Armed Conflict, Women’s Vulnerability and HIV or AIDS in the Great Lake Region of Africa: Reinforcing Human Security to Prevent Widespread of the Pandemic
- 1. Department of Environmental Medicine, Division of Social Medicine, Kochi Medical School, Japan
- 2. Disaster Nursing Global Leader doctoral Program (DNGL), Graduate School of Health and Nursing Sciences, University of Kochi, Kochi, Japan
Citation
Ngatu NR, Kanbara S (2014) Armed Conflict, Women’s Vulnerability and HIV/AIDS in the Great Lake Region of Africa: Reinforcing Human Security to Prevent Widespread of the Pandemic. Clin Res HIV/AIDS 1(1): 1003.
ABBREVIATIONS
AIDS: Acquired Immunodeficiency Syndrome; ART: AntiRetroviral Therapy; GBV: Gender-Based Violence; DRC: Democratic Republic of the Congo; HIV: Human Immunodeficiency Virus; MTCT: Mother-To-Child Transmission.
HIV infection pandemic has been progressively spreading in Africa and over 33 million people are estimated to be living with the virus worldwide, of whom 70% are in the Sub-Saharan Africa region and 58% are young women [1]. Systematic gender inequalities and women’s subordinate position in Africa are among the factors that are linked to the HIV epidemics in the region [2,3]. Armed conflicts and war cause population to flee in search of safe settlement and create a situation of instability with a reduced human security condition in the affected areas; this fact invariably affect the social status and health of local communities and increase the incidence of communicable diseases [4], including sexually transmitted infections such as HIV infection.
Gender-based violence and HIV infection in the great lake region
A sizeable literature actually links gender-based violence (GBV) and HIV infection and sexual violence can possibly lead to the transmission of HIV infection. According to Andersson and colleagues, victims of childhood sexual abuse are more likely to be HIV positive and to have high risk behaviors. GBV perpetrators are also at risk of acquiring HIV infection, particularly in conflict zones, as their victims might have been victimized before and have a high risk of infection [5].
Considering the specific features of the violence against women in conflict zones, the United Nations has recently recognized mass rape during armed conflicts as a weapon of war [6]. In most armed conflicts occurring in the great lake region of Africa, it has been reported that soldiers and militia members were involved in rape and violence against women and young girls. For example, one of the most striking features of the ‘Congo war’ is the use of sexual violence as a weapon of war. A study conducted by Bartels and colleagues in the war-torn Eastern part of the Democratic Republic of the Congo (DRC) showed that a high proportion of sexual assaults were being perpetrated by armed combatants [7,8].
HIV infection status in armed conflict-affected great lake region
The high rate of HIV infection among soldiers in the Sub-Saharan Africa poses a serious threat to regional security [9]. Armed conflicts, and the societal disarray that it causes, create a unique environment that potentially lead to epidemic spread. During the ethnic conflicts in Rwanda and Burundi in the last century and the current “Congo war” involving the Congolese army in one side and some neighbor countries’ armies and militias in the other, considered as the worst armed conflict since the World War II that already caused more than 5 million deaths since 1998 [10], mass rape has been perpetrated systematically.
When evaluating the potential impact of mass rape on the incidence of HIV in conflict-affected countries, with the use of a mathematical model, Virginie and colleagues found mass rape could cause 1,120 and 2,172 cases of HIV infection in the DRC and Uganda per year, respectively, and that the number could reach 10,000 in DRC and 20,000 in Uganda per year under extreme conditions. Regarding Rwanda and Burundi, similar trends were observed [11]. In the early 1990’s in Rwanda, it has been estimated that hundreds of thousands of women reported rape or sexual coercion during the Rwanda genocide [12,13]. Besides the killings during those armed conflicts, these data are suggestive of an organized and planned mass rape.
Necessity to reinforce human security in armed conflict affected regions
The occurrence of widespread sexual violence in conflict zones suggests insufficient or lack of protection of affected populations. Governments of affected countries should reinforce the law in regard to sexual assault against women both in conflict zones and in humanitarian settings. In addition, public health, medical interventions, human rights interventions that improve human security conditions in conflict-affected regions are of utmost importance in order to prevent or reduce the negative impact of sexual violence against women. Coercive measures should be taken against those who perpetrate rape in conflict zones by governments and United Nations’ specialized organizations to put an end to the rape phenomenon in the African great lake region, whereas the promotion health education on HIV infection targeting local high risk behaviors and preventive measures to reduce mother to child transmission (MTCT) of HIV with the use of antiretroviral therapy (ART), counselling and psychological support to victims of sexual violence during armed conflicts should be envisaged as a part of the strategies to assure human security in conflict zones.
ACKNOWLEDGMENT
The authors thank Professor Sayumi Nojima for the documentation.
Keywords
• Conflict
• HIV infection
• Human security
• Women
• Sexual violence
