What Works for Women and Girls

of Congo, southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia and Burundi—foundinsufficient data to support assertions that conflict, forced displacement and wide-scale rapeincreased HIV prevalence. Of the 12 sets of refugee camps, nine had a lower prevalence of HIVinfection, two a similar prevalence and one a higher prevalence than the host communities(Spiegel et al., 2007: 2193–94).There is, however, significant evidence that women and girls in complex emergenciesoften experience rape and other sexual violence that puts them at high risk for HIV (Shannonet al., 2008). For example, a population-based, random sample survey of 991 households ofinternally displaced families (with a total representation of 9,166 individuals) living in threecamps in Sierra Leone found that 9% of female respondents reported having been victims ofsexual violence related to the war and 13% of all households reported some member (maleand/or female) having experienced sexual violence. Thirty-three percent of those abusedreported being gang raped. Respondents who reported having “face to face” contact with theRevolutionary United Front (RUF) also reported higher incidences of sexual violence than didthose who came into contact with other combatant groups, 53% compared to 6%. Twenty-threepercent of the women who reported sexual abuse also reported being pregnant at the time ofassault (PHR and UNAMSIL, 2002).The post-conflict period may also be a very vulnerable time for HIV transmission, perhapsmore so than during conflict (Spiegel et al., 2007: 2193–94). A survey conducted by IRC in1997 found that since becoming refugees, 27% of 12–49 year old female refugees living incamps in Tanzania had been victims of sexual violence (RHR Consortium, ND). Refugees areespecially at risk for missed services because, as non-nationals, they are not always covered bynational health and HIV/AIDS programs (RHR Consortium, ND).Donors and governments must be aware that “countries in the throes of complex emergenciesare unlikely to prepare successful funding proposals to bilateral, multilateral, private sectordonors or the…Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)” (Hankins etal., 2002: 2248). Yet the needs in these countries, especially among refugee groups, are asgreat, if not more so, than many others.What Works—Prevention for Key Affected Populations: Women and Girls in ComplexEmergenciesPromising Strategies:1. Voluntary counseling and testing can be successfully provided to internally displacedpeople.2. Public support campaigns for rape survivors may be effective in encouraging survivorsto test for HIV and access services.104 CHAPTER 4 PREVENTION FOR KEY AFFECTED POPULATIONS