in Ethiopia make women inferior to men and expose both to

It is clear that HIV/AIDS policies and programs have to be geared towards resolving gender
disparities and promoting processes that put men and women in mutual respect and responsibility
in a relationship of monogamous faithfulness. Such a policy and program objective can be
realized in due process by availing structures and services that harness development of men and
women at the community and government structures. This research has made it evident that
prevailing policies and programs need to be revisited by making communities and gender
relations as focal points of intervention of quick and sustainable changes are to be happen. One
may argue that Ethiopia has very good policies and programs in place. But the HIV/AIDS which
is now related to all the development programs of the country has made it necessary that it is time
to ramify available policies and programs and make other provisions that speed up the fight
against HIV/AIDS which we think all revolve around gender issues. The gender issue can be
described as rights issue towards addressing development issues and preventing HIV/AIDS.
Policies and programs have to make specific reference to addressing the right of men and women
towards healthy development and relation at the family and community level. This would guide
intervention activities by NGOs, government, private and other civil societies to focus on
communities and families and empower them with the skills and knowledge to address their
health and development issues. Major activities on HIV/AIDS are envisaged to focus on:

       Identifying the social capital that can be used as a basis for policy and program
        intervention as demonstrated in chapter five of this report. In any community there are
        structures and fora that can be used for harnessing social change and can be taken as
        social capital. However, there are those that are hurdles to social change. HIV/AIDS,
        nevertheless, as this study shows, requires a change on the very basis of community
        perceptions and ways of life. The change can happen within the community social
        structures where intervention from outside would facilitate the changes to happen as
        quickly as possible in order to deal with the pandemic. Intervening bodies have to be
        prepared to work within community structures if they are to bring desirable behavioral
        changes of men and women.

       Masculinity and femininity perceptions of communities and how such perceptions can be
        ramified on the basis of understanding and appreciation of the dangers of existing
        practices that emanate from such ideologies. Such a program activity requires prolonged
        community conversations and reflections

       Rights of sex and sexuality; the right of men and women to know about their sexual
        bodies and use them healthily and safely, and be able to decide on when and who to
        marry. This activity would face serious challenge from pastoralist communities and

        would have to be managed with care and sensitivity. For the Hamers, for example, a girl
        is a source of wealth.

       Rights to access to resources: the rights of men and women to own property and share
        equally on divorce. This entails legal literacy, reconciling customary laws with the law of
        the land, discussions on constitutional rights of men and women and available policy
        provisions that articulate gender equity.

       Rights to access information and services; the rights of women to learn and access on
        new in formation such as education on HIV/AIDS and others, and services like
        education, health, credit and saving benefits and others that enable people to be out of
        poverty and improve the quality of life.

       Affirmative measures to boost women's participation in the social, economic and political
        life of communities: enroll women in schools and help them to assume positions with
        government and non-government bodies. Women can be heard of they prove themselves
        to be a viable force. This entails strengthening existing women associations and
        structures within government and the civil societies. Policies and programs have to create
        environments where women get better opportunities to narrow the gab between men and
        women we see in the areas of employment be it professional or other wise, encourage
        women to play important leadership role in politics.

       Strengthening the health services with more health education, VCT, PMTCT and Family

Fighting HIV/AIDS by addressing gender issues may seem difficult in the Ethiopian context.
However, there are opportunities, which practically all Ethiopian communities share and that can
be used to help in the implementation of program activities of methodologically handled:

       People value health more than any other and are scared of HIV/AIDS. They are ready to
        know and to do if they are properly educated on the pandemic. Many people do not relate
        HIV/AIDS with their customary practices mainly due to ignorance. Denial is the coping
        mechanism to hide ignorance.

       People are suffering from poverty and their customary ways of living are exposing them
        to more difficulties and the quality of life that they are leading is declining. In the Focus
        group discussions conducted with men and women all agree that they need guidance on
        how to deal with the problems they are in. The community conversations being held at
        Alaba and Yabello reflect that communities can be helped to understand and decide on
        things that they do not need and instill new practices to live a healthy life.

       Within the traditional structure, there are enthusiastic community and religious leaders
        that can be of help in community mobilization to address the root causes of HIV
        infection; there, civil societies youth and women and NGOs that can be utilized in
        helping communities to bring about fundamental changes that help bring about quick halt
        of the infection.

