Although a significant proportion of people affected by humanitarian emergencies are people at risk of or living with HIV, access to HIV prevention, treatment, and care is often not prioritized during emergencies. HIV transmission in humanitarian settings is complex and is dependent on the dynamic interaction of a variety of factors. This includes HIV prevalence and vulnerability of some groups within the population in the region of origin and that of the host population, the level of interaction between displaced and surrounding populations, the duration of displacement, and the location and extent of isolation of the displaced population (e.g., urban versus camp-based refugees).
The Minimum Initial Service Package (MISP) components related to HIV interventions at the onset of a humanitarian response focus on prevention of HIV transmission and reduction in morbidity and mortality due to HIV and other STIs.Once the conditions allow, scaling up should occur from the initial minimum HIV package to comprehensive HIV prevention, treatment and care services for people at risk of acquiring HIV and people living with HIV and their families.
- Establish safe and rational use of blood transfusion.
- Ensure application of standard precautions.
- Guarantee the availability of free, lubricated male condoms and, where applicable (e.g., already used by the population), ensure provision of female condoms.
- Support the provision of antiretrovirals to continue treatment for people who were enrolled in an antiretroviral therapy program prior to the emergency, including women who were enrolled in prevention of mother-to-child transmission (PMTCT) programs.
- Provide post exposure-prophylaxis (PEP) to survivors of sexual violence as appropriate and for occupational exposure.
- Support the provision of co-trimoxazole prophylaxis for opportunistic infections for patients found to have HIV or already diagnosed with HIV.
- Ensure the availability in health facilities of syndromic diagnosis and treatment of STIs.
- Conduct needs assessment: SRH coordinators and programme managers collect or estimate relevant information regarding population characteristics, health services characteristics, national legislation and policies, and HIV epidemic characteristics.
- Expand public information campaigns: Raise community awareness about how HIV is and is not transmitted and promote the rights of people living with HIV, the benefits of knowing one's HIV status, and the availability of services for HIV prevention, testing, care, and support.
- Ensure HIV prevention: Tailor combination HIV prevention programs by including different interventions depending on local HIV geographic population vulnerabilities.
- HIV counselling and testing:
- Voluntary counselling and testing (VCT)
- Provider initiative counselling and testing
- Prevention of mother-to-child transmission (PMTCT)
- The use of antiretroviral (ARV) for prevention and treatment purposes
- Care for persons living with HIV
- Management of opportunistic infections, STIs and tuberculosis
- Coordinate and make linkages: Work with other sectors and stakeholders to integrate HIV services.
Contact the Public Health Section, Division of Programme Support and Management. At: [email protected].