When Lhe nurse dlscovered l was Plv posluve, she was Loo

ashamed Lo call me back Lo Lhe hosplLal. lnsLead, she Lold

members of my community. I was immediately disowned.
My neighbours forced me to leave my house they thought
I could infect them. They thought I had a killer disease.
Now I live alone; I am isolated.
HIV and AIDS: Rarely discussed
HIV and AIDS is rarely discussed in Somalia. Perceived as
an lmmoral dlsease," Plv-relaLed sugma remalns a ma[or
challenge. Pusseln Passan, Lhe lnLernauonal Crganlzauon
for Mlgrauon's (lCM) PealLh CoordlnaLor ln Somalla sLaLes:
Many people Lhlnk LhaL Plv can be Lransmlued vla waLer,
food or Lhe human Louch. Mlsconcepuons lncrease sugma
and deLer people from ndlng ouL Lhelr sLaLus."
des
Awareness raising
lunded Lhrough Lhe Clobal lund Lo llghL AluS, 1uberculosls
and Malaria (ClA1M), lCM and parLners are sensluzlng
vulnerable populauons on Plv prevenuon, sexual and
gender-based vlolence and Lhe rlghL Lo healLh. ln 2011, over
300 peer educaLors were Lralned across Somalla Lo LargeL
aL-rlsk populauons lncludlng porL workers, Lruck drlvers and
female khat (a herbal sumulanL) sellers.
Cur volces musL be heard
lor vulnerable persons already llvlng wlLh Plv, lCM has
partnered with the Youth AIDS and HIV Network (?APAn)
Lo provlde a space where Plv posluve men and women can
share Lhelr experlences and advocaLe for sugma reducuon.
Known as the Network for People Living with HIV in Puntland,
members are slowly galnlng Lhe condence Lo dlscuss Lhelr
HIV status.
Powever, we sull have a long way Lo go Lo lncrease Plv
awareness and curb sugma, buL wlLh lCM's supporL, Lhls
forum ls glvlng people back Lhelr dlgnlLy, and a new sense of
communlLy. 1hey can now share Lhelr experlences openly
wlLh each oLher, Lhey no longer need Lo feel so alone," says
?APAn ulrecLor.
A Plv posluve mlgranL member, who prefers Lo remaln
anonymous, adds: l nd lL hard Lo Lell people my sLaLus. l
hope one day our voice will be heard that is the aim of this
forum. Cnly Cod can klll me, noL Lhls Plv. l know my sLaLus,
so now Lhe only problem l have wlLh my llfe ls sugma."
As many dlsplaced women are sleeplng ouLslde, or ln
Lemporary shelLers, sexual and gender-based vlolence
ls Lraglcally common. lCM and parLner, We Are Women
Acuvlsts, are Lralnlng vulnerable dlsplaced and mlgranL
women on mlrco-nance.
8ape and physlcal vlolence ls a blg lssue here, especlally ln
Lhe lu camps. lf we can oer women an lncome, we can
empower Lhem. 1hey can Lhen sLarL Lo exerclse Lhelr human
rlghLs," sald peer educaLor Shukrl larah Mohamed who has
been Lralned by lCM.
Filling the strategic data gap
WlLh exLenslve experlence ln conducung quallLy research
ln conlcL and posL-conlcL semngs, lCM conunues Lo ll
Lhe evldence gap Lo advlse Lhe nauonal Plv response and
advocate for targeted programming to be implemented at
scale.
ln 2008, an lCM hoL-spoL mapplng sLudy ldenued key
populauons where Lhe Plv epldemlc ls concenLraLed. Also
ln 2008, lCM led Lhe rsL ever Plv and syphllls lnLegraLed
biological and behavioural surveillance survey among
female sex workers ln Pargelsa. 1he sLudy found LhaL of 219
female sex workers lnLervlewed, 69 per cenL were mlgranLs,
and none knew their HIV status. 93 per cenL lacked correcL
prevenuon knowledge and 28 per cenL had never used a
male condom.
ln 2010, an assessmenL on Plv and sexual and gender-
based violence among vulnerable and displaced women
ln Somallland found LhaL sysLems for asslsung survlvors
of sexual and gender-based vlolence need sLrengLhened
coordlnauon and sLronger lmplemenLauon.
uaLa gaLhered by lCM was used as an evldence base for
Somalla's success ln lLs ClA1M 8ound 8 appllcauon and has
dlrecLly reshaped Lhe nauonal Plv response ln Somalla.
