Some neglected and emerging factors in HIV transmission in Ethiopia

: Although comprehensive information is needed on HIV transmission for planning of interventions, several modes of transmission are either understudied or are newly emerging. The objective of this review is to evaluate the potential role of illicit drug injection, penile-anal sex, and male circumcision in HIV transmission in Ethiopia. Injecting drug use is an emerging HIV risk as a result of the expanding international drug traffic. Penile-anal sex, which has been denied by the Ethiopian and other African societies, constitutes a high HIV risk that remains underreported. Recent studies indicate that male circumcision may be added as an effective supplemental prevention measure in the low-circumcision areas of southwestern Ethiopia. Suggestions are made for further epidemiological and operational research of these three factors in HIV transmission.