During and after disasers, physical, financial, and social insecurity may erode the caring and coping strategies of individuals and households, rendering communities more vulnerable to HIV infection.

• Loss of livelihoods. -Disasters and emergencies lead to loss of livelihoods and further impoverishment, especially in poor societies. Women and girls become especially vulnerable, as they may find themselves coerced into engaging in sex as a survival strategy to gain access to food, shelter, and physical security. In some emergencies, increased powerlessness and insecurity make this group more vulnerable to rape and other sexual violence.

• Breakdown of social norms - Displacement often leads to the breakdown or weakening of traditional social norms and systems that control social behavior and activities, including sexual relationships. The breakdown of families and communities and exposure of the uprooted population to unfamiliar social and livelihood situations can increase vulnerability to HIV infection.

• Challenges to health care - Disaster situations can greatly overtax the existing health-care infrastructure. The result can be gaps, such as in the supply and distribution of condoms, which hamper HIV prevention. Efforts to treat STIs and other diseases are sometimes ineffective and sporadic in this setting. (STIs are relevant to this research not only because HIV is sexually transmitted but also because infection with other sexually transmitted diseases can increase a person’s risk of contracting HIV.)
The risk of transmitting HIV through transfusion of contaminated blood might also rise due to inadequate screening services at health centers.

• Disruption of HIV-control activities -During disasters, HIV- and AIDS-control activities like awareness campaigns tend to be disrupted or eclipsed by other priorities, like the provision of basic food, water, and shelter, and the treatment of wounds and more acute diseases and infections. Institutions like schools and shopping centers, where awareness campaigns tend to be conducted, are sometimes closed down in emergencies.

• General trauma -Trauma related to an emergency may sometimes lead to problems like alcoholism and high-risk sexual behavior.

• Relief efforts -Paradoxically, relief and rehabilitation efforts by aid providers may sometimes contribute to the risk of HIV and AIDS.3 In the case of the tsunami, for example, the structure and location of the new temporary shelters were major contributing factors.

(Referance: Oxfam Humanitarian Field Studies & Swasti Health
Resource Center of Bangalore-
Understanding the Effect of the Tsunami and Its Aftermath on Vulnerability to HIV in Coastal India )

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