Women and Girls in Complex Emergencies

1. Antiretroviral therapy can be provided with successful outcomes in conflict settings.

Since 2003, Medecins Sans Frontieres has provided antiretroviral therapy in 22 programs in conflict or post-conflict settings, most in sub-Saharan Africa. In the 22 programs where ART was initiated, more than 10,500 people tested HIV-positive and 4,555 commenced ART. Of complete data for 4145 adults (66% female) in 20 programs, 64% remained on ART, 10% had died, 11% were lost to follow up, 10% transferred to another program and 5% had unclear outcomes. Median 12 month mortality was 9% and loss to follow up was 11%. Median six month CD4 gain was 129 cells with a median follow up time on ART of 11.8 months. All programs had a gender-based violence component, including treating STIs, emergency contraception, counseling, and access to PEP. Patient outcomes were comparable to those in stable resource-limited settings.

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