1.2.2 Increased vulnerability of people living with HIV/AIDS

‘People living with HIV/AIDS in emergency conditions are more prone to suffer from disease and death as a consequence of limited access to food, clean water, and good hygiene than are people with functioning immune systems.'
Source: World Food Programme 2004. HIV/AIDS & emergencies: Compounding crises.

People living with HIV/AIDS are more prone to illness and death as a result of the emergency, and therefore must receive assistance and care that addresses their particular vulnerability. They are also more prone to epidemics, and their illness can have an impact on increased food insecurity and economic recovery. HIV/AIDS can aggravate the crisis, and delay the recovery and reconstruction rehabilitation.

The provision of care and treatment for people living with HIV/AIDS is also affected by emergencies. Caregivers may be killed or injured during an emergency. Health care systems break down (attacks on health centres, inability to provide supplies, flight of health care staff), and populations have limited access to health facilities because roads are blocked or mined, and financial resources are even more limited than usual.

PLWHA who have been receiving ART prior to the emergency are often unable to gain access to life saving drugs in emergency settings.  Many ART regimens are interrupted through displacement, lack of proper records and the breakdown of social services. Inability to access treatment is life threatening, but even the interruption of regimens can have severe impacts on one’s health and can cause the surfacing of resistant strains. Modification of treatment regimens in response to availability of drug supplies should also be mitigated, and as much effort to maintain regimen consistency as possible should be prioritized in the response.

Per WHO guidelines, continuation of treatment for those already on treatment prior to the crisis should be considered a priority intervention and part of the minimum initial response to HIV even during the acute phase of an emergency.  Organizations responding to emergencies and health providers have a vital social responsibility to continue treatment to the best of their ability. Emergency preparedness plans must integrate the issues of HIV treatment in order to save lives and mitigate the impacts of HIV.