Article Text
Abstract
Objective: To quantify the proportion of people living with HIV who are being affected by emergencies.
Methods: Emergencies were defined as conflict, natural disaster and/or displacement. Country-specific estimates of populations affected by emergencies were developed based on eight publicly available databases and sources. These estimates were calculated as proportions and then combined with updated country-level HIV estimates for the years 2003, 2005 and 2006 to obtain estimates of the number of men, women and children living with HIV who were also affected by emergencies.
Results: In 2006, 1.8 (range 1.3–2.5) million people living with HIV (PLHIV) were also affected by conflict, disaster or displacement, representing 5.4% (range 4.0–7.6%) of the global number of PLHIV. In the same year, an estimated 930 000 (range 660 000–1.3 million) women and 150 000 (range 110 000–230 000) children under 15 years living with HIV were affected by emergencies. In emergency settings, the estimated numbers of PLHIV in 2003 and 2005 were 2.6 million (range 2.0–3.4 million) and 1.7 million (range 1.4–2.1 million), respectively, representing 7.9% and 5.1% of the global number of PLHIV).
Conclusions: These estimates provide a rationale to ensure that HIV interventions are integrated into rapid assessment of all emergency and preparedness and response plans to prevent HIV infections and address excess suffering, morbidity and mortality among these often overlooked vulnerable groups.
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Footnotes
Competing interests: None.
Acknowledgements: We thank Alix Boulud, Isabel de Bruin, Gabriella Hok, Irene Javakhadze, Sarah Karmin and Jennifer Kim for data collection, and Elizabeth Zaniewski, UNAIDS, for contributions to data analysis.
The statements in this paper and the views of the authors do not necessarily reflect the policies or the views of UNICEF, UNHCR of UNAIDS.
Contributors: MLZ conceived and developed the methodology, participated in data collection and analysis and wrote the paper; PSB developed the methodology, participated in data collection and analysis and co-wrote the paper; SK participated in data collection and analysis and co-wrote the paper; KLD co-wrote the paper; NW developed the methodology; PG developed the methodology, participated in data analysis and co-wrote the paper.
↵i We use the definition of “humanitarian crisis” provided by the School of Peace Culture at the University of Barcelona, which defines it as “… any situation in which there is an exceptional and widespread threat to human life, health or subsistence. Such crises tend to occur in situations of poverty, fragile government and scarcity of food, in which a natural disaster or armed conflict leads to the appearance of a food crisis, disease and the enforced displacement of the population, either within or outside the country, along with an important mobilisation of international resources in the form of aid.” See School of Peace Culture1 for more details on the methodology.
↵ii 9.9 million refugees recorded by UNHCR, plus 4.4 million recorded by UNRWA.
↵iii In some countries where the HIV prevalence is assumed to be very low, data may be insufficient to provide a country-level estimate. We believed it not to be appropriate to use 0 for this analysis but rather to set a very low default value (in this case 0.05%) as in most countries there are high-risk groups where HIV is present.
↵iv Sudan is part of the Middle East and northern Africa region according to WHO and UNAIDS.