Scale-up needed for Plv comblnauon prevenuon
Awareness ralslng and reduclng Plv sugma ls an lmporLanL
rsL sLep, however, lL musL lead Lo more eecuve evldence-
based programmlng. Chlakl lLo, lCM's PealLh rogramme
Cmcer for Somalla, sLaLes: 1hrough our programmlng
and research we have ldenued Lhe LargeL populauon and
hlghllghLed Lhe programmauc gaps. now we need Lo oer
targeted male and female friendly services that combine
blomedlcal lnLervenuons, behavloural change, and acuvlues
that address underlying determinants of risk behaviour and
service access.
SCALE-UP NEEDED FOR HIV COMBINATION
PREVENTION IN SOMALIA
.................................................................
We geL cash-ln-hand, so lL ls
easy to go to into town and get
female partners.
Aer Lralnlng by uan-uor &
lCM l now know LhaL Plv can
be Lransmlued by sex. We wlll
be more careful in future.
lCM and local parLner uan-uor have sensluzed numerous porL workers ln Lhe
unLland SLaLe of Somalla on Plv Lransmlsslon and prevenuon. Many porL workers ln
8ossaso are mlgranLs from war-Lorn SouLh CenLral Somalla.
lCM and local parLner, we Ate womeo Acuvlsts, have sensluzed numerous Lruck
drlvers on Plv Lransmlsslon and prevenuon. 1ravelllng long dlsLances across Somalla,
LLhlopla and u[lbouu, many drlvers spend hours on Lhe road. Lonely, away from
famlly, and wlLh dlsposable lncome, Lruck drlvers are an aL-rlsk populauon.
We have S1l lnfecuons, buL no
healLh faclllues Lo LreaL Lhem. lL
ls Loo expenslve."
We have to travel very long
[ourneys. We geL lonely, whlch
makes us vulnerable.
People believe that Muslims cannot get HIV so they do not check themselves or their
parLner. Pavlng Plv ls very shameful ln Lhls communlLy, so only when people are bed-rldden
do Lhey go and see a docLor. lCM's sLudy on Plv and young people ls a groundbreaklng sLarL,
buL more lnLervenuon ls needed."
AbJotobmoo 5oeeJ Moso, neoJmostet of Nowowl 5cbool - o key pottoet wltb lOM ooJ tbe
lootlooJ Alu5 commlssloos 2011 yootb & nlv sotvey
ln !une 2010, lCM embarked on one of Lhe rsL sLudles explorlng Plv
knowledge and prevalence among young people in Somalia. Preliminary
ndlngs suggesL LhaL only 0.3 per cenL of 13 - 24 year olds ln unLland
could correcLly ldenufy ways of prevenung Lhe sexual Lransmlsslon of
Plv. 1he omclal reporL ls expecLed Lo be publlshed ln CcLober 2011. ln
parLnershlp wlLh nauonal AluS commlsslons and several schools, Plv
sensluzauon was also conducLed.
lCM and parLners, 8lollL and WAWA, have sensluzed female khat and tea sellers and
lnLernally dlsplaced women ln areas where sexual and gender-based vlolence ls a recurrlng
issue.
We are boLh Plv posluve, l
have been kicked out of my
home. 1hank you lCM for
providing us with a forum
where we can share our
experlences and noL feel so
alone.
8efore Lhe Lralnlng, l had heard abouL
Plv, buL l had no ldea how lL was
Lransmlued. now l know LhaL you can
geL Plv Lhrough sex, or blood."
Sexual and gender-based
vlolence ls common here,
so it is important we learn
about HIV.
Peer educators train
displaced women
suscepuble Lo sexual and
gender-based vlolence on
mlrco-nance.