Determinants of Vulnerability to HIV in Urban Settings in Ethiopia

Background: Although urbanization is associated with improved access to services, urbanization poses health disparities and vulnerability to health problems particularly HIV is pronounced in urban setting. However, there is... [ view full abstract ]

Background: Although urbanization is associated with improved access to services, urbanization poses health disparities and vulnerability to health problems particularly HIV is pronounced in urban setting. However, there is limited evidences on determinants of such vulnerability in Ethiopia. This study seeks to identify determinants of vulnerability to HIV in selected urban centers.
Methods: We conducted series of focus group discussions and in-depth interviews with a total of 150 community members as well as 40 in-depth-interviews and 15 case studies with selected residents in six purposively selected cities. Data was coded and categorized manually and analyzed thematically.
Result: Finding shows that it is not only people who are vulnerable, but also specific places in the towns. While factors of vulnerability for places include being hub of in-migrants and transistors, loose social controls and restraints. Such residents as daily laborers, Female Sex Workers, students living away from family, widows, separated and divorced women, girls who work in restaurants and those in petty trade were found to be relatively more vulnerable to HIV infection. These same section of the population were not using available HIV services due lack of awareness, competing priorities to generate their livelihood and cost of services; institutional factors related to availability of supplies and equipment, decreased number of institutions providing support as well as stigma associated to HIV infection.

Conclusion: In conclusion different group of people are vulnerable to different problems and different sections of the towns show different level of vulnerability. Therefore, every urban need to be mapped to determine which groups of people are vulnerable to selected social, economic and health factors and which section of the town is vulnerable to these defined problems so that authorities plan interventions accordingly. Vulnerability to HIV has roots in various sectors that require coordinated multi-sectoral response.
Keywords: HIV, Vulnerability, Ethiopia