'They were about to take out their guns on us': accessing rural Afar communities in Ethiopia with HIV-related interventions.

Although pastoralists are a significant proportion of the rural population in many African countries, they are often underserved with regard to health-related interventions. This paper presents data on an effort to provide information about HIV prevention and treatment to Afar people living in remote, northeastern Ethiopia. Using an evidence-based approach, we worked together with the National Network of Positive Women Ethiopians to build relations with Afar communities to design and test an intervention to improve HIV awareness. In this study we observed how multi-directional, local level perceptions--of Afar regarding HIV and existing health-related interventions, of staff from organisations regarding Afar and of the researchers conducting this study regarding Afar--shape the ways in which health-related interventions are offered to Afar and how these are understood by them. While the Afar people express a desire for culturally appropriate HIV-related interventions, few such initiatives have reached them to date. Organisations working in the area often believed that Afar people did not want to accept HIV and were therefore not responsive to their interventions. We argue that the specific history of the Afar people and how this affects their understanding of HIV needs to be better understood and integrated into HIV interventions.