HIV/AIDS, conflict and security in Africa: rethinking relationships

Becker, Joseph; Theodosis, Christian; Kulkarni, Rick

doi:10.1186/1758-2652-11-3

Cited by 30 publications

(25 citation statements)

References 23 publications

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“…Ciantia in a review paper concluded that conflict creates conducive environment for factors that increase the risk of HIV infection though this may not necessarily translate into higher prevalence [18]. Similar arguments have been raised by Becker and colleagues who underscore conflict and society disarray that follow as a unique and conducive environment to increase the spread the HIV epidemic [19]. Indeed IDPs are often isolated and relatively inaccessible characterised by poor government infrastructure and systems[17].…”

Section: Discussionmentioning

confidence: 95%

Interface of culture, insecurity and HIV and AIDS: Lessons from displaced communities in Pader District, Northern Uganda

Rujumba

Kwiringira

2010

Confl Health

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BackgroundNorthern Uganda unlike other rural regions has registered high HIV prevalence rates comparable to those of urbanized Kampala and the central region. This could be due to the linkages of culture, insecurity and HIV. We explored community perceptions of HIV and AIDS as a problem and its inter-linkage with culture and insecurity in Pader District.MethodsA cross sectional qualitative study was conducted in four sub-counties of Pader District, Uganda between May and June 2008. Data for the study were collected through 12 focus group discussions (FGDs) held separately; 2 FGDs with men, 6 FGDs with women, and 4 FGDs with the youth (2 for each sex). In addition we conducted 15 key informant interviews with; 3 health workers, 4 community leaders at village and parish levels, 3 persons living with HIV and 5 district officials. Data were analysed using the content thematic approach. This process involved identification of the study themes and sub-themes following multiple reading of interview and discussion transcripts. Relevant quotations per thematic area were identified and have been used in the presentation of study findings.ResultsThe struggles to meet the basic and survival needs by individuals and households overshadowed HIV as a major community problem. Conflict and risky sexual related cultural practices were perceived by communities as major drivers of HIV and AIDS in the district. Insecurity had led to congestion in the camps leading to moral decadence, rape and defilement, prostitution and poverty which increased vulnerability to HIV infection. The cultural drivers of HIV and AIDS were; widow inheritance, polygamy, early marriages, family expectations, silence about sex and alcoholism.ConclusionsDevelopment partners including civil society organisations, central government, district administration, religious and cultural leaders as well as other stakeholders should mainstream HIV in all community development and livelihood interventions in the post conflict Pader district to curtail the likely escalation of the HIV epidemic. A comprehensive behaviour change communication strategy is urgently needed to address the negative cultural practices. Real progress in the region lies in advocacy and negotiation to realise lasting peace.

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Section: Discussionmentioning

confidence: 95%

Interface of culture, insecurity and HIV and AIDS: Lessons from displaced communities in Pader District, Northern Uganda

Rujumba

Kwiringira

2010

Confl Health

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“…The highest number of armed conflicts occur in Sub-Saharan Africa [5] where many Conflict-Afflicted-Countries (CACs) have a high prevalence of HIV [6]. Consequently it has been hypothesized by several authors [7–11], that mass rape may be increasing HIV epidemics in some CACs. This hypothesis has recently been questioned by Spiegel et al [12] who have assessed the link between mass rape and HIV prevalence by conducting a detailed review of the literature.…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of mass rape on the incidence of HIV in conflict-affected countries

Halima

Blower

2010

Aids

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Objectives To quantify the potential impact of mass rape on HIV incidence in seven conflict-afflicted-countries (CACs), with severe HIV epidemics, in Sub-Saharan Africa. Design Uncertainty analysis of a risk equation model. Methods A mathematical model was used to evaluate the potential impact of mass rape on increasing HIV incidence in women and girls in: Burundi, Democratic Republic of Congo (DRC), Rwanda, Sierra Leone, Somalia, southern Sudan and Uganda. The model was parameterized with data from UNAIDS/WHO and the US Census Bureau’s International Data Base. Incidence data from UNAIDS/WHO were used for calibration. Results Mass rape could cause ~five HIV infections per 100,000 females per year in the DRC, Sudan, Somalia and Sierra Leone, double that in Burundi and Rwanda, and quadruple that in Uganda. The number of females infected per year due to mass rape is likely to be relatively low in Somalia and Sierra Leone, 127 (median: Inter-Quartile-Range (IQR) 55–254) and 156 (median: IQR 69–305), respectively. Numbers could be high in the DRC and Uganda: 1,120 (median: IQR 527–2,360) and 2,172 (median: IQR 1,031–4,668), respectively. In Burundi, Rwanda and Sudan numbers are likely to be intermediate. Under extreme conditions 10,000 women and girls could be infected per year in the DRC, and 20,000 women and girls in Uganda. Mass rape could increase annual incidence by ~ 7% (median: IQR 3–15). Conclusions Interventions and treatment targeted to rape survivors during armed conflicts could reduce HIV incidence. Support should be provided both on the basis of human rights and public health.

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“…12,13 Sexual violence is often used as a tool of war, 14 and these practices have been shown to be prevalent in informal migrant settlements. 15 Transnational female migrants may also be exposed to sexual violence while attempting to illegally cross country borders. 13 …”

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confidence: 99%

Social Support, Sexual Violence, and Transactional Sex Among Female Transnational Migrants to South Africa

et al. 2016

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Objectives To examine the relationship between sexual violence and transactional sex and assess the impact of social support on this relationship among female transnational migrants in Cape Town, South Africa. Methods In 2012 we administered a behavioral risk factor survey using respondent-driven sampling to transnational migrant women aged between 16 and 39 years, born outside South Africa, living in Cape Town, and speaking English, Shona, Swahili, Lingala, Kirundi, Kinyarwanda, French, or Somali. Results Controlling for study covariates, travel-phase sexual violence was positively associated with engagement in transactional sex (adjusted prevalence ratio [APR] = 1.38; 95% confidence interval [CI] = 1.07, 1.77), and social support was shown to be a protective factor (APR = 0.84; 95% CI = 0.75, 0.95). The interaction of experienced sexual violence during migration and social support score was APR = 0.85 (95% CI = 0.66, 1.10). In the stratified analysis, we found an increased risk of transactional sex among the low social support group (APR = 1.56; 95% CI = 1.22, 2.00). This relationship was not statistically significant among the moderate or high social support group (APR = 1.04; 95% CI = 0.58, 1.87). Conclusions Programs designed to strengthen social support may reduce transactional sex among migrant women after they have settled in their receiving communities.

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HIV/AIDS, conflict and security in Africa: rethinking relationships

Cited by 30 publications

References 23 publications

Interface of culture, insecurity and HIV and AIDS: Lessons from displaced communities in Pader District, Northern Uganda

Interface of culture, insecurity and HIV and AIDS: Lessons from displaced communities in Pader District, Northern Uganda

Assessing the impact of mass rape on the incidence of HIV in conflict-affected countries

Social Support, Sexual Violence, and Transactional Sex Among Female Transnational Migrants to South Africa

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