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HOME: STATE OF WORLD POPULATION 2004: Reproductive Health for Communities in Crisis
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Reproductive Health for Communities in Crisis

Safe Motherhood
Family Planning
Sexual and Gender-based Violence
HIV/AIDS and Other STIs
Adolescent Reproductive Health
Gains and Gaps

HIV/AIDS and Other STIs

All sexually transmitted infections, including HIV/AIDS, thrive under crisis conditions, which coincide with limited access to the means of prevention, treatment and care.

Other conditions increasing the risk of exposure in emergencies include:

  • Large movements of people;

  • The break-up of stable relationships and the disintegration of community and family life;

  • Disruption of social norms governing sexual behaviour;

  • Adolescents starting sexual relations at an earlier age;

  • Coercion of women and adolescent girls and boys to exchange sex for food, shelter, income and protection;

  • Mixing of populations with higher rates of HIV infection;

  • Increased risk of sexual violence, including rape.

Rape by infected men directly exposes women to HIV, and resulting abrasions or tearing of vaginal tissues may increase the risk of infection dramatically.

In some conflicts, the planned and deliberate HIV infection of women has been a tool of ethnic warfare. An association of Rwandan genocide widows found that two thirds of its members who had been raped by Hutu militants were HIV-positive.

While data on HIV prevalence in refugee settings are scarce, it is believed that displaced populations are at increased risk of contracting the virus during and after displacement.(4)

The STI/HIV/AIDS interventions needed in refugee settings, once the situation has stabilized, are much the same as those for settled populations: information and education, condom promotion and distribution, use of syndromic case management for STIs, voluntary counselling and testing for HIV, precautions to ensure safe blood supply, and prevention of mother-to-child transmission.

But in post-conflict settings like Liberia and Sierra Leone, where years of war and continual displacement have created a situation in which growing HIV/AIDS prevalence poses a major threat to postconflict reconciliation and reconstruction, UNFPA and partners have developed a more comprehensive approach (see Box 28, page 71).

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