Preventing the spread of HIV by educating in Ethiopia


Meriem and Akberet in a counseling session. Akbetet, a former sex worker, is now married and expecting her first child. Photo: John Snow, Inc.
In 2009, twenty-year-old Akberet Kahsay’s life took a change for the worse after she left her safe but economically challenged life in rural Wukro to work as a waitress in the town of Shire. Just as Akberet was adjusting to her new life, a friend started calling, painting rosy pictures of life in the town of Adigrat and promising Akberet more money and an easier life if she moved there. Eventually, Akberet succumbed to the temptation of a better life and moved to Adigrat. When she got there, however, Akberet discovered what her friend had failed to mention: she earned her money by selling sex. Akberet, with no other work or resources, was soon doing the same.

Akberet lived in constant fear of HIV infection and despaired at how her life was derailed from the future of love, marriage, and the family that she had imagined for herself. In 2011, however, she met Meriem Adem, an Urban Health Extension (UHE) professional working in Akberet’s catchment area. Meriem helped Akberet understand her risk of HIV infection and walked her through the steps of prevention, including consistent and correct condom use, and the importance of knowing her HIV status. Akberet agreed to have an HIV test, and, upon finding out that she was negative, gained renewed hope for the future. Soon, Meriem was able to convince her to stop working as a commercial sex worker.

Meriem received a 3-month pre-service training that was conducted by the Tigray Regional Health Bureau with financial and technical support from the JSI-managed USAID/Urban Health Extension Program. Her skill-based health needs and risk assessment training also provided her with the knowledge and skills to help Akberet decrease her risk of HIV infection.

Today, Akberet is married and expecting her first child. She beams as she recalls Meriam’s support. “Meriem helped me see that I still had a bright future. Her continuous counseling, sincerity, and persistence helped me to see that my case was not hopeless and I could change my life if I wanted.” She adds, “I hope she will continue to give similar service to the friends I left behind and help them as she helped me.”