The HIV/AIDS epidemic sweeping across sub-Saharan Africa has been widely reported. In Ethiopia, attention has focused mainly on urban populations, despite the fact that most people live in rural areas. The spread and the effects of HIV/AIDS are often very different between these areas. Although the number of people who have HIV is estimated to be lower in rural areas than urban at present, greater understanding of the spread of HIV/AIDS within rural communities is required to prevent the problem reaching the levels experienced in the cities and towns.

Research from the Food and Agriculture Organization HIV/AIDS Programme, Italy, focuses on the situation in selected rural communities in eastern Ethiopia. Ethiopia has the second largest population in sub-Saharan Africa and 85 percent live in rural areas. Along with Nigeria, China, India and Russia, Ethiopia is predicted to experience the biggest increase in HIV/AIDS cases in the next few years. The potential loss of physically fit people in rural areas to farm represents a huge threat to a country that is heavily dependent on the agricultural sector for food production and generating export earnings.

The causes of HIV/AIDS transmission in rural areas differ from urban areas. The main risk is from people who are involved with HIV-risky activities in urban areas (namely having unprotected sex with an infected person) and then carry the disease into the rural community. These are known as ‘bridging populations’. Examples are:

• men staying away from home during markets, or seasonal migration
• young people staying away from home for secondary school, seeking employment or seasonal migration
• young women meeting high risk groups (for example, road construction workers and military personnel) whilst selling their produce in local markets.  They may also be at risk of rape on their way home from market
• workers moving between rural and urban areas, such as truck drivers and livestock traders.

In addition to specific factors that place different members of the community at risk of exposure to HIV, there are general factors that place rural communities at risk of infection.  These include:

• poverty, arising from insecure livelihoods that are unable to provide food and nutrition for all throughout the year
• limited access to HIV/AIDS information, in particular in the local language
• a lack of detailed understanding about HIV transmission, AIDS symptoms and methods of protection
• a lack of rural health services, including treatment for sexually transmitted infections, access to condoms, voluntary counselling and testing centres
• gender inequality: women and girls are disadvantaged with regard to safe sex due to discriminatory social and cultural practices
• silence and denial of the problem that arises from the problems associated with discussing sex.

Rural communities can play an important role in reducing the impact that HIV/AIDS may have on the population. Changing to crops that are less labour demanding will reduce the impact on food production of young people dying from AIDS-related illness. Increasing incomes through new forms of rural employment, such as bee keeping and blacksmithing, may reduce the need for travel to high-risk urban areas, especially amongst young people and women. The communication networks that exist in rural communities, along with training programmes at agricultural colleges, can be used to increase knowledge and awareness of HIV/AIDS.

Further research is required to understand the situation in different rural settings in Ethiopia more fully (such as small-scale irrigation schemes, state farms, commercial farms, pastoralists and peri-urban agriculture). This is vital, as there still exists an opportunity to tackle the problem before it takes over rural areas. Whilst the disease has had huge impacts in many parts of Africa, these could become even worse if greater efforts are not made to protect the agricultural community, on whom the region is so dependent.

Source(s):
‘The challenge of the HIV/AIDS epidemic in rural Ethiopia: averting the crisis in low AIDS-impacted communities’, Food and Agriculture Organization Sustainable Development Department, Rome, March 2004 Full document.

Funded by: Food and Agriculture Organization of the United Nations, HIV/AIDS Programme

id21 Research Highlight: 16 February 2005

Further Information:
Clare Bishop-Sambrook
Gender and Population Division
Sustainable Development Department
Food and Agriculture Organization
Rome
Italy

Tel: +39 06 570 53234
Contact the contributor: clare.bishop@fao.org

Food and Agriculture Organization, Sustainable Development Department

Other related links:
'Ageing rural populations: a blessing or a curse?'

'HIV/AIDS awareness and treatment: effective at fighting the HIV epidemic in rural Uganda?'

'Changing behaviour, changing disease – the case of HIV in rural Uganda'

See id21's collection of links relevant to HIV/AIDS

'The Impact of HIV/AIDS on Food Security' from the FAO committee on world food security

HIV/AIDS and agriculture - FAO factsheet