Almost two-thirds of the global burden of HIV infection is in countries affected by complex emergencies. Although access to antiretroviral (ARV) treatment is being scaled up in low- and middle-income countries, the emphasis on preventing new infections remains paramount. DDR programmes are increasingly including HIV/AIDS interventions and linking them with national HIV/AIDS control programmes and strategies.
Understanding and addressing the gendered HIV needs of male and female ex-combatants and women and men formerly associated with armed groups, is key to successful DDR programming. These needs have to be understood in relation to gender dynamics, gender based violence (GBV), sexual and reproductive health (SRH), livelihood opportunities, community security and access to HIV services.
The United Nations Inter-Agency Working Group on DDR (IAWG) has made HIV/AIDS a priority. The Integrated DDR Standards (IDDRS) provide guidance on DDR and HIV/AIDS in planning, implementation, and monitoring and evaluation (module 5.60). DDR programmes often take place in areas of high HIV prevalence or high-risk environments. Ex-combatants are considered a high-risk group.
As noted by the Inter-Agency Standing Committee (IASC), the characteristics of a complex emergency favour the spread of HIV and other sexually transmitted infections in the following ways: (1) Mass displacements of people between high and low HIV/AIDS prevalence areas, especially migration towards urban settings. (2) Breakdown of social networks and support mechanisms place women, young people and children at an increased risk of violence and exploitation and can force them into selling sex as a means of accessing basic goods and protection. (3) Risk of HIV is further increased in complex emergencies where rape and other forms of sexual abuse may be heightened, including being used as methods of war.