Wars In Africa Not Contributing To Spread Of HIV

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Wars, refugee crises and widespread rape in Africa are not contributingto the spread of HIV on the continent, according to a study publishedThursday in the journal Lancet, Reuters reports. For the study, researchers led by Paul Spiegel, chief of the public health and HIV section for the United Nations High Commissioner for Refugees,tracked HIV rates in seven sub-Saharan African nations that recentlyhave experienced war or other types of conflict. The researchers didnot find evidence that HIV prevalence increased in the countries intimes of conflict. The seven countries are Burundi, Democratic Republicof Congo, Rwanda, Sierra Leone, Somalia, Sudan and Uganda (Dunham, Reuters, 6/28).

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Theresearchers examined 12 refugee camps in the seven countries and foundthat nine of the camps had lower HIV prevalence than the surroundingcommunities. Two of the camps had similar HIV prevalence, and one had ahigher prevalence, the study found (UN News Service,6/29). According to Spiegel, HIV rates might increase in areas affectedby conflict but not to the same degree as similar areas not affected bywar. The study also found that large-scale rapes during conflicts didnot increase overall HIV prevalence. "Every case of rape is abhorrentand must be cared for properly," Spiegel said, adding, "At theindividual level, the person is at risk of becoming infected with HIV.However, given simple epidemiology, this may not translate into anoverall increase in HIV prevalence at the country level."

Accordingto the researchers, men during times of peace often have multiple,concurrent sex partners or leave their families to work in urban areas,where they might engage in sex with HIV-positive commercial sexworkers. The men then transmit the virus to their wives when theyreturn home. According to Spiegel, war might disrupt such transmissionpatterns because people are less mobile (Reuters, 6/28).

Spiegelsaid that the study's results should not be applied to all conflictsworldwide, adding that every case "must be examined individually andcontext is very important." In addition, Spiegel said that the resultsshould not be interpreted to mean that HIV is not a cause for concernin conflict areas. He called for effective prevention programs toprotect refugees against HIV and added that prevention programs shouldbe implemented in postconflict periods to curb the spread of the virus.According to the study's authors, previous reports of high HIVprevalence in conflict areas are because of poor surveillance methodsand biased interpretation of data, UN News Service reports (UN News Service, 6/29). Gopa Kumar Nair, HIV/AIDS adviser for Save the Children,said that the study's finding might not reflect the situation on theground. "Our experience from the field clearly shows that there is ahuge link between vulnerability to HIV and conflict," he said, adding,"We have seen community-based health systems breaking down" (Reuters, 6/28).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . TheKaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service ofThe Henry J. Kaiser Family Foundation.

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