HIV, like in other areas of Ethiopia, has spread to towns and the countryside. Kellem is one of the zones that have suffered more from HIV due to a number of reasons. Despite the poverty of much of its population, it is rich in natural resources and one of the more known producers of coffee, which is the main export article of Ethiopia. During the coffee harvest season which lasts for several months, very large numbers of daily workers from other regions, truck drivers and their assistants flood both urban centres and the countryside. Coffee is a source of money which comes in for a few months to farmers, labourers, petty merchants, brokers and others. There are also commercial and casual sex workers mainly from bigger towns and cities who come in for their share. Traditionally, coffee harvest season is a time of plenty and merrymaking. The family man who sells his coffee and does not stay in town to enjoy the company of friends and ladies can become the laughing stock of his friends. Initially, people were completely oblivious to the presence of the disease. Those who had heard about did not know how it spread. This holds true even today for some districts in the zone.

When Walal started its activities on HIV Prevention, Care and Support in July 2005, the HIV stigma was so strong that despite the common knowledge that there were bed-ridden people everywhere, not a single one was found to start with. The fear of being found to have the virus, of being isolated from the community, of not being offered even a menial job, of being derided and shunned was so intense that no amount of encouragement could be effective. Much work had to be done and although, at first, it looked like it was wasted effort, it did bring the desired effects. People started discussing it, learning about it, de-demonizing it and being sympathetic of the HIV carriers as patients of just another disease. Today, in a few of the zone's districts, a moderate understanding of the disease has been reached. This is not so for most of the districts where, except sporadically, very little work has been done.

AIDS is bound to poverty very tightly. Despite the awareness, poverty and the low awareness of the community in general of women's rights, play a decisive role in keeping the disease going. Walal intends to continue working on awareness creation on school children (43% of the population are below 13) and vulnerable groups like adolescents, commercial and casual sex workers and unemployed youth. Income generation activities are a main component of its work. It might be the best tool for keeping all these away from liquor and drugs whose abuse is skyrocketing. Walal has been implementing a project on the prevention, care and control of AIDS in three districts from July 2005 to June 2009. Despite the termination of this project, no funds have been obtained for its continuation and expansion to the rest of the 11 districts.