3.4.5 Prevention of HIV/AIDS
As social networks and livelihoods collapse due to emergencies and conflicts, people are subjected to situations that are known to increase their vulnerability and risk to HIV. An individual’s access to information and services-including prevention information, condoms or health care-is either limited or completely cut off.
Loss of livelihoods and income may force women and adolescent girls into transactional or commercial sex; many women have to trade sex for food or security, making contraception a necessity. Increased interaction between military, peacekeepers and local populations also put women and men at risk of contracting HIV and other sexually transmitted infections (STIs), especially when they practise unsafe sex (without condoms). Women and girls seldom have control over sexual negotiation or the relationship. Men who have sex with men (MSM) as well as LGBT populations may be disproportionately affected and marginalized, so may need particular attention in service delivery for HIV prevention/treatment as well as other STIs.
A minimum package of services should be in place to prevent transmission of HIV/AIDS among the population affected by the emergency. This includes free condoms, safe blood supply, universal precautions for infection prevention, relevant information and education, case management of STIs, and basic health care for people living with HIV/AIDS. HIV control activities should be continually informed by assessing local needs and circumstances. See also Chapter 41 HIV/AIDS. Refer to Annex 26.5.6 for a list of the minimum requirements for infection control.
Vertical transmission of HIV from mother to child must also be considered in the prevention response. Current guidelines recommend that all pregnant women of unknown status be offered HIV testing and counseling, and that all women testing HIV+ should receive an appropriate prophylactic regimen to reduce the chance of HIV transmission during delivery and post-partum. HIV+ mothers should also receive counselling on exclusive breastfeeding of infants for the first 6 months to further reduce the chances of transmission of the virus.
HIV control activities should be continually informed by assessing local needs and circumstances. See also Chapter 9.3 HIV/AIDS. Refer to Annex 26.5.7 for a list of the minimum requirements for infection control and for UNAIDS best practices on HIV and emergencies.