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STIs/HIV/AIDS

The relationship between conflict and vulnerability to STIs, including HIV/AIDS, is complex. In humanitarian settings, the vulnerabilities for STI transmission include sexual violence and opportunities for sexual abuse and exploitation, the presence of workers in high mobility jobs (truck drivers, peace keepers), transactional sex, alcohol and drug use, lack of information and access to condoms and high population density in camps. Studies have shown that the factors that affect HIV transmission specifically in humanitarian settings are multifaceted, and depend on many dynamic and interacting factors, including the HIV prevalence in the region of origin and that of the host population, the level of interaction between displaced and surrounding populations, the duration of displacement and the location and level of isolation of the displaced population (urban vs. camp-based refugees).

It is important to consider that even with low prevalence rates in refugee or IDP camps, the stage is set for STIs, including HIV, to quickly spread in the absence of appropriate and effective interventions. 

Key Messages:

The disruption of HIV treatment is often a concern during humanitarian emergencies. Of the 1.7 million people living with HIV who were affected by humanitarian emergencies in 2013, almost 1.3 million did not have access to treatment. The treatment gap is particularly acute amongst children and adolescents.

HIV interventions should be routinely incorporated in all humanitarian emergency preparedness and response programmes, including disaster risk reduction to ensure the continuation of comprehensive HIV services during humanitarian emergencies. The introduction of innovative approaches such as decentralized stock piles and Health Travel Cards can help ensure the continuity of treatment in emergencies.

STIs have a profound impact on sexual and reproductive health worldwide, and can increase the risk of HIV acquisition. STI prevention and management must be part of a larger public health package and it must be integrated into family planning, adolescent reproductive health and maternal and newborn health services.

Facts & Stats

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8% to 90% of the global burden of STIs occurs in the developing world. An estimated 340 million episodes of curable sexually transmitted infections (chlamydial infections, gonorrhoea, syphilis, trichomoniasis) occur throughout the world every year.

Reference: WHO, Global Strategy for the Prevention and Control of Sexually Transmitted Infections: 2006-2015: Breaking the Chain of Transmission, Geneva, 2007.

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The total number of people living with HIV increased from previous years, even as more people are receiving life-saving antiretroviral therapy. At the same time, the number of AIDS-related deaths is also declining with 1.6 million AIDS deaths in 2012, down from 2.3 million in 2005.

Reference: UNAIDS, 2013 Report on the Global AIDS Epidemic, 2013.

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Women who have experienced intimate partner violence are 50% more likely to be living with HIV.

ReferenceUNAIDS, 2013 Report on the Global AIDS Epidemic, 2013.

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Globally, women comprise 52% of all people living with HIV in low- and middle-income countries. However, in Sub-Saharan Africa, the center of the global epidemic, women still account for approximately 57% of all people living with HIV.

Reference: UNAIDS, 2013 Report on the Global AIDS Epidemic, 2013.

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Political conflicts and war are commonplace in Africa and affect the risk of HIV/AIDS by interrupting normal social networks, increasing poverty and social instability, and weakening or destroying medical infrastructure. Women are disproportionately infected compared to their male counterparts.

Reference: Ramjee, G., & Daniels, B. (2013). Women and HIV in Sub-Saharan Africa. AIDS Research Therapy. doi:10.1186/1742-6405-10-30