Prejudice and discrimination against HIV/AIDs patients in Somalia remains at a very high level.
Those suffering with the disease find it difficult, if not impossible to mingle with the rest in the society.
Accessing employment opportunities is not easy while at the same time even landlords refuse to house victims of the disease.
Most of them are left to wallow and suffer in the streets occasionally getting help from a few well-wishers.
Their children also suffer discrimination. They are insulted in the streets and nobody wants to play with them even though they do not have the virus.
Their education has been badly disrupted because they have had to move home so many times due to the evictions.
Some of the older children regularly miss school because they have to look after their younger siblings while their mother hunts for work.
Some media channels refuse to run HIV and AIDS awareness campaigns because they do not want to be associated with the disease.
Private hospitals and pharmacies avoid stocking HIV/AIDs medication for fear that they will lose clients who do not want to have anything whatsoever to do with the disease.
The HIV programme manager at the Ministry of Health, Dr Sadia Abdisamad Abdulahi, says stigma reduction training for medical staff in public hospitals has significantly reduced prejudice. Now the ministry is training health workers in private facilities.
So intense is the stigma against those living with HIV and AIDS in Somalia that people are terrified of disclosing their status or even seeking life-saving treatment because they don’t want to risk others seeing them taking the medication.
Some of those who do seek treatment hide their faces when they go to hospital to receive care and medication. Women wear the full face veil or niqab; men use scarves. In Benadir hospital in the capital Mogadishu which is one of the few facilities offering care, nurses call patients by numbers not their names in order to protect their identities.
When people fall sick with symptoms of the disease they often shy away from taking an HIV test, preferring ignorance about their status to the prejudice they fear they will face.
Somalis’ reluctance to test for HIV not only means they miss out on treatment; it also makes it difficult to obtain accurate statistics about the rates of infection. According to UNAIDS, 7,700 adults and children were estimated to be living with HIV in Somalia in 2021, which is less than .0005% of the population.
It might be more helpful to consider the prevalence of HIV among prisoners, more of whom receive routine testing. According to UNAIDS the rate was 0.4% in 2019. Pregnant women are also tested more regularly. Dr Abdulahi says that in 2017, average HIV antenatal prevalence across Somalia was less than 0.1%.
She warns that the recent growth of drug abusers who inject themselves with opioids is putting a new group of Somalis at increased risk of catching the virus.
Since 2009, Somalia has developed four strategic frameworks for dealing with the disease and aims to eliminate HIV and AIDs from the country by 2030. But with an infrastructure destroyed by more than three decades of conflict, limited funding and such immense stigma against the disease, the challenges are immense.