Jul 27, 2025 | blog, Sexual Health
This July, as part of Letena Ethiopia’s HIV Awareness Month, we spoke with Mrs. Krittayawan Boonto, a seasoned public health expert with over two decades of experience across Asia and Africa who currently leads UNAIDS efforts in Ethiopia as a UNAIDS Country Director, to gain an understanding of the state of Ethiopia’s HIV response. We entered the conversation recognizing the progress that had been made. But we left with something more pressing: stories of burnout, budget gaps, and young people facing the crisis in isolation.
UNAIDS, the Joint United Nations Programme on HIV/AIDS, is the UN’s leading body driving the global response to HIV. It brings together the resources and expertise of 11 UN agencies to support countries in preventing new infections, expanding treatment access, ending stigma, and ultimately ending AIDS as a public health threat by 2030. In Ethiopia, UNAIDS works closely with the government, civil society, and international donors to align efforts, fill data gaps, and keep the HIV response accountable and inclusive.
Over the past twenty years, Ethiopia has made significant progress in fighting HIV. The 90-94-96 numbers speak for themselves: many people living with HIV know their status, are receiving treatment, and have achieved viral suppression. These results didn’t occur by chance; they came from long-term investments, community outreach, and the dedicated efforts of health professionals. But that progress is now under threat.
Here’s what many don’t realize: 94% of Ethiopia’s HIV response is funded by external donors. In 2025, major budget cuts from programs like PEPFAR and the Global Fund dealt a blow to the country that it was not prepared for. These cuts aren’t abstract. They translate into fewer services, stalled outreach programs, and broken trust.
This isn’t just about systems or spreadsheets. It’s about real people. During a recent visit to Bahir Dar and Afar, Mrs. Boonto and her team saw the gaps firsthand. Community health networks, peer educators, and expert patients, who help others with testing, care, and adherence, are in a vulnerable position. Their funding has been completely cut off, leaving many without the resources to continue their work. In some areas, medications are no longer available, and several service delivery centers have shut down entirely. In regions affected by conflict or displacement, mobility is also a challenge; some community health workers can’t even move safely to reach the people in need.
Then there’s the youth, the part of the epidemic we still aren’t addressing properly.
Despite being more digitally connected than ever, many young people in Ethiopia lack basic knowledge about HIV. On our own Letena platform, which reaches thousands of youth across the country, we regularly hear staggering misconceptions. These aren’t rural or uneducated voices who have limited access to information, but rather many are the urban and misinformed youth.
Some don’t know where to go for testing, others wait until they’re seriously ill before seeking care, and far too many believe HIV is a problem of the past. The silence around HIV in Ethiopia is dangerous. As Mrs. Boonto noted, “HIV has fallen off the radar.”
But it shouldn’t be. Especially not now.
This is a crucial moment. If HIV fades from view, years of progress risk being undone. The truth is, Ethiopia’s youth are not just at risk; they are essential to ending the epidemic. But they need better tools, accurate information, and sustained support.
That’s why digital innovations matter.
UNAIDS plans to launch a new chatbot in September, drawing from successes in countries like Indonesia. The goal is to create a safe and anonymous space where young people can ask questions, express concerns, and get linked to services, without fear or shame.
At Letena, we’ve already seen how this approach works. Our content speaks openly about sex, consent, prevention, and testing. And because we speak honestly, youth respond. They ask for help, share their stories, and follow up.
Even just having someone hear them out can make a difference. And this is why Mrs. Boonto emphasizes the necessity of enhancing and expanding existing efforts by supporting more youth-led groups, volunteer networks, and community-based programmes. To support Ethiopia’s HIV response, we need to invest in the people who are already involved and encourage more young individuals to take on leadership roles. However, empowering youth and building community networks is just one part of a much larger equation. We also need to address the systemic barriers that still hold many people back. Having medical supplies alone will not solve the issue. Stigma and discrimination continue to prevent individuals from seeking care. Moreover, displacement, poverty, and fear prevent individuals from getting the help they need.
Overcoming these barriers takes more than just logistics or infrastructure; it requires trust, consistency, and care from people who understand the local realities. And of course, building that kind of system can be challenging. But, making that vision a reality needs political will and ongoing funding, both of which are currently in short supply. Ethiopia’s Ministry of Finance and the Ministry of Health proposed a plan to tax workers to fund domestic HIV efforts. But the proposal stalled in parliament due to economic hardship and public pushback.
So, where does that leave us? It leaves us needing local innovation. It means empowering health extension workers with specialized HIV training. It means expanding safe digital platforms that meet young people where they are. It means scaling peer-led programs in universities and towns. It means fostering youth ownership and empowerment, transforming them from passive recipients into active participants who drive Ethiopia’s HIV response.
