Sexually Transmitted Infections, including HIV/AIDS
The risk factors for the spread of STIs increase when there is instability
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- The 2005 Human Development Report identified AIDS as the factor inflicting the single greatest reversal in human development history.1
- In most settings, sexually transmitted infections (STIs), including HIV, spread fastest where there is poverty, powerlessness and instability--these factors are characteristic of displaced settings.2
- Vulnerability to STIs for refugees and displaced persons include poverty, food insecurity, lack of access to health services, mobility and lack of protection against violence and/or exploitation by military, peacekeeping forces and others.3
- In some contexts, decreased mobility and access may be protective against the spread of HIV among displaced populations.4
- Although refugees may have higher or lower HIV prevalence rates than their host communities, they often suffer from the perception that they “bring HIV/AIDS” with them.5
- The power imbalances that make girls and women disproportionately vulnerable to the infection become more pronounced during conflict and displacement.6
- Gender-related factors, such as breakdown of social and community structures and increased gender-based violence (GBV), can contribute to the spread of HIV in these settings.7
- HIV transmission among conflict-affected and displaced populations is complex. The common assumption that these populations’ increased vulnerability necessarily translates into more HIV infections is not supported by data. Various competing and interacting factors affect HIV transmission during conflict and displacement.8
- When planning HIV programming in humanitarian settings, RH officers and program managers must consider:
- The combined impact of humanitarian emergencies and HIV, including factors that may increase vulnerability to HIV;
- existing policy and practice in humanitarian response that aim to prevent the spread of HIV and mitigate its impact;
- the availability and accessibility of prevention, care and treatment services for people living with HIV (PLHIV),including interruption, restarting or continuation of antiretroviral treatment;
- stigma and discrimination against people infected and affected by HIV.9
- While behavioral and biological data on HIV in situations of forced migration is slowly increasing, information is currently available to help design, implement and evaluate HIV/AIDS programs.10
- A mathematical model developed by Supervie et al., has indicated that the use of HIV prevention and treatment programs for rape survivors could potentially reduce HIV incidence in conflict affected countries.11
- In the context of complex emergencies, effective HIV/AIDS interventions are possible and necessary. At the onset of a new crisis, it is possible to guarantee the availability of free male and female condoms and enforce respect for universal precautions against HIV/AIDS.
- The passing of UN Resolution 1308 in July 2000 urged UN agencies and member states to develop effective HIV/AIDS prevention strategies in peacekeeping missions. As a result, most peacekeeping missions now have HIV/AIDS policy advisors and progress has been made in controlling the effect of HIV/AIDS in conflict zones.12
- Despite UN Resolution 1308, gender units in peacekeeping missions are often lacking and agencies still need to adequately address the link between HIV/AIDS and women.13
- As adolescents’ transition into adulthood, RH programs and services that have skilled health providers, in combination with other social services including comprehensive sexuality education, can help prevent unwanted pregnancies, maternal mortality and morbidity, as well as sexually transmitted infections including HIV/AIDS.14
Note: Links provided only if resource is available to public.
2 UNAIDS/UNHCR, Strategies to support the HIV-related needs of refugees and host populations,
3 UNAIDS/UNHCR, Strategies to support the HIV-related needs of refugees and host populations,
4 Spiegel, PB., HIV/AIDS among conflict-affected and displaced populations: dispelling myths and taking action. Disasters 2004; 28: 322-39.
5 Spiegel, B., A. Nankoe, UNHCR, HIV/AIDS, and Refugees: Lessons Learned, 2003; SMEC International, A Social and Gender Assessment of HIV/AIDS among Refugee, IDP and Host Populations in the Great Lakes Region of Africa, November 2005.
8 Spiegel, PB., HIV/AIDS among conflict-affected and displaced populations: dispelling myths and taking action, Disasters 2004; 28: 322-39.
9 Reproductive Health in Humanitarian Settings: An Inter-agency Field Manual, Inter-agency Working Group on Reproductive Health in Crises, revised for field-testing, 2010.
11 Supervie,V., Halima Y., & Blower, S. (2010) Assessing the impact of mass rape on the incidence of HIV in conflict-affected countries. AIDS DOI:10.1097/QAD.0b013e32833fed78
13 E. Rehn, E. Johnson-Sirleaf, Women, War and Peace: The Independent Experts' Assessment on the Impact of Armed Conflict on Women and Women’s Role in Peace-building, UNIFEM, 2002.
14 Laski, L. & Wong, S. (2010). Addressing Diversity in Adolescent Sexual and Reproductive Health Services. International Journal of Gynecology and Obstetrics. 110, 510-512.
Updated December 2010. Please note: while this site is periodically updated, it is up to the user’s discretion to verify that the facts provided are the most current.
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