Ravano, Wendy V.El-Saharty, SamehAli, OmarAbdel-Rahmane, Maissa2017-08-102017-08-102010-10https://hdl.handle.net/10986/27713This 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.en-USCC BY 3.0 IGOACCESS TO TREATMENTADULT POPULATIONAGEDAIDS CASESAIDS EPIDEMICAIDS ORPHANSAIDS PATIENTSAIDS PROGRAMAIDS PROJECTAIDS PROJECTSANTENATAL SERVICESAWARENESS CAMPAIGNSBABIESBEHAVIOR CHANGEBEHAVIORAL CHANGEBLOOD BANKBLOOD DONORSBLOOD TRANSFUSIONCAPACITY BUILDINGCASE MANAGEMENTCASUAL SEXCHILD MORTALITYCHILD MORTALITY RATESCITIZENSHIPCIVIL SOCIETY ORGANIZATIONSCLINICSCOMMERCIAL SEXCOMMERCIAL SEX WORKERSCOMMUNICATION CHANNELSCOMMUNITY DEVELOPMENTCOMMUNITY HEALTHCOMPLICATIONSCOMPREHENSIVE CARECONDOMCONDOM DISTRIBUTIONCONDOM SALESCONDOM USECONDOMSCORRECT USE OF CONDOMSCOUNSELORSDEMAND FOR CONDOMSDIETDISCRIMINATIONDROPOUTDRUGSEARLY DETECTIONEPIDEMICEPIDEMIOLOGICAL SURVEILLANCEEPIDEMIOLOGYESSENTIAL MEDICINESEXISTING CAPACITYFAMILIESFAMILY HEALTHFAMILY HEALTH INTERNATIONALFAMILY MEMBERSFAMILY PLANNINGFAMILY WELFAREFEMALE GENITAL CUTTINGFERTILITYFERTILITY RATESFOCUS GROUP DISCUSSIONSGENDER INEQUALITYGLOBAL HIV/AIDSGOVERNMENT AGENCIESHEALTH CENTERSHEALTH EDUCATIONHEALTH FACILITIESHEALTH INFRASTRUCTUREHEALTH PLANNINGHEALTH POLICYHEALTH PROBLEMSHEALTH SECTORHEALTH SERVICESHEALTH SYSTEMHEALTH WORKERSHIGH-RISK GROUPSHIVHIV INFECTIONHIV PREVENTIONHIV TRANSMISSIONHOME VISITSHOSPITALHOSPITALSHUMAN DEVELOPMENTHYGIENEILLITERACYILLNESSESIMMIGRATIONIMMIGRATION STATUSIMMUNODEFICIENCYIMPACT OF AIDSINCOME-GENERATING ACTIVITIESINFANTINFLUX OF REFUGEESINSTITUTIONAL CAPACITYINTERCOURSEINTERNATIONAL COMMUNITYINTERNATIONAL COOPERATIONINTERNATIONAL RESPONSEINTERPERSONAL COMMUNICATIONINTERVENTIONLABOR FORCELACK OF KNOWLEDGELEVELS OF EDUCATIONLIFE EXPECTANCYLIVE BIRTHSLIVING CONDITIONSLOCAL COMMUNITIESMALARIAMANDATESMARITAL STATUSMASS MEDIAMATERNAL HEALTHMATERNAL MORTALITYMATERNAL MORTALITY RATIOMATERNITY HOSPITALSMEDIA COVERAGEMEDICINESMIDWIVESMIGRANTMIGRANT POPULATIONSMIGRATIONMILLENNIUM DEVELOPMENT GOALMINISTRY OF EDUCATIONMINISTRY OF HEALTHMORTALITYMOTHERMOTHER-TO-CHILDMOTHER-TO-CHILD TRANSMISSIONNATIONAL AIDSNATIONAL AIDS CONTROLNATIONAL CAPACITIESNATIONAL LEVELNATIONAL PLANNATIONAL POLICIESNATIONAL STRATEGYNUTRITIONOPPORTUNISTIC ILLNESSESOPPORTUNISTIC INFECTIONSORPHANSPARENTHOOD FEDERATIONPATIENTSPEER EDUCATIONPEER EDUCATORSPHYSICIANSPILOT PROJECTSPOPULATION GROUPSPOSTERSPREGNANT WOMANPREGNANT WOMENPRENATAL CAREPREVALENCE RATEPREVALENCE RATESPREVENTION ACTIVITIESPREVENTION INTERVENTIONSPREVENTION OF MOTHER-TO-CHILD TRANSMISSIONPREVENTIVE ACTIVITIESPRIMARY HEALTH CAREPROGRESSPROPHYLAXISPSYCHOLOGICAL SUPPORTPSYCHOSOCIAL SUPPORTPUBLIC HEALTHQUALITY CONTROLRADIORATE OF POPULATION GROWTHREFUGEESRELIGIOUS LEADERSRESOURCE MOBILIZATIONRISK FACTORSRISK GROUPSRISK OF INFECTIONRISKY BEHAVIORSCHOOL CHILDRENSCHOOL CURRICULUMSCHOOL YOUTHSCREENINGSECONDARY SCHOOLSSERVICE DELIVERYSERVICE PROVIDERSSEXSEX WORKSEX WORKERSEX WORKERSSEXUAL CONTACTSEXUALLY TRANSMITTED DISEASESSEXUALLY TRANSMITTED INFECTIONSSOCIAL AFFAIRSSOCIAL CLASSSOCIAL IMPACTSOCIAL MARKETINGSOCIAL MOBILIZATIONSOCIAL SERVICESSOCIAL STATUSSOCIAL SUPPORTSOCIAL WORKSOCIAL WORKERSSTISSUPPLY NEEDSSURVIVAL RATETECHNICAL ASSISTANCETELEVISIONTRANSPORTATIONTREATMENT SERVICESTUBERCULOSISTUBERCULOSIS CONTROLTVUNAIDSUNEMPLOYMENTUNFPAUNITED NATIONS POPULATION FUNDUNPROTECTED SEXURBAN AREASUSE OF CONDOMSVOCATIONAL TRAININGVOLUNTARY COUNSELINGVOLUNTARY TESTINGVULNERABILITYVULNERABLE CHILDRENVULNERABLE GROUPSWORLD HEALTH ORGANIZATIONYOUNG GIRLSYOUNG PEOPLEYOUNG PREGNANT WOMENYOUNG WOMENWorking PaperWorld Bank10.1596/27713