This won’t be solved by one ministry, one agency, or one donor. It will take collective action from local governments, community organizations, health professionals, educators, and young people to show up and move forward.
And finally, to Ethiopia’s youth:
You’re not just the spectators in this fight; you’re in the middle of it. As Mrs. Boonto made clear, the fight isn’t over. And it won’t be won without you. What we do now determines what comes next. Let’s not wait until it’s too late. So learn the facts, call out the silence, share what you know, support your friends, and stay curious.
Help bring the issue back into the spotlight.
Written by : – Bezawit Elias, Fourth Year Medical Student
Jul 20, 2025 | blog, Sexual Health
Discussing condom use isn’t always easy, but it’s necessary. When it comes to HIV prevention, communication and protection go hand in hand. Whether the relationship is casual or long-term, setting boundaries around safe sex protects both partners and fosters mutual respect.
Why Condom Use Matters
Condoms remain one of the most effective and accessible tools to prevent the transmission of HIV. When used correctly and consistently, they provide a physical barrier that reduces the risk of HIV infection through sexual contact.
According to UNAIDS:
• Nearly 60% of new HIV infections in 2023 occurred in Sub-Saharan Africa, making it the most affected globally.
• In Ethiopia, an estimated 610,000 people were living with HIV in 2023, with around 8,300 new infections that year.
• Condom use among young people in Ethiopia remains low. A 2022 DHS report found that only 32% of young women and 52% of young men reported using a condom during their last high-risk sexual encounter.
These numbers highlight the urgent need for open conversations about protection and consistent condom use.
Common Barriers to Condom Use
Many people still hesitate to use condoms due to myths, discomfort, or social pressure. Common objections include:
• “Don’t you trust me?” – Condom use is about health and prevention, not distrust.
• “It doesn’t feel the same.” – While some may experience a difference, the risks of HIV far outweigh any temporary discomfort.
• “It kills the mood.” – Taking a moment to protect each other should be seen as part of a healthy sexual relationship.
“The art of the deal” how to negotiate condom use (without killing the mood or causing World War III)
- Bring it up early
Don’t wait until the heat of the moment. Discuss condom use calmly and ahead of time.
- Use clear, respectful language
Express your preference using “I” statements, such as “I use condoms to protect my health.”
- Stay calm if there’s resistance
If your partner is hesitant, ask why and listen. Then explain your reasons clearly. Avoid arguments, but stand firm.
- Respect your own boundaries
If your partner refuses to use a condom, it’s your right to say no to sex. Your health comes first.
If Your Partner Says No
• Stay calm, but don’t compromise.
• Ask questions to understand their reasoning.
• Do not give in to guilt or emotional pressure.
• If your boundaries are not respected, walk away.
To wrap it up (pun definitely intended)
Talking about protection and condom use might not be anyone’s idea of foreplay, but neither is an unexpected trip to the clinic. Whether you are in a situationship, long-term love bubble, or just figuring it out with someone new, this is about knowing your worth, your standards, and your health priorities. You don’t need to be aggressive, and you don’t need to be apologetic. Because at the end of the day, for as long as you are clear, confident, open, and maybe a little charming. The only thing that should be going raw is your sense of humor.
Written by : – Kidus Solomon, 4th Year Medical Student
Jul 13, 2025 | blog, Sexual Health
It all started when I was in 5th grade. I got sick at school, and the principal called my mom, telling her I was experiencing severe abdominal pain. She rushed me to the hospital, and I was diagnosed with appendicitis. But that year, those few days in particular, changed everything for me.
That was when I learned something that made me feel inferior to other students, to my family members, and to people in general. My dad told me I was HIV positive. He even told my friends’ families, thinking they would show me a little more empathy or keep an eye on me when I played with their children. But instead, he shattered the privacy and innocence I had. At that age, no one really keeps secrets, especially not ones like that.
Even though deep down I know I am not the problem, it’s hard not to connect every experience of rejection to that one truth about me. Every time I was bullied at school, left out of events, or looked at differently, I couldn’t help but think it was because of that.
Now, I’m a second-year university student. Here, no one knows the virus that lives within me. To them, I’m just a girl from a well-off family who’s accomplished everything she set her mind to. I have friends, some really close ones, too, the kind I share nearly all my secrets with. But they still don’t know the biggest one.
Sometimes, I think about the guys who flirt with me, who ask me to sleep with them without knowing who I really am. And I wonder what I would’ve done if I hadn’t come this far in my healing journey.
