Women and Girls in Complex Emergencies

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.