Excerpt: … The factors that affect HIV transmission vary by context and arise during different phases of the cycle of displacement. The three phases in the cycle of displacement are:
— the emergency phase, associated with the onset of conflict or some other emergency and flight of those affected;
— the post-emergency phase, marked by greater stability; and
— the final phase, when durable solutions are secured, and refugees return home, are resettled in a third country, or are permanently integrated within their host country.
The many factors that can contribute to the increased risk of HIV transmission among refugees in emergency and post-emergency phases are relatively well understood.
Refugees are uprooted from their homes and communities. Livelihoods are lost. The breakdown of social networks and institutions reduces community cohesion, weakening the social and sexual norms that regulate behaviour. Disruption to health and education services reduces access to HIV prevention information and commodities, sexual and reproductive health services, as well as HIV-related treatment and care for those who need it. Exposure to mass trauma such as conflict can increase alcohol and other drug use and influence people’s attitudes towards risk.
Conflict and displacement make women and children, particularly girls, disproportionately vulnerable to the risk of HIV. During conflict, rape is often used as a weapon of war. Women and girls are also subject to sexual violence and exploitation in refugee settings. As refugees struggle to meet their basic needs such as food, water and shelter, women and girls are often forced to exchange sexual services for money, food or protection. Children living without parental support, whether due to separation from or death of family members, are also particularly vulnerable to sexual and physical violence and exploitation … (full text).