Original article HIV prevalence and socio-cultural contexts of sexuality among youth in Addis Ababa, Ethiopia

Background: Periodic cross-sectional studies that combine data on HIV/AIDS prevalence with behavioural survey can help assess the extent of disease prevention and control efforts overtime. Objectives: Estimate the prevalence of HIV infection and examine the contexts of sexuality among youth (15-24 years) in the city of Addis Ababa, Ethiopia. Methods: Unlinked, anonymous screening of air-dried saliva for HIV-1 IgG antibodies using BionorTM HIV-1&2 rapid ELISA kit and focus group discussions on young people’s sexuality. Results: Of the 677 study subjects, 20 (3.0%) tested positive for HIV-1 antibodies. Of the 319 youth in school, 1 (0.3%) was positive, while of the 358 youth out-of-school, 19 (5.3%) were positive. In the focus groups, parents were blamed for their stereotype attitudes towards young people's sexuality and for failing to provide vital information and support. Young people were faced with enormous pressure to engage in sex, especially from peers, exposure to unlicensed erotic video films and the desire for economic gain. Love relationships lacked adequate romantic period for partners to learn more about each other and negotiate condom use. Cultural shaping of young people's sexuality gave privileges for males to be sexually active, be in control of sexual relationships and be less responsible for precautions to prevent HIV/AIDS. The youth in general sensed their excessive vulnerability to HIV/AIDS but lacked individual motivation and skills to practice safe sex behaviour. Conclusion: HIV is significantly prevalent among youth in Addis Ababa, particularly out-of-school and female youth. Different socio-cultural contexts of sexuality and gender norms underpin this excess vulnerability. [Ethiop.J.Health Dev. 2002;16(2):139-145