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HIV and Sexual Assault in Times of War: Conscious Acts of Terror

By Dave R.

November 17, 2014

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War is a strong ally of HIV. It means we say goodbye to our communities and prevention strategies and we say hello to HIV and AIDS.

-- A Save the Children health worker in Burundi

I wonder where you're reading this. On your tablet on your way to work? Sitting with a glass of wine in the warmth of your home? In a café on the corner? Wherever it is, I would imagine most of you will be glancing at it in a position of comfort, with all mod cons around you, warm and well-fed, just as I am while writing it.

The reason I say this is because the subject of this article highlights the fact that there are broadly two sorts of HIV sufferers; the haves and the have-nots. The haves can take their meds, live where they choose and live a more or less, normal life span. They can moan about their daily lives, argue with the traffic warden, shout at the TV and fill their lives with the trivia of living in the developed world and yes, they can also have valid health problems and difficult times -- it's all relative. The have-nots on the other hand, have none of those luxuries, have done nothing wrong and have been caught up in a particular hell that's none of their doing. They are victims of circumstance, of their surroundings and of their birth but many are also tragic victims of the worst and most unthinkable aspects of human nature and there are literally millions of them. They're women and girls, and occasionally men and boys, and they are the faceless statistics of rape in wars where the penis is used as a loaded gun and HIV becomes a weapon of mass destruction. They have the same HIV that you do, and thinking about them should make you feel uncomfortable and fearful because there but for the grace of God go we all.

In the context of these people, the word "rape" takes on a whole new dimension. It's not simply a violent act to satisfy sexual need, it becomes a political tool to subjugate and undermine, to infect and destroy society for generations to come. It's meant to humiliate and demean and its effects and consequences are meant to be shared and passed on, so that norms and values disintegrate in the face of pain and nightmares.

The following account comes from a survivor of the Rwandan conflict of 1994 and speaks for itself.

About 10 of them came. They picked two of the women in the group: a 25-year-old and a 30-year-old and then gang-raped them. When they finished, they cut them with knives all over while the other Interahamwe watched. Then they took the food from the table and stuffed it into their vaginas. The women died. They were left dead with their legs spread apart. My husband tried to put their legs together before we were told to get out of the house and to leave the children behind. They killed two of our children. My husband begged them not to kill us, saying that he did not have any money on him, but that he had shoes and secondhand clothes that he sells at the market. He gave them all the clothes. Then, one Interahamwe said, "You Tutsi women are very sweet, so we have to kill the man and take you.

The woman's husband was indeed slaughtered and she was taken away to be repeatedly raped until she managed to escape. Those are the bare facts.

This is rape in war. There's no humanity here; it's a brutal act of possession carried out by human beings that are so emotionally desensitized, they cannot feel empathy for their victims. The victims must very often end up the same way.

Rape as a feature of war has always existed; it's not a 20th century phenomenon and before any unwitting racist conclusions are jumped to, it's not only a feature of black African history, it happens and has happened everywhere. As far back as the Japanese occupation of Nanking in 1937, where rape was a deliberate military tool; through the mass rapes of the Bangladeshi independence struggles in 1971; to the relatively recent Balkan civil wars, in which 20,000 Muslim women and girls were raped in Bosnia, as a deliberate attempt to ethnically cleanse, rape has long been used as a military tactic.

What is historically new, is the use of rape as a biological weapon. Again in Rwanda in that terrible conflict, a rape victim recalled being told:

We are not killing you. We are giving you something worse. You will die a slow death.

As a deliberate act, many women and girls were set apart, to be raped by soldiers who had HIV/AIDS.

They gang-raped women -- they used their weapons to tear them apart, causing internal tears resulting in fistula -- and they forced the families of the victims to watch gang rapes in progress. The stories were unbearable.

I think most ordinary people can't help but feel disconnected on reading this sort of account because it's almost too horrifying to make an emotional connection. How must it feel to be living your life one minute and to be surrounded by angry, wild-eyed, animalistic men the next? To perhaps watch as they slaughter your family, or people you know and then to come to the terrible realisation that they have something else in store for you! These are women or young girls; innocent and unprepared for the brutality of war. They're beaten or maimed and then physically invaded and degraded to the point where you can only hope they can somehow switch off from the situation. I'm a man and the thought already fills me with fear; little wonder that these women are physically and mentally damaged for the rest of their lives yet it's a major miracle that many of them do find the strength to return to life and try to pick up the threads afterwards. How is that possible?

I regret that I didn't die that day. Those men and women who died are now at peace whereas I am still here to suffer even more. I'm handicapped in the true sense of the word. I don't know how to explain it. I regret that I'm alive because I've lost my lust for life. We survivors are broken-hearted. We live in a situation which overwhelms us. Our wounds become deeper every day. We are constantly in mourning."

-- Women Under Siege

"You have to ask yourself why HIV has become a weapon. Is it any different to any other form of biological or chemical warfare? Is it any different to the bullet which maims but doesn't kill?"

