The eight member states (Djibouti, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda) of the Intergovernmental Authority for Development (IGAD) have the largest proportions of cross-border mobile pastoralists and refugees in Africa. Although all IGAD countries have had national HIV/AIDS prevention, care and treatment programmes since the late 1980s, the IGAD Regional HIV & AIDS Partnership Program was (IRAPP) established in 2007 to mitigate the challenges of HIV among neglected pastoral and refugee communities. This article assesses vulnerability of pastoralists and refugee communities to HIV and interventions targeting these groups in the IGAD countries. Outcomes from this study may serve as a baseline for further research and to improve interventions. Published articles were accessed through web searches using PubMed and Google Scholar engines and unpublished documents were collected manually. The search terms were HIV risk behaviour, vulnerability, HIV prevalence and interventions, under the headings pastoralists, refugees, IGAD and north-east Africa for the period 2001-2014. Of the 214 documents reviewed, 78 met the inclusion criteria and were included. Most HIV/AIDS related studies focusing of pastoral communities in IGAD countries were found to be limited in scope and coverage but reveal precarious situations. Sero-prevalence among various pastoral populations ranged from 1% to 21% in Ethiopia, Kenya, Somalia and Uganda and from 1% to 5% among refugees in Sudan, Kenya and Uganda. Socioeconomic, cultural, logistic, infrastructure and programmatic factors were found to contribute to continuing vulnerability to HIV. Interventions need to be further contextualised to the needs of those impoverished populations and integrated into national HIV/AIDS programmes. HIV/AIDS remains a major public health concern among the pastoral and refugee communities of IGAD countries. This calls for IGAD to collaborate with national and international partners in designing and implementing more effective prevention and control programmes. Furthermore, interventions must extend beyond the health sector and improve the livelihood of these populations. © 2016 NISC (Pty) Ltd.

Health IRAPP Horn of Africa HIV/AIDS vulnerability IGAD Cross-border HIV programme Interventions

vulnerable population National Health Programs livestock publication HIV Infections refugee Eritrea Human immunodeficiency virus infection health care policy poverty agricultural worker human survivor HIV test Refugees middle aged search engine AIDS patient Agriculture Acquired Immunodeficiency Syndrome morbidity Kenya Medline Human immunodeficiency virus prevalence Uganda neglected disease patient counseling Young Adult social status Humans Adolescent male female Socioeconomic Factors rangeland Africa socioeconomics pastoralist refugee camp prostitution Conference Paper prevalence cultural factor high risk behavior legislation and jurisprudence organization and management Ethiopia South Sudan adult Africa, Northern migration public health awareness infection risk Somalia Djibouti outcome assessment malnutrition Health Policy Transients and Migrants systematic review gender based violence acquired immune deficiency syndrome mortality water supply Africa, Eastern exposure health care delivery Sudan