Preventing HIV among adolescents and youth in rural Ethiopia

Mitike Molla is on May 28, 2009 defending her PhD at the University of Bergen.

The title is: Preventing HIV among young people: A community based study from Butajira on traditional norms, sexual health and HIV associated deaths. 

The health needs of young adults in Ethiopia are often neglected.  HIV is one of the major health problems among young people in Ethiopia, where the transmission often starts to pick up at the age of 15-24 years.

She interviewed 3743 young adults about sexual behaviours and sexually transmitted infections. She also asked about the attitude, opinion and knowledge of health providers towards young adults reproductive health needs. She used data from the Butajira Rural Health Programme, Demographic Surveillance Site to assess mortality trends among young adults aged 10-24 years.

She found the traditional norm of keeping virginity until marriage is still followed among the youth in rural South Central Ethiopia. Only 3% of the never-married youth had premarital sex, while almost all married youth started their union as celibates. Young adults who used alcohol, chewed khat, and did not believe in the traditional norm were more likely to have premarital sex. However, the study also showed that married women are vulnerable to HIV and other sexually transmitted diseases because of risky sexual behaviours among their husbands.

4% had had a sexually transmitted disease during the year preceding the study. Most of these were married women. Half of them who had STI symptoms did not seek help, mainly because of shame of having the infection in marriage and taboos related to premarital sex. Lack of readiness of the health services for the youth, unfavourable attitude of health professionals, women’s subordinate position in the society, and lack of knowledge about STIs among youth are possible reasons for low health seeking behaviour among young people. Six out seven of the sexually active young adults never used condoms.

Among young adults, the deaths rates declined during the period 1987-2004, with only a few deaths caused by HIV.

Upholding the traditional norm of virginity, prevention programmes should encourage HIV counselling and testing (HCT) before marriage, and faithfulness in marriage. Condom use among non-users should be encouraged and strengthened among ever-users to bring about consistent use in all non-mutual monogamous relations. The health services should be reoriented towards young adults’ SRH to improve use.

Mitike Molla’s PhD publications:

Molla M, Byass, P: Berhane Y, Lindtjørn B. Mortality decreases among young adults in south-central Ethiopia. Ethiop J Hlth Dev 2008; 22: 218-225.

Molla M, Berhane Y, Lindtjørn B. Traditional values of virginity and sexual behaviour in rural Ethiopian youth: results from a cross-sectional study. BMC Public Health. 2008;8:9.

Mitike Molla, Maria Emmelin, Yemane Berhane, and Bernt Lindtjørn. Youth in rural Ethiopia hesitate to seek health services for sexually transmitted infections: A mixed method research in Butajira, Central Ethiopia. African Journal of AIDS Research 2009, 8(2): 135–146

M. Molla A. Nordrehaug Åstrøm , Y. Berhane Y: Applicability of the theory of planned behavior to intended and self reported condom use in a rural Ethiopian population. AIDS Care, 2007, 19 (3):425-431.

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