11.02.2010

HIV/AIDS In Conflict Zones

HIV/AIDS In Conflict Zones
In modern warfare it is becoming increasing common for sexual violence to be used as a weapon of war. Particularly in Asia and Africa, conflicts have fueled the HIV/AIDS epidemic in the regions and exacerbated the infection rates. In order for the HIV epidemic to be controlled, the relationship between HIV and conflict needs to be addressed. 

Conflict in Asia
In the past several decades there have been dozens of conflicts throughout Asia in Afghanistan, Nepal, Myanmar, Sri Lanka, Indonesia, Pakistan, India, and the Philippines and across Central and Southeast Asia. It is not just sexual violence that fuels HIV infection rates, but also the longterm effects that conflict has upon the effected populations. For example, Afghan refugees who lived much of lives in refugee camps ended up turning to drug use when they left the refugee camps because of lack of opportunities. Increased use of IV drugs increases the risk that HIV will be transmitted to many other people in the region then. Along the Thailand/Burma boarder, refugees from the ongoing conflict have had to resort to survival sex in order to meet daily living needs, which increases the risk of contracting HIV. Also, the general increase in rape being used as a weapon of war (like in the August Congo rape incident) significantly impacts the prevalence of HIV in conflict zones.

HIV/AIDS In Post-Conflict Regions
Democratic Republic of Congo (DRC)
As someone who has worked with resettled refugees, I found it extremely surprising when I read the UNAIDS review on HIV/AIDS and Conflict and found that many refugee camps test refugees, IDPs, migrants, and displaced persons for HIV; and if they tested positive, they are often times turned back! Refugees should not only be admitted for shelter if they are HIV negative. I understand the implications and danger that having thousands of HIV positive people can have on a camp where violence is possible and sexual assaults are common; but to bring the situation under control, humanitarian aid groups (like Doctors Without Borders) need to be present in camps to provide the needed medicines and ART treatment for those in need which would significantly minimize the risk. 

Recently, the U.S. repealed the mandatory HIV testing for refugees to be resettled into the country. This has been widely applauded throughout the humanitarian and HIV activist community as a step in the right direction and hopes are that other countries will follow suite. 

In post-conflict settings, HIV education and treatment can play a very vital role. During war, soldiers often partake in high-risk sexual activities and therefore have a high chance of exposing themselves to HIV. In the demobilization process, soldiers are rehabilitated and introduced back into civilian life. If HIV testing was integrated into the demobilization process, soldiers who acquired HIV during their time in armed conflict could then be identified, informed, and treated with the necessary medications. When HIV is not part of the demobilization process, soldiers who could have been exposed to HIV might go home and then proceed to transmit HIV to their wifes and other partners they might have. 

Also in post-conflict nations, after the aid organizations leave, women continue to feel unsafe and at risk for sexual violence. According to UNAIDS, displaced women from Haiti, Liberia, and the Democratic Republic of Congo reported feeling more unsafe after the conflict rather than during. With relief agencies less present in post-conflict nations, women often are more at risk of being raped which increases their chances of contracting HIV. 

Moving Ahead
It is clearly evident that HIV and conflict often times intertwine. Areas that are embroiled in conflict will often be sites of increased rape which puts women at a great risk of contracting HIV. In post-conflict settings, displaced people may turn to IV drug use and/or survival sex and/or increased high-risk sexual encounters as a result of the lack of opportunities that are open to them, all of which put the population at a greater risk of exposing themselves to HIV and contracting it. In the future, it will be vital for governments and aid organizations to integrate HIV awareness, education, and treatment services in their dealings with conflict regions so as to limit the risk of the HIV epidemic to be exacerbated through that specific region.

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