Gender Dimension of HIV related Stigma in Ethiopia Wubayehu Guangul Network of networks of Ethiopian Positives (NEP+)

Overview of the epidemic in Ethiopia Total Population 73,918,505 HIV prevalence 2.3% Male 1.8% Female 2.8% Urban 7.7%, (Male 6.2%; Female 9.2%) Rural 0.9% (Male 0.7%; Female 1.1%) According to EDHS surveillance survey 2010 Now thought to be closer to 1.2 million

People living with HIV 1,116,216 Pregnant women living with HIV 84,189 HIV+ births 14,140 Children living with HIV 72,945 Annual AIDS deaths 44,751 The highest incidence age for women is 20-29 years and men 25-34 years

PLHIV Stigma Index Methodology Data was collected in 2010, report published in 2011 The PLHIV Stigma Index questionnaire was used by PLHIV to collect quantitative data from 3353 PLHIV from all regions of the country. In addition 30 focus group discussions were conducted with 240 PLHIV to collect qualitative data.

Partners involved WHO, FHAPCO, PLHIV Networks and Associations, UNAIDS Ethiopia, Tulane University, Christian Aid, EIFFDA, Consultants(Research partners), FGAE

Why gender? Gender inequalities in Ethiopia are deep rooted and exacerbate HIV. As a result, women and girls living with HIV experience double stigma - HIV and gender. We hope to unite gender, HIV  and stigma which are all part of the same puzzle.

Key findings Women living with HIV are at lower socio-economic status than men living with HIV (36 % 0f Women & 21%mem are getting monthly below14.8 USD. Women are more likely disclose their status to family members (apart from their husbands) while men are more likely disclose their status to their wives/partners

25% women are unemployed compared to 14% of men. PLHIV have relatively better confidence in health personnel than any other group Self-stigma, prevailed among both, however women blame others whilst men blame themselves.

Self Stigma amongst men and women in Ethiopia %

Health findings Males are more sexually active (61%) than women (39%) PLHIV are denied family planning & SRH services because of their HIV status . There is high level of mother to child transmission. (only 8% received PMTCT) 28% of PLHIV reported that they have a child / children known to be living with HIV

“We get free examination … but when we reach the pharmacy the pharmacist says to us the drug is not available if he/she sees we got examined for free.” “the fact that our [medical] cards are different from the other patients is a stigma by itself.”

Gaps & Opportunities for to reduces stigma in health settings…… Educate Health Care Professionals More access to PMTCT Improve accessibility and affordability of health care Ensure newly diagnosed are retained by health and support services Need for stigma reduction and awareness activities in Ethiopia

Workplace findings 95% of females and 93% of males are below extreme poverty level More women are unemployed are than men (25% vs. 14%).

Gaps & opportunities to reduce stigma in workplace settings.... Educate employers on what it means to empower PLHIV rather then marginalise them. Develop Work Place Policies Income generation programmes for PLHIV

Social findings Women (71%) are more likely to be aware of being gossiped about compared to men (66%) Education more than 75% of men had completed primary education whereas only 56% of women had. Women experienced 2% more physical assault then men

Percent of respondents who reported physical assault by their relation to the assaulter and sex

Gaps & opportunities to reduce stigma in social settings…… Gender inequality must be considered in the HIV response. There is a greater need to educate and raise awareness of HIV to increase understanding and therefore improve the situation of PLHIV in society.

Rights findings A significant number of PLHIV have the awareness about Declaration of Commitment on HIV/AIDS and the HIV/AIDS policy of Ethiopia. 17% PLHIV had experienced abuse of their rights because of their HIV status

Gaps & opportunities to improve the rights…… PLHIV need to learn more about their rights There is need to provide legal support for the rights of PLHIV in Ethiopia What about national legislation

Next Steps Strengthen the capacity of PLHIV & PLHIV organizations Realizing GIPA at all level Address gender inequality in HIV programming Increase awareness level of PLHIV on their rights

For more information www.stigmaindex.org Thank you