Intensively educated about HIV/AIDS, refugees in East Africa have made progress in the fight against the infection by changing their sexual behaviour, according to a HIV/AIDS expert in the United Nations refugee agency.
“The number of condoms being used in refugee camps has increased dramatically,” Dr. Patterson Njogu, an expert for the UN High Commissioner for Refugees (UNHCR) on HIV/AIDS for East Africa and the Horn of Africa, told a workshop in Kenya’s capital, Nairobi.
“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 and transactional sex decreased as well,” he said.
In Kala camp in northern Zambia, home to 21,000 Congolese refugees, the number of condoms distributed monthly soared to 18,000 in November 2003 from only 538 in the January before.
In northwestern Kenya, the infection rate in 2002 was found to be 5 per cent in Kakuma camp, housing about 60,000 Sudanese refugees and 20,000 refugees from other countries, compared to 18 per cent in the surrounding area of Lodwar, Kenya, UNHCR said.
Refugees were at greater risk for HIV infection – because of rape during conflicts, disrupted health care and the need while fleeing sometimes to trade sex for food. This exposure did not necessarily translate into higher infection rates, however, UNHCR said.
Ironically, chronic conflicts like those in Angola and south Sudan actually curbed the spread of HIV/AIDS by destroying 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 make sure refugees contribute to the solution of the problems posed by the pandemic in their own countries, UNHCR will work with other agencies and local authorities to ensure that health care is available even in remote areas of return and will train community health workers and nurses, Dr. Spiegel said.