       The government structures available in the visited areas are ready to help and work for
        the benefit of communities. If programs and policies are perceived from what
        communities can do and how the government and other non-government structures can
        help communities to build their capacities to deal with issues like HIV/AIDS.

Ethiopia offers opportunities for a quick change to halt the spread of the pandemic. However, at
present there are confusions that need to be cleared out. The government at the leadership level
seems to be complacent with its policies and programs it has. However, the prevailing policies are
good intentions and need to be ramified and conceptualized in the light of new developments,
particularly HIV/AIDS.

6.2        Way Forward

Focusing on the behavioral aspect of HIV/AIDS would not bring any considerable effect in
halting the infection. Existing strategies and programs in prevention and control of HIV/AIDS
have to make two things focal in their conceptualization and planning processes: centering gender
and communities.

      (viii)   The gender dimension of policy and program ramifications has to speed up the
               realization that men and women have equal rights to property, information, services,
               sex and sexuality.

                  The right of a woman to inheritance of land, livestock and other properties on
                   divorce and death of a spouse has to be realized as quickly as possible. In the
                   absence of economic empowerment, women cannot afford to disappoint or
                   challenge 'irresponsible' husbands. In areas where women are able to ensure their
                   right to share land on divorce, men behave and live in mutual respect with their
                   wives. In order to ensure rights of women to access economic resources, the law
                   has to be reinforced at the level of peasant association or kebele through the use
                   of the kebele and community structures. The kebele shengo (local court) has to
                   be strengthened through training and giving more responsibility on such issues.

                  There should be upgrading programs of wereda judges and police on the rights of
                   women as stated in the Constitution of the country. Attempts need to be done to
                   bring customary and statutory laws to some degree of harmony. The training of
                   local leaders and religious fathers on the country laws and rights of women
                   would help create positive environment to realize the constitutional rights of
                   women. The threat of HIV infection can be used to reinforce the need to scrap off
                   harmful customary practices and using the country law to sanction those who
                   perpetuate such practices.

                  Women's access to services such as health, education and information has to be
                   realized by mobilizing women to be beneficiaries of such services. Women‘s
                   organizations, youth association and interested NGOs in gender matter would be
                   of great help to raise awareness in women of the benefits they get from such
                   services. To this end, the capacity building of these organizations must be in
                   place. Also, communities can be mobilized to influence women to participate in
                   such activities and benefit from services available.

                  Scrapping off all harmful customary practices, which are embedded in values of
                   masculinity and femininity, is urgent. The practice of sharing wife like jala jalto
                   in Borena and Kereyou, widow inheritance, including polygamy, abduction,
                   female genital mutilation, and unprotected health services such as done by local
                   medical practitioners have to be stopped. Such acts have to be handled carefully

               at community levels and gradually community decisions have to be guided to be
               in congruence with the statutory law.

(ix)       The methodology suggested in bringing policy and program ramification needs to be
           based on advocacy works and PR activities targeting policy makers, religious and
           opinion leaders, business and industry leaders, media mangers and agencies. Since it
           is mainly transmitted through unprotected sex, gender has to be a focal point in
           policy and program ramifications. Equal opportunities for men and women have to
           be the guiding principle. For the realization of this, it is suggested that a supportive
           atmosphere needs to be created through continuous dialogue on the following issues
           by involving the above-identified groups.

              Gender and HIV/AIDS
              Equal opportunity for women and men
              Reproductive health, sex and sexuality
              The legal dimension of gender and customary laws.

(x)        The community dimension has to be based on the belief that any community is
           capable of dealing with its problems. It only needs help and assistance in focal areas
           so that communities develop knowledge and skills of dealing with beliefs and norms
           that underpin harmful customary practices. This entails helping them to:

              Redefining the social meaning to be a man or a woman in the light of good health
               and good family life.

              Using existing good practices and social assets to effect quick changes.

              Transforming existing community leadership through conversation and reflection
               to assume leadership in the fight against HIV/AIDS by first helping community
               members to question their sexual behaviors in relation to modes of HIV/AIDS
               infection. Use of community conversations in Alba and Yabello have
               demonstrated the possibility of changing cultural practices using available
               community and religious structures ( see ch 5).

