Curbing the HIV/AIDS Epidemic in Djibouti
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World Bank, Washington, DC
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This study outlines the initial
challenge presented by the HIV/AIDS epidemic, describes
Djibouti's response, reviews the results achieved and
the enabling factors in curbing the spread of the epidemic,
and identifies remaining challenges. Between 2002 and 2008,
HIV prevalence among young pregnant women aged 15-24 was
reduced from 2.7 percent to 1.9 percent and among sentinel
surveillance groups from 2.5 percent to 1.9 percent. HIV
prevalence among tuberculosis patients was reduced from an
estimated 22 percent to 12 percent. Condom use during last
intercourse outside marriage increased from 27 percent to 55
percent and reached 95 percent among sex workers. Among the
general population, awareness of HIV/AIDS increased to 95
percent and knowledge about transmission and prevention rose
to 50 percent. Political commitment, engagement of community
and religious leaders, rigorous communication, social
marketing and the provision of an integrated package of
medical and social services, and donor harmonization were
among the key factors that contributed to the achievement of
these results. Despite these impressive results in a
relatively short period, Djibouti still has to address
several challenges and consolidate program gains, but most
importantly, funds are being mobilized from government
resources to sustain the national AIDS control program.
Palabras clave
ACCESS TO TREATMENT, ADULT POPULATION, AGED, AIDS CASES, AIDS EPIDEMIC, AIDS ORPHANS, AIDS PATIENTS, AIDS PROGRAM, AIDS PROJECT, AIDS PROJECTS, ANTENATAL SERVICES, AWARENESS CAMPAIGNS, BABIES, BEHAVIOR CHANGE, BEHAVIORAL CHANGE, BLOOD BANK, BLOOD DONORS, BLOOD TRANSFUSION, CAPACITY BUILDING, CASE MANAGEMENT, CASUAL SEX, CHILD MORTALITY, CHILD MORTALITY RATES, CITIZENSHIP, CIVIL SOCIETY ORGANIZATIONS, CLINICS, COMMERCIAL SEX, COMMERCIAL SEX WORKERS, COMMUNICATION CHANNELS, COMMUNITY DEVELOPMENT, COMMUNITY HEALTH, COMPLICATIONS, COMPREHENSIVE CARE, CONDOM, CONDOM DISTRIBUTION, CONDOM SALES, CONDOM USE, CONDOMS, CORRECT USE OF CONDOMS, COUNSELORS, DEMAND FOR CONDOMS, DIET, DISCRIMINATION, DROPOUT, DRUGS, EARLY DETECTION, EPIDEMIC, EPIDEMIOLOGICAL SURVEILLANCE, EPIDEMIOLOGY, ESSENTIAL MEDICINES, EXISTING CAPACITY, FAMILIES, FAMILY HEALTH, FAMILY HEALTH INTERNATIONAL, FAMILY MEMBERS, FAMILY PLANNING, FAMILY WELFARE, FEMALE GENITAL CUTTING, FERTILITY, FERTILITY RATES, FOCUS GROUP DISCUSSIONS, GENDER INEQUALITY, GLOBAL HIV/AIDS, GOVERNMENT AGENCIES, HEALTH CENTERS, HEALTH EDUCATION, HEALTH FACILITIES, HEALTH