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HIV/AIDS,
women and conflict
Nearly
40,000,000 people in the world have been driven from their homes by
emergency situations, whether natural or man-made. They live in refugee
camps abroad or are moved within their home countries. Some have been
displaced from their homelands for more than 20 years.
Whatever the length of a refugee’s exile, his or her existence
always contains an element of instability, increasing the risk of
exposure or transmission of AIDS. HIV/AIDS is often neglected in the
aftermath of a catastrophe, because there seem to be more pressing
issues to address. However, it is precisely in this moment that AIDS
is most threatening, especially to women and children, who make up
75% of the refugee and displaced population (UNAIDS, 1997).
Mobility and Propagation of HIV/AIDS
The brutal civil wars in Liberia and Sierra Leone beginning in the
1990s led more than one million citizens of the Mano River basin to
take refuge in Ivory Coast and Guinea in the last decade. In addition
to the refugees, one or two million people are estimated to have moved
inside their countries as a result of these conflicts (UNAIDS, 2002).
Such a forced and massive population movement accelerates the propagation
of sexually transmissible infections, including AIDS, particularly
among women and children as well as in the host communities, armed
forces and international peacekeeping forces.
The consequences of such a massive population movement in the Mano
River basin countries, as well as the nearby Ivory Coast, include:
n
destruction of family or community networks
n
increase in poverty, in particular by the growing number of women-headed
households
n
adoption of at-risk survival strategies including sex as a means of
survival
n
drug consumption or abuse
n
sexual, physical and other kinds of abuse against women
When a disaster strikes, AIDS will be usually the last thing on both
the refugees’ and aid workers’ minds. After all, the propagation
of HIV/AIDS is not immediately visible; infections often do not manifest
in physical symptoms until several years.
However, there is great reason for us to be concerned with HIV/AIDS
in conflict situations. AIDS is a major problem in many existing refuge
populations, though in many cases AIDS was already present in the
original community (i.e., Rwanda in 1994).
In these cases, social instability, poverty, and the vulnerability
will accelerate the propagation of HIV/AIDS. Factors that increase
propagation of HIV/AIDS in emergency situations are multiple:
n
shortages in safe blood supplies for transfusions of the wounded (as
well as malnourished women and children) in times of combat.
n
sexual contact: Populations fleeing conflict include many non-accompanied
children and women. Often these women and children run the greatest
risks. They can be raped or forced to have sexual intercourse to meet
their basic needs (for example, Uganda, where men controlled the water
sources).
n
prostitution: food insecurity is frequent in situations of conflict.
It is thus not rare for women to have sexual intercourse for money
to buy food and meet other basic needs. This practice is fueled by
the fact that the men and women often are separated from their usual
partners. Prostitution is established inside or around the refugee
camps. It inevitably implies both the refugee and host communities.
n
drugs, the mixing of populations, lack of access to condoms and many
others.
Measures to be taken to reduce the propagation of HIV/AIDS
Firstly, one must avoid imposing obligatory HIV/AIDS testing of refugees
to avoid worsening their state of shock. In fact, obligatory testing
will not stop the propagation of HIV/AIDS infection. There are nevertheless
various manners of managing to overcome the risks relating to HIV/AIDS
that threaten these populations. These methods include a minimum of
activities for the prevention and the assumption of responsibility
of HIV/AIDS in an emergency:
n
Guarantee a safe blood supply: this is a vital measure at all the
stages of an emergency; the blood intended for transfusions must always
be subjected to HIV/AIDS tests. Nevertheless, taking into account
this acute and chaotic period, it is necessary to employ special urgent
procedures. One can organize brief discussions with blood donors to
gauge if they seem apt to provide a safe supply.
n
Distribution of condoms. Even if field humanitarian agents concentrate
on other questions, it is very important to guarantee a sufficient
supply of condoms. The refugees are often already relatively well
informed of the risks of HIV/AIDS infection related to sexual behavior
and the importance of condoms.
n
Access to basic information on HIV/AIDS. Information on the risks
of HIV is also very important, and, like condoms, must be provided
quickly in an emergency.
n
Physical protection of refugees and displaced people, particularly
women and children, who are most vulnerable, must be protected from
violence and mistreatment. The physical protection of the vulnerable
people is not only a principle of human rights; it is also an essential
measure to reduce the risk of HIV/AIDS infection of the refugees and
host community.