Over the past few years, I challenged myself to grow beyond the darkness in my own mind. I started listening to motivational podcasts on YouTube, reading all kinds of books, and journaling to keep track of my growth and achievements. I began taking my medication consistently, something my mom used to remind me to do every day. Now, I don’t need her to check in. I eat well, sleep well, and I’m fully focused on becoming the best version of myself.
Still, I feel a deep sadness for my mom. I can’t imagine how much guilt she’s carried, thinking she’s the one who brought this into my life. And truthfully, I didn’t make it easy for her either, and that breaks my heart. Now, I’m trying to spend as much time with her as I can. I’m working on that.
So, when Hermon asked me to share my story and give some advice, here’s what I want you all to know:
You are not the problem. One day, you’ll see that clearly. And when that day comes, you’ll be proud of how far you’ve come.
Written by : – Hermon Israel, 4th Year Medical Student
Jul 7, 2025 | blog, Sexual Health
HIV is a virus that attacks the body’s immune system. If left untreated, it can lead to AIDS, a condition where the immune system becomes very weak and unable to fight infections. While HIV is a serious health issue, it is not a death sentence. With proper knowledge and the right tools, young people can protect themselves and others from it. Even those living with HIV can live long, healthy lives.
An important aspect of the fight against HIV that has been often overlooked in awareness campaigns is the knowledge about its powerful medications. Apart from the ABC method (Abstain, Be Faithful, Use Condoms), these medicines are the cornerstone of HIV treatment. They can be functionally grouped into three: PrEP, PEP and ART.
What is PrEP?
Pre–Exposure Prophylaxis (PrEP) is protection aimed at reducing risk of HIV infection when risk of infection is high. It is a daily pill taken by people who are HIV-negative but are at high risk of getting HIV. It can be recommended for individuals who are assumed to have unavoidable exposure such as those whose partners are HIV-positive. When taken consistently, PrEP can reduce the risk of HIV by over 90%.
PrEP is available in many health facilities in Ethiopia, especially in urban areas like Addis Ababa, Hawassa, and Bahir Dar. It is safe, free in many centers. If you think you’re at risk, ask your nearest healthcare provider about PrEP.
What is PEP?
Post–Exposure Prophylaxis (PEP) is an emergency medication for people who may have already been exposed to HIV. PEP must be started within 72 hours (3 days) after exposure, such as through unprotected sex, sexual assault, or a needle injury. Many of the drugs used in PEP are also used in the prevention of HIV from mother to a child.
PEP is taken for 28 days and can significantly reduce the chance of infection. The earlier PEP is started, the more effective it is. If you think you may have been exposed to HIV, don’t delay, go to a nearby health center immediately. Time is critical.
What is ART?
Antiretroviral Therapy (ART) is the treatment for people living with HIV (PLHIV). ART doesn’t cure HIV, but it helps people live healthy, full lives by reducing the amount of the virus in the body. When taken regularly, ART can lower the viral load to undetectable levels, meaning the virus can’t be detected by standard blood tests. This also means it can’t be transmitted to others during sex. This is known as U=U (Undetectable = Untransmittable).
Anyone diagnosed with HIV should start ART as soon as possible. The earlier treatment begins, the better the health outcomes. ART is free and available at many health facilities in Ethiopia.
What can you do?
Get tested regularly: Only 86% of PLHIV are aware of their status
Use condoms and communicate with your partners: Barrier contraception is the only contraception that protects against HIV
Share what you learn, help break the silence and stigma.
HIV is preventable and manageable. With the right choices, you can lead the way to a healthier, HIV-free generation.
Written by :- Dr. Hosaena Gebru
Jun 29, 2025 | blog, Sexual Health
One weekend in Addis, just like any other, Natty had a friend visiting from the States, someone he hadn’t seen in a long time. They decided to catch up by going out for drinks and enjoying the vibrant nightlife, indulging in all it had to offer. As the night unfolded, they met new people at the clubs, and Natty took a liking to someone with whom he danced, drank, partied and eventually left the scene.
“I would describe it as a mix of euphoria and excitement,” he later said. On the way home, buzzed and unguarded, the heat of the moment gave way to an encounter that felt harmless in its simplicity, fleeting, quick and easy to tuck away. He didn’t think much of it at the time. He didn’t think at all. That was until a few days passed and the “present” he’d unknowingly brought back with him began to unwrap itself.
“I primarily worked as a ride driver and my evening was going like any other day at work. I’d made a quick stop to relieve myself, and that’s when I felt it, a burning sensation followed by a white discharge after finishing. I immediately ran back to my car, heart thudding in my chest, gripped by a storm of emotion.”