              Focusing on community conversations, which would create an opportunity to
               highlight the understanding that everybody, not only those falling in ―high risk
               groups‖, is at risk of HIV infection. This would help the securing of collective
               response against HIV/AIDS.

(xi)       The approach to impact cultural change by any facilitative group such as
           government, NGO or otherwise has to be process based, continuous and
           methodological. This entails:

          Building positive relationship with community by recognizing existing structures and
           forums in community including the leadership
          Working closely with communities to identify and prioritize their problems and be
           able to relate their practices with their problems;
          Focusing on direct conversation involving all community members. Because of low
           literacy level in rural communities, especially among women, printed materials could
           be of little use.
          Helping communities to take decisions and plan course of action to be followed;

           Helping them to identify what assistance they need to carry out their activities;
           Helping them to monitor and eventually evaluate their activities and plan future
            course of action;
           Helping communities to reinforce their decisions through consensus and sanction
            whenever needed.

  (v)    Special attention needs to be give to pastoralists as compared to settled farmers or
        urban dwellers. The life of pastoralists revolves around livestock. Hence programs on
        HIV/AIDS must be mainstreamed in their ways of keeping livestock and using livestock
        products including marketing, while enhancing roles of women in animal husbandry. It is
        necessary to establish health services, which would provide VCT services while providing
        condoms. It is also recommended that schools with hostel facilities be built to enable
        boys and girls to have access to education. The basic problem with the pastoralists is that
        they see their daughters as sources of bride wealth and this needs to be dealt with
        vigorously especially through community conversations using their local networks.

  (vi) The mainstreaming of HIV/AIDS in any programmes/projects is believed to be a good
       strategy to address HIV/AIDS in the rural population. However, in the mainstreaming,
       gender and community structures have to be central for any HIV related activity.
       Although gender tends to be seen as a separate issue, it is clear that every activity is
       gender governed.

The expected outcomes of the above mentioned processes could be measured in terms of process
and product indicators.

(i) The process indicators would be:

       Community participation increases.
       Community leadership structures, forums and associations assume more responsibilities.
       Community discussions show depth in understanding the pros and cons of their beliefs,
        norms and customary practices.
       Communities starting decisions on practices affecting their health and quality of life.
       Communities create ways of reinforcing their decisions such as community sanctions,
        reinforcing the law of the country.
       Community leadership and government work closely in mutual trust.
       Women actively participate along with men in community discussions.
       Masculinity and femininity redefined in terms of mutual responsibility and love and care;
        not in terms of sexual conquest.

(ii) The product indicators would be:

       Girls enrolment in schools increase.
       Number of women attending meetings, getting health care services increases.
       Number of women refusing early marriage, bride price and polygamous marriage
       Number of monogamous marriage increases.
       Number of women and men marrying on the basis of personal arrangements increase.
       Number of women bringing their cases to police and court increases so also number of
        women cases receiving court decision increases and time to get court-ruling gets

       Number of women having land, livestock and other valuable sources increases.
       Number of women demanding safe sex such condom use, VCT and PMTCT services
       Number of harmful practices such as FGM cases decreases, abduction, rape, early
        marriage, sharing of wife, widow inheritance decreases.
       Occurrences of wife beating, harassment and threat decrease.
       Number of women seeking traditional treatment such as going to village doctors,
        witchcraft decreases.
       Number of divorce cases decreases and so also number of women migrating to towns
        seeking livelihood.
       Number of women seeking family planning services increases.
       Number of women assuming community leadership and occupying government offices

To sum up, the study has shown that existing gender relations remain very conducive for
HIV/AIDS infection. It makes it absolutely essential that quick measures be taken to deal with the
prevailing gender disparities in order to create conducive environment for halting HIV/AIDS. The
more we explore HIV/AIDS the more we see that gender should assume centrality if we are to
make headway in dealing with the pandemic. This study shows that gender disparities, rooted in
sanctioned traditional beliefs and practices, are fueling HIV infection. The very socially
sanctioned multiple sexual relationships, meant to perpetuate social integration and survival, fuel
the spread of HIV/AIDS in all the weredas. Certain sexual practices pause a serious threat to
entire communities. A mosaic of sexual networking that renders entire communities generally at
risk of HIV infection characterizes the different weredas.

