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Increasing the Capacity of Humanitarian Practitioners to Address HIV/AIDS in Complex Emergency Setti

Due to the increased vulnerability to sexually transmitted infections experienced by refugees and internally displaced persons, it is critical for humanitarian practitioners in situations of forced displacement to know how to effectively address STI/HIV/AIDS issues. Sexually transmitted infections, including HIV/AIDS, thrive under crisis conditions. Limited access to the means of prevention, treatment and care as well as the disruption of community and family life all serve to make people more vulnerable to infection.

Adolescents may begin sexual relations at an earlier age and women and children may be coerced into having sex to obtain their survival needs and during times of civil strife they are especially at increased risk of sexual violence, including rape. There is also closer proximity to peacekeeping forces, military and police, a population which has long been associated with higher rates of sexually transmitted infections. And, in refugee settings people from low HIV areas may mix with populations from high prevalence areas, increasing the overall HIV rate in the region. Sexually transmitted infections have been neglected in refugee settings and humanitarian workers have only very recently had access to comprehensive guidelines on HIV/AIDS diagnosis, prevention and care in forced migration and/or emergency settings. Humanitarian workers in the field are a critical link in the effort to prevent and manage STIs, including HIV/AIDS, in complex emergency situations.

The Reproductive Health Response in Conflict Consortium, formerly the Reproductive Health for Refugees Consortium, has responded to this need with a two-year project, Increasing the Capacity of Humanitarian Practitioners to Address STI/HIV/AIDS in Complex Emergency Settings. The project aims to fill the critical need for humanitarian aid workers to know how to prevent STI/HIV/AIDS and to care for persons affected by these diseases in situations affected by conflict.

The RHRC Consortium has reviewed and modified existing STI guidelines for use in emergency settings, developed an STI/HIV/AIDS Training Manual for use in the field, and conducted pilot trainings using this manual in field sites in Sierra Leone and Kenya. In addition, the International Rescue Committee’s new manual, Protecting the Future: HIV Prevention, Care and Support Among Displaced and War-Affected Populations, has been disseminated widely as a model for best practices in STI/HIV/AIDS care and prevention. This project draws upon the collaboration of RHRC Consortium members as well as the technical expertise and experience of the Centers for Disease Control and Prevention. It is overseen by the Women’s Commission for Refugee Women and Children.

The goal of the project is to reduce morbidity and mortality due to STI/HIV/AIDS among conflict-affected populations worldwide. The specific purpose is to improve the knowledge and skills of humanitarian workers in regard to STI/HIV/AIDS prevention, diagnosis and treatment.

The RHRC Consortium HIV/AIDS Course
The course is aimed at health program management staff and clinical staff. While technical aspects are covered, broader programmatic issues are emphasized and staff from non-medical backgrounds also benefit from attending. The course aims to deepen individual understanding of the complexities of HIV/AIDS and to equip participants with knowledge and skills to improve HIV/AIDS-related program design and implementation. A further important aim is to encourage positive attitudes toward people living with HIV/AIDS. The teaching style is participatory, with short presentations alternating with a variety of group activities which encourage participants to apply information to their own contexts.

Participants in the pilot trainings in Sierra Leone and Kenya responded very positively to the course. Their responses illustrate the critical nature of changing personal attitudes toward people living with HIV and examining personal risk behavior thus becoming better practitioners, advocates and community members in the fight against AIDS: “This training has changed my way of thinking on HIV/AIDS. The testimonies and videos were a challenge to my life and career.”
“I always felt there is no hope for those infected, but the training changed this in me. I will be able to help those infected and affected in living positively – a chance they may not have had.”

“HIV/AIDS is not a medical issue. It is not an issue for politicians and policy makers. It has a face. It has a human face. I’ll think more about the human face than the virus, thanks to this course.”

The five-day course includes facts about transmission routes, vulnerability and clinical manifestations; behavior change; condoms; sexually transmitted infections, voluntary testing and counseling; universal precautions and safe blood; mother to child transmission; stigma and caring for people with HIV/AIDS.

The curriculum will soon be available. For further information about the training course, contact Julia Matthews, Reproductive Health Senior Coordinator, Women’s Commission for Refugee Women and Children at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Diana Quick is director of communications for the Women’s Commission for Refugee Women and Children.