The act of rape is destructive enough but if you then add HIV to the mix ...

You have to ask yourself why HIV has become a weapon. Is it any different to any other form of biological or chemical warfare? Is it any different to the bullet which maims but doesn't kill? It seems such a strange development in human behaviour; there must be a reason.

To begin with, many of the current conflicts where rape and HIV play a part, take place in patriarchal societies where the role of women is already both precarious but well-defined. Unlike in the first world, women must behave in a certain way, otherwise they can be rejected by their men and punished by their own communities. Sexuality is a very sensitive issue and a sexual disease can remove status at a stroke. Knowing this, an enemy is well aware of the effect rape will have on the community. The woman will be rejected and even cast out, irrespective of the fact that she was at no fault whatsoever. She's ruined; spoiled goods and in many societies, there's no way back. That's why rape has been such an effective fighting tool throughout history. If the rape also transmits HIV, then the damage is so much greater because it's a weapon that attacks the very fabric of the enemy society. If you think about it, it targets mostly women and children and the men that carry it out set out to undermine family structures, which in turn corrodes the values and beliefs of the society it's aimed at, whether a small village or a particular ethnic group. The individuals are left completely violated and often close to death and carrying the seeds of a disease that can spread out of control. It's a sad fact of life that a woman who has been raped is, despite the injustice of it all, often rejected by her immediate social group and is forced away from her home and often into prostitution to survive at all. If HIV travels with her and if she is pregnant, it moves into future generations. It's a truly vicious circle.

You have to wonder at the diabolical minds that instigate this sort of strategy in a war zone. At least the bullet brings a quick death; rape and HIV have much longer-lasting consequences and apart from the poor individual victim, her whole community is tainted forever. It's far too easy to assume that a community should look after its own in these circumstances. Even in the 1st world, with all its luxuries, a rape victim is too frequently viewed with suspicion and perversely stained with guilt. Add HIV to those prejudices and the traumas spread out like ripples on a pond.

The problem is internationally recognised but almost never acted upon. According to UNICEF:

The laws of war prohibit the use of all weapons or tactics of warfare that cause superfluous injury, unnecessary suffering, or violate "principles of humanity and the dictates of public conscience.'' Rape is a prohibited weapon or tactic of war under the criteria set by the laws of war.

Yet, however widespread rape is used as a weapon on the killing fields of the world, no state has ever been held to account for the use of rape as a military weapon and god knows, there's enough evidence! Just taking one example; the SF Gate reports:

"Some estimate that approximately 60 percent of combatants in Congo are HIV-infected and Zimbabwean troops there may be up to 70 percent infected. The group Women's Equity in Access to Care and Treatment has estimated that 67 percent of rape survivors in Rwanda are HIV-infected."

So given that HIV has added a whole new dimension to "collateral damage," why on earth aren't the world's international bodies, starting with the UN, doing anything about it? It may be because of something as pedantic as defining the term "weapon of war." According to the United Nation's women's organisation, there seems to be a lot of unnecessary quibbling about definitions:

"How is a "weapon" or a "tactic" of war defined under international law and where does rape fit in?"

War rape falls under the technical meaning of a "tactic" or "method" of warfare rather than a "weapon" or "means" of warfare under IHL. However the term "weapon" is frequently used by the International Committee of the Red Cross (ICRC) and others as a broad term to cover both the means ("weapon") and methods ("tactics") of warfare, and this practice is followed in this FAQ. The criteria for assessing the lawfulness of a weapon (or a tactic) under IHL is the same for all practical purposes. The term "weapon" means the objects, materials or projectiles used for gaining military objectives, whereas the term "tactic" or "method" refers to strategies that may involve the use of legal items or weapons. For example, the deliberate starvation of civilians for military advantage is a prohibited method of war. The Security Council has characterized the use of rape in armed conflict both as a "weapon" and as a "tactic" of war, but the more correct term under IHL would be "tactic."

-- Global Justice Center

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HIV, Neuropathy and More: Avoiding Becoming a Nervous Wreck

Dave R.

Dave R.

English but living since 1986 in Amsterdam, the Netherlands. HIV+ since 2004 and a neuropathy patient since 2007. I've seen quite a bit, done quite a bit and bought quite a few t-shirts if you know what I mean; but all that baggage makes me what I am today: a better person I believe, despite it all.

Arriving on, originally, was the end result of getting neuropathy as a side effect of the medication, or the virus, or both. I found it such a vague disease and discovered very little information that wasn't commercially tinged, or scientifically impenetrable, so I decided to create a daily Blog and a website where practical information, hints, tips and experiences for patients could be gathered together in one place.

However, I was also given the chance to write about other aspects of living with HIV and have now contributed more articles about those than about neuropathy. That said, neuropathy remains my 'core subject' although one which unfortunately dominates both my life and that of many other HIV-positive people.

I'm not a doctor or qualified medical expert, just someone with neuropathy and HIV who has spent the last few years researching the illness and trying to create information sources for people who want to know more.

I also have my own personal website and write for

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