AIDS, War and the Spread of (Rape in War)

The role of war in the spread of acquired immunodeficiency syndrome (AIDS) and its impact on women. More than 40 million people in the world today are positive for human immunodeficiency virus (HIV), and more than 20 million people have died from AIDS. In sub-Saharan Africa, the majority of HIV-positive people are women, and the trend in almost all nations is for women to represent an increasing proportion of new infections. Since its emergence, the spread of AIDS has been associated with military conflict, which has particularly affected the HIV rate among women (Beyrer 1998, 198-199).

Conflicts tend to spread HIV for a number of reasons (Irwin, Millen, and Fallows 2003, 35-37). Wars may so weaken national governments that they cannot implement AIDS prevention programs. Rural areas or entire sections of a country may be cut off from the government’s health authority. For governments struggling to survive, HIV/AIDS may not be a priority, and warfare consumes resources that could otherwise be devoted to health education and programs. For people facing daily risks in a war zone, the long-term dangers of HIV/AIDS may also not be an immediate concern. During warfare the social order tends to collapse, and many women are put in a position in which it is difficult to deny men sex for protection or resources.

Armies at war can also serve to introduce or accelerate the transmission of HIV. In many developing countries, the HIV rate among soldiers is higher than in the general population and may be more than 50 percent in some armies in southern Africa (Irwin, Millen, and Fallows 2003, 36). By the mid-1990s, some army units in Thailand had a 10 percent HIV rate, whereas in Cambodia the rate reached 30 percent (Beyrer 1998, 140, 145). Historically, most soldiers are more likely to visit prostitutes and to have multiple partners (World Bank 1999, 161). The movement of soldiers thus presents opportunities for the transmission of the virus. The first appearance of AIDS in Uganda (the African state most affected by AIDS early in the pandemic) was associated with the Tanzanian invasion that overthrew Idi Amin in 1978-1979. The virus first appeared in the subcounties through which the victorious troops initially traveled (Hooper 2000, 42-51). In civil wars from Colombia to Kosovo, combatants also have used rape as an instrument of terror, which can leave women not only traumatized but also HIV-positive.


The displacement of large numbers of people also creates opportunities for HIV to spread to new groups. From Africa to Southeast Asia, guerrilla groups have turned to trafficking women to support their activities. Soldiers stationed abroad for peacekeeping may have financial resources denied to local communities and have often fueled the sex trade, as has been the case in Kosovo. In Cambodia in the early 1990s, United Nations peacekeepers seem to have contributed to the rapid spread of HIV, which particularly affected women (Beyrer 1998, 63-65). High rates of HIV tend to weaken the state, which may lead to social unrest and exacerbate regional conflicts (Beyrer 1998, 199).

Warfare tends to seal borders. In some instances, this may have helped to isolate nations from the spread of HIV/AIDS. This appears to have been the case in Nicaragua in the 1980s, during which the Nicaraguan contras conducted warfare along its border, without penetrating deep into the country, or challenging the local authority of the state. But such wars are the exception. In most cases, the closing of borders has accelerated the spread of HIV/AIDS. Warfare impedes the ability of UNAIDS and other organizations to acquire accurate information about HIV rates and epidemiology. Danger and chaos also restrict the ability of nongovernmental organizations to educate and pressure governments to act, which has been the case in Burma and the Democratic Republic of the Congo. For this reason in many developing nations at war, it is difficult to obtain good information about HIV rates among women, although it is clear that they are heavily affected.

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