While the refugee status should not be equated with an increased risk of contracting HIV, the nature of a refugee environment may increase the vulnerability of people – especially women, adolescents and children – to the disease. HIV/AIDS spreads faster where there is poverty, lawlessness and social instability; these are the conditions that often give rise to, or accompany, forced displacement.

The link between the respect and protection of human rights and effective HIV/AIDS programmes is clear. People will not seek HIV-related counselling, testing, treatment and care if lack of confidentiality, discrimination, refoulement, restrictions on freedom of movement or other negative consequences could follow a positive diagnosis. For these reasons, an essential component in refugee protection is the creation of a legal and ethical environment which is protective of the human rights of HIV/AIDS victims. Towards that aim, in June 2004 UNHCR became the tenth co-sponsor of UNAIDS, thereby helping to broaden and strengthen the UN response to the global epidemic. Since then, UNHCR has collaborated with other organizations to advocate the inclusion of refugee issues in countries’ plans, proposals and policies related to HIV/AIDS.

Examples of such cooperation include:

• Nigeria: UNHCR received funds from UNAIDS for an HIV/AIDS prevention project at Oru Camp.
  
• Pakistan: UNHCR and other sponsors provided funds to support a National HIV/AIDS programme officer for three years.
  
• Indonesia: Training of asylum seekers on HIV/AIDS prevention was supported by UNAIDS.
  
• Yemen: A joint UNAIDS-UNHCR mission to assess the prevalence of HIV/AIDS among refugees in Yemen was undertaken.
  
• Great Lakes Initiative on AIDS: The UNAIDS Secretariat, the World Bank and governments in the region have cooperated extensively on this innovative and important sub-regional initiative.
  
• Mano River Union (MRU) Initiative on AIDS: UNHCR has increased collaboration with the UNAIDS Secretariat, UNFP, the African Development Bank and the Governments involved in the MRU.

Given the movements of displaced populations, UNHCR emphasizes a sub-regional approach linking countries of asylum and origin. These initiatives acknowledge two key points. The first is that refugees and other migrant populations have frequent and sometimes sustained interactions with surrounding host communities. This regular contact places both groups at increased risk of contracting or transmitting HIV. The second is the inherent mobility of these populations. The frequent movements of refugees and other migrant populations often make it more difficult to provide them with the HIV services they require. The creation of regional and/or sub-regional plans will help to ensure that refugees, returnees and other migrant populations find care throughout their travels, potentially reducing the risk of HIV transmission in the host-country population.

Sub-regional and regional HIV/AIDS plans provide services to people who might not otherwise receive regular care. They allow more mobile populations, such as refugees and those in the transport sector, to continue to be treated. More comprehensive interventions, such as anti-retroviral therapy, are also made possible. The ability to provide and sustain such treatment has become increasingly important in moving toward the goal of providing access to HIV/AIDS treatment to all those who need it.

Box 3.4 Xenophobia and refugees

Chapter 4 Responding to emergencies