Lobbying and communication to reassure the community and the host
country. Emergencies do not occur in a political vacuum. So that a
humane operation or assistance proceeds harmoniously, one needs good
relations with the national and local authorities of the host country,
if they still exist, particularly with the military authorities.
It is also vital to consider the host community in the planning refugee
programs, particularly those involving HIV/AIDS, otherwise the problems
such programs attempt to address will ultimately persist.
Often the conditions that reign at the time of a humanitarian crisis
-- war, physical insecurity, human rights violations and rape - accelerate
the propagation of HIV/AIDS, especially among women and girls. In
short, we must act quickly to protect refugees from all forms of violence,
mistreatment and intimidation from the very start of an emergency
situation.
Prevention of HIV/AIDS and other sexually transmissible infections
is an essential component of effective measurements of refugee protection
and reproductive health programs. Let us act to prevent the spread
of this deadly disease, rather than reacting once it is too late.
--Mme.
Kalo Assa Camara
_ Reproductive health specialist and
MARWOPNET member
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Women and HIV/AIDS in Africa
n As
of 2000, around 14 million Africans had died of AIDS
n
28 million of the 40 million people estimated
to be HIV-positive in the world live in sub-saharan Africa
n
More young African women than men have
contracted HIV/AIDS (see cultural factors below), yet two-thirds of
HIV-infected women claim to have only one sexual partner
n
New medications that can slow the progression
of AIDS, such as anti-retroviral therapy, are not yet available in
Africa. There is still no cure for AIDS anywhere in the world.
Source: UNAIDS and UNDP
HIV Rates in Guinea
n National
average : 2.8%
n Forested
Guinea : 7%
n Prostitutes
: 40%
Source : World Bank
Women and HIV/AIDS: Physical Factors
n The
vaginal cavity is porous and retains fluids, facilitating transmission
n Women
receive more secretions during sexual activity than men
n Women
are more likely to receive small injuries during sexual activity,
making them more vulnerable to infection
n STDs
are more difficult to detect in women because the vagina is an internal
organ
Socioeconomic and Cultural Factors
n Cultural
practices like excision and polygamy
n Cultural
myths, i.e. sex with a virgin cures AIDS
n Women
not encouraged to take charge of their sexuality
n Lack
of sexual education amongst women
n Prostitution
used as a means of survival
Terminology
STD: sexually transmitted disease
HIV: Human Immunodeficiency Virus
AIDS: Auto-Immunodeficiency Syndrome
MARWOPNET
joins the
fight against HIV/AIDS...
MARWOPNET joins Women's AIDS Network
The Network of Women Infected and Affected
by HIV/AIDS (REFIAGUI) was launched during a workshop from November
3 - 5, 2004 in Conakry organized by the Executive Secretariat of the
National Committee against AIDS (CNLS) in collaboration with the European
Union, UNAIDS and the Mama Henriette Conté Foundation. (read
complete story)
Teacher training in Forécariah
MARWOPNET’s Forécariah antenna, in conjunction with CLUSA-Guinea,
conducted a training of trainers on STDs/HIV/AIDS in Forécariah
August 23 to 25, 2004.
Thirty members of the Network and civil society took part in this
training course, which aimed to render participants capable of informing
and educating others on STDs/HIV/AIDS.
CLUSA-Guinea staff facilitated the course, which dealt with the following:
- clarification of concepts on STDs/HIV/AIDS
- types and symptoms of STDs/HIV/AIDS
- prevention and means of transmission
- use of condoms
- communication tools in the fight against STDs/HIV/AIDS
- strategies and activities to be used in STDs/HIV/AIDS awareness
campaigns
Hands-on
exercises, educational talks, and distribution of materials and posters
accompanied discussion of these topics. At the end of the session,
CLUSA-Guinea, one of the antenna’s newest partners, donated the
antenna 10 boxes of publicity materials, 8 phalluses and 10 boxes
of condoms.
Awareness campaign launched in Kissidougou
MARWOPNET’s Kissidougou office launched a public awareness campaign
in the urban center of Kissidougou September 3-7, 2004. 1,200 people,
including 854 women, benefited from the campaign, which dealt with
building a culture of peace; the fight against gender-based violence
and child abuse; and STD/HIV/AIDS prevention.
First Lady of Guinea Henriette Conté
hands out condoms to military officers
Links
The
impact of HIV/AIDS on education in conflict situations - UNESCO
Africa,
AIDS and Conflict resources - USAID
HIV/AIDS
and Conflict - UNAIDS
UNAIDS
- West and Central Africa
Mano
River Initiative on HIV/AIDS
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