Gender issues should be central focal points for health, education, development, and HIV/AIDS
policies and programs. Specific provisions on gender and HIV/AIDS be made in the penal and
civil procedure codes; such provisions can address sexual rights and safe sex among others.
Programs on HIV/AIDS should be community centered with the view of helping the respective
communities to take initiatives against HIV/AIDS; these programs should be process based with
the ultimate outcome of empowering communities with knowledge and skills of preventing and
controlling HIV/AIDS.


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Annexes:        Wereda and Community Profiles

Annex 1:        Alaba Special Wereda, SNNPR

Alaba wereda has 74 kebeles with a 1994 total population of 187,034 out of which 16,723 (or 9
percent) live in towns. Alaba Town is a trade center and has the biggest market in SNNPR.
Majority of Alaban people are Muslims. Agriculture is the main economic activity. Pepper is the
main cash crop. Alaba Town has social service giving institutions: there is one government
health center, three private polyclinics, one private laboratory and FGAE run VCT; 3 primary, 1
secondary and 2 junior secondary schools. NGOs (like KMG , FGAE, World Vision and Water
Action) are implementing development programs.

Kebele 02 in Alaba town and Gedeba Farmers Association were selected for the study. The data
collection involved 21 key informants (14 men and 7 women) from government, NGO and
religious institutions, community leaders and people identified as key informants by the
community in the study sites. Four focus group discussions (two FGDs with men and two FGDs
with women) and two hundred structured interviews with equal number of men and women.
Major institutions interviewed with in-depth interviews include the office of wereda HIV/AIDS
prevention and control, Alaba mosque (the imam), Alaba Islamic Development and HIV/AIDS
Coordinating Office, Kambata Women's Self Help Association (local NGO), Head of Islamic
Affairs (SNNPR), Islamic Affairs Alaba, head of health center, Alba Women's Affairs, a high
school and a rural primary school.

Annex 2:        Butajira Wereda in Guraghe Zone, SNNPR

Butajura is located in Guraghe zone. The population is estimated at 240,000 out of which 40,000
live in urban areas. The major occupation is agriculture and the wereda is known for its pepper as
a cash crop. There are civil servants, business men and daily laborers. Enset is a major staple
crop. Butajura town has one public hospital and one health center as well as few private clinics
and drug vendors. The town has four primary schools, one secondary and one technical school.
There are NGOs operating in the wereda: Progenist, Goal Ethiopia, GTZ, Kawedo, Synodos, and
Mersi Ethiopia. Progeniest works on HIV/AIDS education, support for PLHAs and HIV/AIDS
orphans, family planning, and it advocates the enrolment of girls in school. It also advocates for
the economic empowerment and rights of women. Mersi and Goal Ethiopia provide educational
support while Kawdeo, GTZ and Synodos supply water. Self Help Ethiopia and Irish Aid work in
collaboration with the government hospital for the betterment of health facilities including the
minimization of health service costs.

Butajera town, Kebele 03, and Debi Peasant Association were selected as study sites as per the
research design. Twenty one key informants were interviewed in addition to 200 structured
interviews and two focus group discussions. The key informants included heads of government
offices: women's affairs, wereda court, high school, health office, HIV/AIDS office, kebele
leaders. NGO and civil organizations including staff of Progenist, a local NGO (head and
program coordinators), religious leaders, Anti HIV/AIDS club leaders and knowledgeable women
and men identified by representatives of the study sites.

Annex 3:        Humbo Wereda in Welaita Zone and Mareka Wereda in Dawro Zone,

Welaita and Dawro communities have a lot in common. Humbo is the wereda selected from
Welaita. Its population is estimated at about 130,000 out of which 30,000 are urban residents. The
major economic activity is agriculture. The majority of the people are engaged in petty trade like
merchandizing teff, maize, and beans, and some people are civil servants. Most women get their
income from selling local beverages. The majority of the population are followers of the
protestant church. In the wereda town, Humbo, There is one secondary and one primary school.
There is one health center and three private drug vendors. The peasant site has one primary
school and a nearby protestant church and World Vision food distribution camp. There are
Orthodox churches of Kalehiwot, Mulu wengel, Meserete kirstos, Hawariyate..

