War poverty and the AIDS epidemics in Ethiopia.

The major war mounted in Northern Ethiopia in 1962 continued for 30 years. At one point Ethiopia had one of the largest army in Africa approximately 250000 troops. Having sexual intercourse yet often unwilling to practice safer sex soldiers are both especially vulnerable to HIV infection and potentially capable of transmitting the virus from place to place as they move about and between war zones. Emergency blood transfusions in the field are also a mode of HIV transmission among troops. A 1991 Ministry of Health report stated that 17.5% of government military troops were infected with HIV. After the fall of the former government in June 1991 many troops were abandoned and expected to return to the various parts of the country from which they had come. Neither blood testing nor health education programs were offered to the troops prior to their repatriation. HIV-infected ex-soldiers are now spread across Ethiopia most likely infecting others through unprotected sexual intercourse. Organized interventions against AIDS were not possible in the war zone areas. War in Ethiopia therefore both created conditions favorable for the spread of HIV and impeded the necessary actions for its prevention and control. Compounding the problem are the approximately 9.5 million civilians displaced mainly due to war drought and famine during 1977-92 the approximately 90000 people displaced in February 1992 in one of the southern regions of the country due to tribal and ethnic conflicts and refugee in-migration from neighboring countries where there has been significant sociopolitical turmoil in recent years. Unemployment is high the divorce rate has increased and prostitution is booming in major towns and cities. Recent prevalences of HIV infection in Ethiopia are thought to be 2.3% 44% 15% and 2.45% among blood donors commercial sex workers truck drivers and scholarship students respectively.