More than 100 million condoms will be distributed annually to sex workers, men who have sex with men and other groups vulnerable to HIV as part of a new five-year programme to be run by the Ethiopian government and the US President's Emergency Plan for AIDS Relief (PEPFAR).
Dubbed MULU, the Amharic word for comprehensive, the US$70 million programme - implemented by the NGOs Population Services International and World Learning - will also target day labourers in the booming construction industry, migrant workers and their partners.
"Over the five-year life of MULU prevention, 100 million free condoms per year will be distributed, 2 million counselling and testing sessions will be conducted, and half a million sexually transmitted infection cases will be treated," said Donald Booth, US Ambassador to Ethiopia, launching the programme on 31 May 2012 in the capital, Addis Ababa.
"This programme is going to focus on… getting services for people who practice high-risk behaviours such as having multiple sex partners concurrently," Renee DeMarco, a senior technical advisor to HIV/AIDS Prevention and Social Services at the US Agency for International Development (USAID)-Ethiopia, told IRIN/PlusNews.
Ethiopia has a relatively low national HIV prevalence of 1.5 percent, but a 2011 Demographic and Health Survey puts the rate in urban areas at 5.2 percent, significantly higher than the 0.8 percent generally found in rural areas.
Residents of Addis Ababa say the number of sex workers has gone up in recent years, as the city has grown. One its poorest areas, Autobis Tera, hosts a large number of commercial sex workers, who stand at the gates of their tiny houses every evening waiting for clients.
"It's a life - a hard one," said Betty*, who struggles to pay her 400 birr (about $23) rent each month. "On good days I make 20-30 birr [$1.10-$1.70], but those days are very few."
Every cent is precious, and Betty says even the cost of a condom factors into her negotiations with clients. "Some clients come with their own condoms, which is good, but most don't," she said. "Some demand a certain type of condom. I tell them, 'Go buy and bring it yourself'. It is two or three birr for a condom... that buys a breakfast."
The new programme aims to ensure people like Betty use a condom with all their clients. It will also facilitate HIV prevention services for men who have sex with men, who have until now been left out of the country's HIV prevention plans.
"We know anal intercourse is the most dangerous way in which you can contract HIV, or spread HIV... persons who are engaging in that behaviour, we want to make sure they get services," said USAID's DeMarco.
"We are very much committed to working with healthcare providers so that they are sensitive to this issue. When their clients come and they have complaints, we want the healthcare providers equipped to provide the services in a way that is responsive to the clients."
The Ethiopian government says the new programme will contribute to its goal to halve the number of new HIV infections and quadruple the distribution of condoms by 2015.
*not her real name