For data collection two sites were selected; the wereda town Humbo and Abele Farecho peasant
association. 28 key informants (17 men and 11 women ) were interviewed. The institutions
consulted include the wereda administration, health bureau, health center, women democratic
association, kebele administration, high school, HIV/AIDS secretariat, Berhan Anti AIDS club,
Kalehiwot Protestant church, wereda court, women's affairs zonal bureau, World Vision, Zonal
administration, Zonal head of HIV/AIDS bureau and distinguished kebele residents. Four FGDs,
two for women and the other two for men, were conducted in both the urban and rural sites. Two
hundred structured interviews with equal numbers of women and men were conducted in the
urban and rural sites.

Dawro, Tercha wereda in Dawro zone was selected for the study. The major occupation is
agriculture. The economy is mainly based on petty trade, and the cultivation of maize and ‘Inset’.
The main major resources remain land and livestock. The people are mostly followers of
protestant and orthodox Christian churches with some animists. There are three tribes namely
Manea, Mnja and Mala. NGOs that are presently working in the wereda include Action Aid
Ethiopia ‘koyesha program‘, UNICEF, and the Catholic Mission. Tercha town is the wereda and
Zonal administration seat and it has one primary, one junior secondary, one high school and one
technical and one vocational school and a health center.

Two sites were selected in Tercha wereda: Tercha town is one kebele and Goze Shesh Farmers
association. 26 key informants (16 men and 14 women), four focus group discussion (2 women
and 2 men) and 200 structured interviews (equal number of men and women) were undertaken.
The institutions consulted include the Zonal, wereda and kebele administration, the health bureau,
Zonal and wereda civil and social affairs, religious institutions, rural and agricultural
development office, and distinguished personalities and elders.

Annex 4:        Wenago Wereda in Gedio Zone, SNNPR

Wenago has 41 kebeles out of which nine are in towns; eight of the urban kebeles are in Dilla.
The major source of income is coffee and inset is the stable crop. Coffee and Chat are cash crops.
Vegetables and fruits also grow in the area. The rural people depend on income earned from
agriculture and animal husbandry.

Dilla town has several business houses: hotels, shops, bars and cafes. Dilla has educational
institutions: 1 secondary, 5 junior secondary schools, kindergartens and a university with two
faculties namely teacher education and health science. It has one big hospital, a health center and
several private clinics and pharmacies. The majority are Christians and followers of Kalehiwot,

Mekane Eyesus, and the Ethiopian Orthodox church. Muslims are mostly in towns. Kalehiwet
protestant church is active in the rural sites and runs educational and health programs in addition
to its spiritual mission.

Kebele 08 in Dilla town and Chucha Farmers association were selected for the study. The data
collection involved interviews with thirty key informants (17 men and 13 women)*. The
institutions consulted include the wereda administration, health bureau, information bureau,
women's affairs, kebeles, wereda court, Dilla College of health Sciences, distinguished men and
women in the wereda, and Medane ACTS (a local NGO working on HIV/AIDS and reproductive

Annex 5:        Hamer Wereda in South Omo Zone, SNNPR

Hamer has a population of about 40,000 with 25 villages. The people are predominantly
pastoralists. Agriculture is practiced to some extent. The main source of livelihood is livestock.
Two sites were selected for the study: Demeka market and Shako peasant association. Demaka
market was selected because people from the nearby areas come to do marketing in the town.
Otherwise Hamers do not live in the town. Demeka has one government primary school, one
kindergarten and one government hostel for students. Religious institutions like orthodox,
protestant churches and one mosque are also in the town. There is an NGO of the Catholic
Mission, one clinic and one pharmacy. The catholic mission gives food aid and sends Hammer
children to government schools. In the other rural site there is 1-3 grade primary school, one
health post, one kalehiwot church. The church provides informal lesson on subjects like English,
Amharic and mathematics for its clients. There is also a health post although does not have drugs
to give to patients. ended here People here are expected to walk for about 3 hours carrying a
patient with stretcher to a place called Debeka for medical service.

Annex 6:        Yabelo Wereda in Borena Zone, Oromia

Yabello wereda is located in Borena Zone in Oromia . The people are mostly pastoralists and live
in the rural areas. Those that live in Yabello and other road towns belong to other ethnic groups
mostly Amhara and Guraghe. Cattle raising is a dominant economy. There are limited
agricultural and trade activities.

