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World AIDS Day, held on 1 December every year, was commemorated around the world. There have been great advances in curative and preventive interventions, so people living with HIV/AIDS can live longer life with better quality compared to the 1980s when the epidemic started. International efforts to tackle the disease are now aiming at halting new infections and involving more marginalized people with greater risk.
Unfortunately, many people living with HIV/AIDS still confront discrimination and stigmatization. Social minorities, such as refugees and internally displaced persons (IDPs), who are already suffering from displacement, poverty and food insecurity, are also often targets of discrimination. This discrimination can combine into even worse forms when host societies incorrectly believe that HIV/AIDS is spread by immigrants. One form of those discriminatory measures is travel bans on people with HIV/AIDS, which now are under international pressure. The US lifted immigration screening on HIV in 2010. In July 2012, Republic of Korea also announced that travel ban for immigrants with HIV/AIDS had been removed, although it has been criticized that there were no actual changes made since then.
Refugees, and those classified under ‘unwanted migrants’ - as opposed to ‘professional migrants’ – are often perceived as a burden on healthcare system in host societies. This year, there were reports about Jordan struggling for offering health services for Syrians residing on their soil and about Canada curtailing healthcare coverage for refugees.
Neighbouring countries are the most burdened ones with housing refugees, not the countries in North America or Europe. According to UNHCR Global Trends 2011, the top three countries where refugees headed were Pakistan, Iran and Syria, and DRC and Kenya took the second and third positions when income level of each country was taken into account.
Conflict-affected displaced people including IDPs, refugee, etc. do not bring HIV/AIDS to host societies. Studies have shown that there is insufficient evidence to say that conflicts increase HIV transmission in conflict-affected populations, and conflict-affected population does not necessarily have higher prevalence than populations in surrounding countries do. Generally these refugees move from area with lower prevalence to another area with higher prevalence.
Although conflicts have no significant impact on increasing HIV/AIDS prevalence in population level, they may have impact on vulnerable groups in individual level, namely women, children and refugees, etc. After arriving in a new environment such as refugee camp or urban area, the vulnerable become more susceptible to being infected. Refugees living in refugee camps may benefit from better support than do those living in urban area, where they may have poor access to local government services. Due to social breakdown, lack of resources and access to healthcare system, and increased exposure to sexual violence, people having fled conflict-affected area are more likely to be affected by HIV/AIDS. Conflict-affected migrant populations face higher risk of HIV/AIDS exposure, especially while crossing border or moving to area with higher HIV/AIDS prevalence, where they may be exposed to sexual violence and drug abuse.
Despite this, refugees and IDPs are consistently excluded from HIV/AIDS National Strategic Plans (NSPs) of those countries hosting a great number of displaced people. A report that assessed NSPs of African countries pointed out that an important proportion of countries did not mention refugees and IDPs in their NSPs. Even when they are included in the NSPs and the policies are implemented, there is a gap between policy and actual practice, as seen in South Africa, according to an MSF report in 2009.
When refugees find that HIV/AIDS hampers making a living or receiving adequate treatment due to their status, they would hide their HIV/AIDS status or not want to know their status. This seriously erodes global efforts to fight against HIV/AIDS. Discrimination and stigmatization of conflict-affected displaced people is one of primary challenges to be addressed on the road towards HIV/AIDS eradication. When there still are issues such as hostility and xenophobia around people with HIV/AIDS, the eradication of the disease is still far off.
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