Ethiopia has made significant strides in achieving national control over the HIV epidemic, but there are still pressing challenges in ensuring equitable access to HIV services across different demographics and regions. In 2022, the national HIV prevalence among adults stood at 0.91%, with notable variations between regions. Gambella and Addis Ababa reported the highest prevalence at 3.7% and 3.1%, respectively, while the Somali region had less than 0.1%.
The estimated number of people living with HIV (PLHIV) in Ethiopia is 610,350, with 61% being women. The regions of Amhara, Oromia, and Addis Ababa account for 75% of PLHIV. Alarming statistics reveal 8,257 new infections and 11,322 AIDS-related deaths in 2022. Adolescents and young adults, particularly women aged 15–19, are disproportionately affected, with a sevenfold higher infection rate among females.
Over the past two decades, Ethiopia has witnessed a commendable reduction in new infections (85%) and AIDS-related deaths (93%), attributed to the introduction and scaling up of Antiretroviral Therapy (ART). Mother-to-child HIV transmission has notably declined from 43% in 2001 to 12% in 2022, linked to the introduction of ART and the selection of Dolutegravir (DTG) as the optimal regimen for pregnant and breastfeeding women in 2019.
Care and Treatment
Ethiopia’s journey in providing free ART services has evolved, transitioning from CD4-based eligibility to the “Treat All” approach. The country has achieved the 2nd and 3rd 95 targets nationally, but disaggregation by adults and children reveals gaps. Approximately 84% of estimated PLHIVs know their status, with 98% on ART and virally suppressed.
Continued efforts are needed to sustain progress, address regional disparities, and enhance prevention and treatment strategies. Additionally, ensuring the availability of resources and support for vulnerable populations is crucial for sustaining the gains made in the fight against HIV/AIDS in Ethiopia.
HIV Prevention
HIV Testing Services and Prevention of Mother-to-Child Transmission
HIV testing services, including Index Case Testing, Partner Notification Services, and Voluntary Counseling and Testing, are offered across various health delivery points. In the fiscal year 2014, 7.2 million HIV tests were conducted, with considerable regional variation in test yields. Virtual elimination of Mother-to-Child Transmission (MTCT) of HIV, syphilis, and hepatitis is a priority, with comprehensive Prevention of Mother-to-Child Transmission (PMTCT) services available in over 2,865 health facilities. Despite progress, challenges persist in addressing regional variations, late ANC attendance, and gaps in syphilis testing compared to HIV testing. The adoption of DTG-based regimens for PMTCT is endorsed, but there is room for improvement in ensuring enhanced postnatal prophylaxis.
HIV Response and Prevention Strategies
Ethiopia's HIV response centers on a combination of prevention interventions, encompassing health facilities and community-level strategies. These include social and behavioral change communication, condom distribution, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), Voluntary Male Medical Circumcision (VMMC), STI diagnosis and treatment, harm reduction for drug users, and addressing Gender-Based Violence.
Social and behavioral change communication efforts have reached over five million youth and key populations, but there are challenges in implementing peer education programs effectively. Female Sex Worker (FSW) programs exhibit relative success, but there is a need for improved segmentation to target specific vulnerable groups within the FSW population.
High-risk adolescent girls and young women remain a priority, yet program implementation and defined intervention packages are limited. Other vulnerable groups, including long-distance drivers, divorced and widowed
individuals, and sero-discordant couples, face challenges due to funding shortages and a lack of guidelines.
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HIV and AIDS by the Numbers:
Funding
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- The Global Fund provides 30% of all international financing for HIV programs.
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- The Global Fund have invested US$24.2 billion in programs to prevent and treat HIV and AIDS as of June 2022.
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- The Global Fund have invested US$5 billion in TB/HIV programs as of June 2022.
Prevention
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- 12.5m people were reached with HIV prevention services in 2021.
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- Around 670,000 HIV-positive mothers received medicine to keep themselves alive and prevent transmission of HIV to their babies in 2021.
Testing and Treatment
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- 23.3m people on antiretroviral therapy for HIV in 2021.
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- 70.8 million HIV tests were taken in 2021 in countries where the Global Fund invests.
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- 12.6 million of these HIV tests were taken by priority and key populations, including infants, adolescent girls and young women, adolescent boys and young men, gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs, people in prisons, and other vulnerable populations.
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- 70.8 million HIV tests were taken in 2021 in countries where the Global Fund invests.