INFRASTRUCTURE, HEALTH PLANNING, HEALTH POLICY, HEALTH PROBLEMS, HEALTH SECTOR, HEALTH SERVICES, HEALTH SYSTEM, HEALTH WORKERS, HIGH-RISK GROUPS, HIV, HIV INFECTION, HIV PREVENTION, HIV TRANSMISSION, HOME VISITS, HOSPITAL, HOSPITALS, HUMAN DEVELOPMENT, HYGIENE, ILLITERACY, ILLNESSES, IMMIGRATION, IMMIGRATION STATUS, IMMUNODEFICIENCY, IMPACT OF AIDS, INCOME-GENERATING ACTIVITIES, INFANT, INFLUX OF REFUGEES, INSTITUTIONAL CAPACITY, INTERCOURSE, INTERNATIONAL COMMUNITY, INTERNATIONAL COOPERATION, INTERNATIONAL RESPONSE, INTERPERSONAL COMMUNICATION, INTERVENTION, LABOR FORCE, LACK OF KNOWLEDGE, LEVELS OF EDUCATION, LIFE EXPECTANCY, LIVE BIRTHS, LIVING CONDITIONS, LOCAL COMMUNITIES, MALARIA, MANDATES, MARITAL STATUS, MASS MEDIA, MATERNAL HEALTH, MATERNAL MORTALITY, MATERNAL MORTALITY RATIO, MATERNITY HOSPITALS, MEDIA COVERAGE, MEDICINES, MIDWIVES, MIGRANT, MIGRANT POPULATIONS, MIGRATION, MILLENNIUM DEVELOPMENT GOAL, MINISTRY OF EDUCATION, MINISTRY OF HEALTH, MORTALITY, MOTHER, MOTHER-TO-CHILD, MOTHER-TO-CHILD TRANSMISSION, NATIONAL AIDS, NATIONAL AIDS CONTROL, NATIONAL CAPACITIES, NATIONAL LEVEL, NATIONAL PLAN, NATIONAL POLICIES, NATIONAL STRATEGY, NUTRITION, OPPORTUNISTIC ILLNESSES, OPPORTUNISTIC INFECTIONS, ORPHANS, PARENTHOOD FEDERATION, PATIENTS, PEER EDUCATION, PEER EDUCATORS, PHYSICIANS, PILOT PROJECTS, POPULATION GROUPS, POSTERS, PREGNANT WOMAN, PREGNANT WOMEN, PRENATAL CARE, PREVALENCE RATE, PREVALENCE RATES, PREVENTION ACTIVITIES, PREVENTION INTERVENTIONS, PREVENTION OF MOTHER-TO-CHILD TRANSMISSION, PREVENTIVE ACTIVITIES, PRIMARY HEALTH CARE, PROGRESS, PROPHYLAXIS, PSYCHOLOGICAL SUPPORT, PSYCHOSOCIAL SUPPORT, PUBLIC HEALTH, QUALITY CONTROL, RADIO, RATE OF POPULATION GROWTH, REFUGEES, RELIGIOUS LEADERS, RESOURCE MOBILIZATION, RISK FACTORS, RISK GROUPS, RISK OF INFECTION, RISKY BEHAVIOR, SCHOOL CHILDREN, SCHOOL CURRICULUM, SCHOOL YOUTH, SCREENING, SECONDARY SCHOOLS, SERVICE DELIVERY, SERVICE PROVIDERS, SEX, SEX WORK, SEX WORKER, SEX WORKERS, SEXUAL CONTACT, SEXUALLY TRANSMITTED DISEASES, SEXUALLY TRANSMITTED INFECTIONS, SOCIAL AFFAIRS, SOCIAL CLASS, SOCIAL IMPACT, SOCIAL MARKETING, SOCIAL MOBILIZATION, SOCIAL SERVICES, SOCIAL STATUS, SOCIAL SUPPORT, SOCIAL WORK, SOCIAL WORKERS, STIS, SUPPLY NEEDS, SURVIVAL RATE, TECHNICAL ASSISTANCE, TELEVISION, TRANSPORTATION, TREATMENT SERVICES, TUBERCULOSIS, TUBERCULOSIS CONTROL, TV, UNAIDS, UNEMPLOYMENT, UNFPA, UNITED NATIONS POPULATION FUND, UNPROTECTED SEX, URBAN AREAS, USE OF CONDOMS, VOCATIONAL TRAINING, VOLUNTARY COUNSELING, VOLUNTARY TESTING, VULNERABILITY, VULNERABLE CHILDREN, VULNERABLE GROUPS, WORLD HEALTH ORGANIZATION, YOUNG GIRLS, YOUNG PEOPLE, YOUNG PREGNANT WOMEN, YOUNG WOMEN