Living with HIV requires access to safe water, toilets and hygiene: New WaterAid report


22 Jul 2014 | AU

People living with HIV in the developing world are put at risk of life-threatening infections from their exposure to unsafe drinking water and poor sanitation and hygiene, a new WaterAid report reveals at the International AIDS Conference in Melbourne today.

A new study from WaterAid, Assessing the water, sanitation and hygiene needs of people living with HIV and AIDS in Papua New Guinea, details the increased requirements of people living with HIV for access to these basic services and the necessity to better integrate these into Papua New Guinea’s HIV programs. Better education on hygiene, safe treatment and storage of water, self-treatment for diarrhoea, toilet construction, and education around the transmission of HIV can all help people living with HIV lead longer, healthier lives.

“Weakened immune systems leave people living with HIV at risk of life threatening infections, many of which are caused by exposure to unsafe drinking water, inadequate sanitation and poor hygiene. More than 90% of people living with HIV in developing countries experience diarrhoea. This can mean that antiretroviral medication and nutrients from food are not absorbed properly by the body which can lead to malnutrition and further exacerbate the consequences of HIV and AIDS,” said WaterAid Australia Acting Chief Executive Rosie Wheen.

“Diarrhoea is the second largest killer of children under five globally, and children with a mother living with HIV who has experienced diarrhoea are at increased risk. Prevention of mother to child transmission of HIV through breast milk requires access to clean water for formula and replacement feeding. Just taking antiretroviral medication requires 1.5 litres of safe water,” said Ms Wheen.

“We can mitigate the risks of diarrhoeal disease and reduce deaths by practising treatment and safe storage of drinking water, safe disposal of excreta and hand washing,” said Ms Wheen.

“The situation in Papua New Guinea is particularly pressing. There are approximately 30,000 people living with HIV in Papua New Guinea, and only 40% of the population have access to clean, safe water and only 45% have improved sanitation. It’s crucial that water, good sanitation and hygiene practices are introduced into HIV programs,” said Ms Wheen.

The study found that 40% of people living with HIV in Papua New Guinea use unsafe water, and generally water treatment knowledge is poor. Almost one third only had access to unhygienic toilets, while 6.5% practised open defecation. Travel time to a toilet varied from one minute to 40 minutes and on average people shared a toilet with at least ten people. One quarter had experienced diarrhoea in the last two weeks with increased fluid intake being the main treatment practice for diarrhoea.

Forty-one percent of respondents experienced stigma and discrimination because of their HIV status from their family and 36% from their community. In 18% of cases respondents were prevented from collecting water because of their HIV status, while another 18% reported that members of their family had been prevented from collecting water in the past.

Fifty-three percent of respondents in the study had children, of whom 39% were under the age of five. Almost one quarter of these children were HIV positive. Knowledge and available information about the safe preparation of formula were limited and hygiene practises could be improved.

Recommendations in the report include providing comprehensive guidance on self-treatment of diarrhoea to people living with HIV, prioritising toilet construction in communities where there is low sanitation coverage and a known high HIV prevalence, developing education and guidelines regarding the safe treatment and storage of water, and providing education around the transmission of HIV to overcome stigma.

The report is available here:

Running from 20-25 July in Melbourne, the International AIDS Conference is bringing together 15,000 delegates from around the world.

Facts and figures

  • 35.3 million people in the world live with HIV
  • 748 million people in the world are without access to safe, clean water
  • 2.5 billion people in the world are without access to basic sanitation
  • 90% of people living with HIV will experience diarrhoea
  • Diarrhoea is the second-biggest killer of children under five years old worldwide
  • Hand washing with soap, clean water and basic toilets can prevent the spread of diarrhoea
  • 1.5 litres of safe water is needed to take antiretroviral medication. Diarrhoea may reduce the effectiveness of this life-saving drug

Visit the giant toilet

What: A giant toilet will land in Melbourne’s CBD this week to alert people to the 2.5 billion people in the world without a toilet, and to the water, sanitation and hygiene needs of people living with HIV
When: 8.30am – 11am on Tuesday 22 July and 11am – 2pm on Wednesday 23 July 2014
Where: The Giant Toilet will be outside St Paul’s Cathedral on the corner of Flinders Lane and Swanston Street, Melbourne


Kirrily Johns, Communications Manager: +61 (0)3 9001 8246 or

About WaterAid

WaterAid’s vision is of a world where everyone has access to safe water and sanitation. The international organisation works in 26 countries across Africa, Asia, Central America and the Pacific region to transform lives by improving access to safe water, hygiene and sanitation in some of the world’s poorest communities. Since 1981, WaterAid has reached 19.2 million people with safe water and, since 2004, 15.1 million people with sanitation.