There was panic, yes, but not only for himself. It was the timing, the questions he wasn’t ready to ask, let alone answer. The memory of that night started to feel different now, sharper around the edges. What seemed like a moment of freedom had taken a turn he hadn’t imagined.
He spent hours spiraling through internet searches that only made things worse. He couldn’t sit still. The silence in the car was deafening. There was someone waiting for him at home. Someone he loved. Someone who had trusted him.
He didn’t know what to say. He didn’t know if he should say anything. He didn’t even know what exactly he was dealing with. His chest tightened every time he thought of how close they had been just the night before, how careless it had all been.
“Still, my mind couldn’t figure out who to talk to,” he said. “So I called a friend I knew in medical school and told him what was happening, about the night, the symptoms.”
“My voice was probably shaking. He laughed a little at first, maybe because I was rambling, or maybe to ease the tension. But then he got serious and walked me through what I needed to do.”“Relax, man. It’s probably gonorrhea or chlamydia. It sounds textbook. You’ll need a urine test, maybe a swab. They’ll treat you right away, usually a shot and a pill, nothing dramatic.” He told him to be honest at the clinic, to mention how it happened, and reminded him that oral encounters aren’t risk-free, even if people pretend they are. “It’s treatable. Just don’t wait, it’s a good thing you contacted me early on.” And somehow, that calm, matter-of-fact tone held Natty steady.
What lingered, though, wasn’t just the discomfort. It was the realization of how little he’d understood about risk, how something so seemingly minor could ripple out into something far more complicated. The experience stayed with him, not just in body, but in the spaces between trust, guilt, and silence. He learned about STIs that day, especially the kind people rarely talk about. And in doing so, he came face to face with a version of himself he could no longer afford to be.
Disclaimer: All names and places in this story have been changed to protect the privacy of those involved. While the details have been anonymized, the events described remain true.
Written by : – Kidus Solomon, 4th Year Medical Student
Jun 22, 2025 | blog, Sexual Health
Today’s youth are more informed and connected than ever, but when it comes to sexual health, gaps in knowledge still lead to risky choices and bad decisions. Sexually Transmitted Infections (STIs) remain a major health issue. Whether you’re in a committed relationship, exploring new ones, or somewhere in between, it’s crucial to understand how STIs show up and what you can do to stay safe.
STIs are passed from one person to another through sexual contact, including vaginal, oral, and anal sex. Many are treatable, especially when caught early. In Ethiopia, where lab testing may not be easily accessible, STIs are diagnosed and treated using a syndromic approach. This means healthcare providers look for clusters of symptoms to decide on the best treatment. Let’s look at the three most common ones:
- Urethral and Vaginal Discharge
If you notice unusual discharge from your penis or vagina, and it is accompanied by a burning sensation during urination, or itching, you are most likely dealing with bacterial or fungal infections. These point to infections like gonorrhea or chlamydia and, in women, could also be a sign of bacterial vaginosis, trichomoniasis, or candidiasis (commonly known as yeast infection). STIs presenting with discharge are usually all curable with appropriate regimen of antibiotics.
- Genital Ulcers
Painful or painless sores, ulcers, or open lesions on the genitals or mouth are among the most commonly seen symptoms. They may indicate infections like syphilis, herpes, or chancroid. While treatable, these conditions can lead to serious complications or large wounds if ignored. Painless ulcers are especially dangerous, as they often go unnoticed but can still spread infection.
- Genital Warts
Genital warts are often caused by HPV (Human Papillomavirus). While some strains only cause warts, high-risk types can lead to cervical and other cancers. The HPV vaccine offers strong protection when given between ages 9–14, before any exposure. For women who are already sexually active and may have been exposed, regular cervical cancer screening is essential for early detection and prevention.
What Should You Do?
- Get Tested Regularly:
Even if you feel fine, STIs can often be asymptomatic. If you are sexually active, make testing a regular part of your health routine.
- Use Protection:
If used properly and consistently, condoms are 98% protective of STIs. Carry protection with you and don’t be afraid to insist on its use.
- Talk About It:
Have honest conversations with partners about STI status and testing. It’s not awkward, it’s responsible.
- Seek Care Early:
If you notice any symptoms, however mild you may perceive them to be, don’t wait. Go to a health center for evaluation and treatment. In Ethiopia, the diagnosis and treatment of most STIs is free at public health facilities.
- Complete Treatment & Inform Partners:
Finish the full course of any medication you’re prescribed, and let your partners know so they can get treated too.
Sexual health is just as important as physical or mental health. Staying informed and proactive protects not just you, but your partners and your future. If you have any questions pertaining to your sexual and reproductive health reach out to us, Letena Ethiopia, using any of our platform.
Written by : Dr. Hosaena Gebru
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