Tigray was once considered a model in the fight against HIV. Years of awareness-raising efforts had brought the region’s HIV prevalence rate to 1.4%, one of the lowest in Ethiopia.

Then, in 2020, war began between Ethiopia’s government, backed by neighboring Eritrea, and Tigray fighters.

Now, the average monthly positive rate has “increased considerably”, said Akberet Mengesha, the Anti-retroviral therapy Department Coordinator at the Ayder Refferal Hospital in Mekele, Tigray region.

Sexual violence was widespread in the two-year conflict, which also had mass killings, hunger and disease. As many as 10% of women and girls aged between 15 and 49 in the region of 6 million people were subject to sexual abuse, mostly rape and gang rape, according to a study published by BMJ Global Health in 2023.

At the same time, Tigray’s health system was systematically looted and destroyed, leaving only 17% of health centers functional, according to another study in the same journal.