HIV/AIDS in the Horn of Africa

The Horn of Africa is a vast, diverse, impoverished and troubled region of 125 million people beset by famine, floods, conflict and disease. For the purposes of this chapter, we will consider the Horn to include Somalia, Djibouti, Ethiopia, Eritrea and Sudan; while it is not strictly located in the Horn, Libya will also be mentioned. Ethiopia and Sudan are the largest and most populous of the nations in the region, and have felt the brunt of its HIV epidemic. Unfortunately, instability in most of the region has made conduct of research and surveillance on HIV/AIDS particularly difficult. Ethiopia, however, has been a center of HIV research, most notably by the Ethiopia-Netherlands AIDS Research Project (ENARP). It is this research by Ethiopian and international investigators that provides the source of much of our knowledge about the regional epidemic. This chapter offers an overview of the regional epidemiology and social and environmental factors that affect it, as well as a country-bycountry assessment of epidemiologic trends and efforts to combat the epidemic, with a particular emphasis on Ethiopia.