Matija Kovac/The IRC
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Sexually Transmitted Infections and HIV

Elizabeth*, a widow with six children, remembers the first day she went to be tested for HIV. “It was frightening and I walked up to the door of the testing center but I didn’t go in,” she says. When she gathered the courage to go back and get tested, she found out that she was positive and went to the hospital to get treatment. But Elizabeth notes that many women in her Kenyan community face social stigma that makes it harder for them to get the treatment they need. “Community members are not very supportive to people living with HIV/AIDS.” Elizabeth and a group of women in her town are working to change this by taking others to get treatment and providing them with ongoing support.

(Adapted from  “The Challenges of Living with HIV/AIDS in Northwestern Kenya,” The IRC Blog, Joanne Offer, 1/19/2010).

Sexually Transmitted Infections

Sexually transmitted infections thrive under crisis conditions and in unstable societies, where extreme poverty and lawlessness are prevalent. And, women and girls are particularly vulnerable to infection, with limited access to prevention, treatment and care—and their family and community lives disrupted.

During crises, adolescents may begin to have sexual relations at an earlier age and women and children may be coerced into having sex in order to meet their survival needs. During times of war or conflict, the risks of sexual abuse, domestic violence and exploitation rise. Additionally, close proximity to peacekeeping forces, military and police has long been associated with higher rates of sexually transmitted infections (STIs).

Sexually transmitted infections have significant consequences for global public health. According to the World Health Organization (WHO):

  • Each year 448 million new infections of curable STIs (syphilis, gonorrhea, chlamydia and trichomoniasis) occur.
  • In pregnant women with untreated early syphilis, 25 percent of pregnancies result in stillbirth and 14 percent in neonatal death.
  • STIs are the main preventable cause of infertility, particularly in women.

Any emergency health response must include treatment for STIs and ensure these services are readily available, as highlighted in the Inter-agency Field Manual on Reproductive Health in Humanitarian Settings, the authoritative guidance for reproductive health care in crisis- and conflict-affected areas.

HIV and AIDS

In 2010, there were approximately 34 million people living with HIV globally. In the past, humanitarian agencies did not offer HIV and AIDS programs when responding to emergencies, because HIV/AIDS was not perceived as an immediate, life-endangering threat. However, the humanitarian community now acknowledges that HIV and AIDS prevention and treatment must be provided from the early stages of an emergency. Essential HIV programs should be developed following the Inter-agency Standing Committee (IASC) Guidelines for HIV/AIDS in Emergency Settings and the Inter-agency Field Manual on Reproductive Health in Humanitarian Settings. At the onset of a new crisis, aid workers should ensure that:

  • Condoms are available, free of cost
  • Standard precautions to prevent the spread of infections (including HIV) are taken in health care settings, (e.g. safe blood transfusions)
  • Those already on antiretrovirals continue to receive treatment
  • Measures are taken to prevent mother-to-child transmission of HIV

The Women’s Refugee Commission is committed to ensuring that guidance for preventing and treating STIs, including HIV, is fully implemented at every stage of a humanitarian emergency and that standards are met consistently.  

Our Work

  • The Women’s Refugee Commission, with its partners, has been piloting a community-based model to provide medical care to survivors of sexual violence (including such measures as providing antibiotics to prevent STIs). The community-based model, if deemed safe and feasible, may be a promising approach in providing care to survivors of sexual assault.
  • The Women’s Refugee Commission has worked with its collaborative partners to develop training tools on sexual and reproductive health, including Guidelines for the Care of Sexually Transmitted Infections in Conflict-affected Settings and HIV/AIDS Prevention and Control: A Short Course for Humanitarian Workers.

Related Reports and Tools

*Names changed for anonymity