Awareness leads to drop in HIV infection rates among refugees

A public awareness campaign has led to sexual behaviour changes resulting in a reduction of HIV/AIDS infection rates among refugees in East Africa, an expert with the Office of the UN High Commissioner for Refugees (UNHCR), has said. The HIV/AIDS expert, Dr Patterson Njogu, told IRIN that the lower infection rates observed in some camps could also be partly attributed to the fact that some of the refugees had originated from low HIV/AIDS prevalence countries, such as Somalia and Sudan, or from rural communities where infection rates were also low. "The number of condoms being used in refugee camps has increased dramatically," Njogu told a three-day workshop in the Kenyan capital, Nairobi, last week. "At one time you could not talk about condoms in the camps. Now, condoms are very much in demand. There have also been changes in behaviour. The number of partners decreased significantly," he was quoted in a UNHCR statement as saying. In Kala camp in northern Zambia, home to 21,000 refugees from the Democratic Republic of the Congo, the number of condoms distributed monthly had soared to 18,000 in November 2003 from only 538 in the January before, the statement said. In Kakuma camp, northwestern Kenya, housing about 60,000 Sudanese refugees and 20,000 from other countries, the infection rate in 2002 was found to be 5 percent, compared to 18 percent in the surrounding Lodwar area, where the camp is sited, UNHCR said. Refugees were at greater risk of HIV infection because of rape during conflicts, disrupted health care, and the tendency during flight to sometimes trade sex for food. However, this exposure did not necessarily translate into higher infection rates, it noted. Ironically, chronic conflicts like those in Angola and southern Sudan have actually had the effect of curbing the spread of HIV/AIDS due to the attendant destruction of much of the transportation infrastructure. "In Sierra Leone and Angola, for example, you’ve lost the infrastructure," said Dr Paul Spiegel, a Canadian physician and epidemiologist who heads UNHCR’s HIV/AIDS programmes. "There is decreased mobility. Truckers are not moving around, are not going to urban areas with higher HIV prevalence, sleeping with prostitutes and going back to infect their wives." To ensure that refugees contributed towards the solution of the problems posed by the pandemic in their own countries, UNHCR would work with other agencies and local authorities in making health care available even in remote areas of return, and would train community health workers and nurses, Spiegel said. Njogu said UNHCR had "fairly advanced" HIV/AIDS programmes in refugee camps, giving the example of Kakuma camp, where services available include a voluntary counselling and testing centre, a mother-to-child prevention scheme and home-based care for those infected and for vulnerable children and orphans.