There are government structures and civil societies in the wereda. NGOs like Goal Ethiopia,
Action Aid and Care Ethiopia, Betel local NGO and AFD (Action for Development) are
available. Three primary schools, one junior secondary school and one high school are available.
One government health center and private pharmacy exist. In the rural peasant site studied there is
one primary school, a health post, catholic mission, and a mosque. There is an NGO called Fayu,
which is constructing school for the community and is providing micro-financing services. There
are community agents that give awareness raising education on HIV/AIDS.

Two rural sites were selected for the study. Arero is settled with people totally dependent on
cattle raising and Didabello with peoiple supplementing their cattle raising with some agricultural
activities. Twenty key informants were selected (11 men and 9 women). The key informants
included wereda and zonal leaders of sector ministries: wereda and kebele leaders; heads of
education and health; president of Yabello Court, head of zonal women's affairs. Program
coordinators of CARE, BETEL, and distinguished community leaders and elders were

Annex 7:        Yaya Gulele in Seimen Shoa, Oromia

 Yaya Gulele is located in Oromia, North Shewa. It has a population of 98,000 in 29 kebeles (2
 town and 27 rural kebeles). Agriculture is the major occupation; in town there are small trade
 activities like hotels and bars, shops. There is one government clinic, one private clinic and
 pharmacy. There are also government primary schools from grade 1-8 and 1-6 and there is no
 high school. An organization called Osho (Oromo self help organization) lent 1000birr for
 farmers who can pay back the loan by breeding and selling cattle and selling grains with profit
 when there is shortage of grain supply.

 Two sites were selected: Debre Tsighe and Tere Gherghis PAs.19 key informant interviews
 (13 men and 6 women) and two four FGDs and 200 structured interviews were made. The key
 informant interviews included representatives from government and NGOs namely wereda
 administration, kebele leaders and representatives of education and health offices, clinics and
 office of women's affairs.

Annex 8:        Fentale in East Shoa Zone, Oromia

Fantale wereda is loctaed in eastern Shoa and its werda town is Metahra, which is on the main
highway going from Addis Ababa to Djibuti. There are 18 PAS and 2 urban kebele in Metrahra
and Addis ketema. The population is about 90,000 and the rural population can be about
60,000.The kereyus and etu Oromos live in rural areas. The population in the road towns belong
to other ethnic groups such Amhara, Guraghe and Tigre and others.

Two sites were selected; Gola PA, live on irrigation and Debiti PA pastoralists. 28 key
informants (17 an and 11 women), four FGDs and 200 structured interviews were conducted.

Two ethnic groups that have distinct features of livelihood and religion inhabit the Wereda. The
Etu –migrants from Harar – are predominantly followers of Islam and are agriculturalists, while
the Kereyou – the natives of the Wereda - are pastoralits and the largely animist with Islam now
being adopted. The urbanization has influenced the behavior of the young generation in the
wereda, who formerly never consumed alcoholic drinks or visited prostitutes, this practice has
now become a common occurrence. The main sources of information for the community are
radio, kebele officials and rumor. NGOs like Care Ethiopia, CCF and Goal Ethiopia are found
and one mosque is available.

Annex 9:        Fedis in East Haraghe Zone, Oromia

Fedis is a wereda located in east Hararghe. It consists of 26 kebeles out of which one is a town
kebele called Boko, which is also the wereda headquarter. The population of the wereda is about
165,000, about 5000 live in the town. There are 28 schools: 1-8 (3); 1-4 (21) and 1-7 (4). The
participation of girls in second primary is low: in 2003 there were 2,249 girls and 6,354 boys
attending grades 1-4; and 278 girls and 1,350 boys attending grades 5-8. the people are
predominantly Oromo muslims and are agriculturalists and traders. CISP is a Germen NGO,
which gives water, seed and food support and works development activity in this community.
RRC is a governmental organization that gives food aid during starvation in collaborating with
the international organizations. Menschen fur Menschen used to give education to the
community to avoid the harmful traditions especially FGM but now they left this place

The study was conducted in two sites: Fedis wereda town called Boko and a rural farmers
association, which is described as HIV/AIDS corridor called Lencha. The key informants
included representatives of government officers: wereda administration wereda health and
education offices, women's Affairs, wereda court, health office, youth leaders, kadi court, bureau
for Islamic affairs, women wereda representative at region, clinic head, kebele leaders and
distinguished elders both men and women.


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