Wars in Africa Not Contributing to Spread of HIV, Study Says

Wars, refugee crises and widespread rape in Africa are not contributing to the spread of HIV on the continent, according to a study published Thursday 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 recently have experienced war or other types of conflict. The researchers did not find evidence that HIV prevalence increased in the countries in times of conflict. The seven countries are Burundi, Democratic Republic of Congo, Rwanda, Sierra Leone, Somalia, Sudan and Uganda (Dunham, Reuters, 6/28).

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

According to 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 sex workers. The men then transmit the virus to their wives when they return home. According to Spiegel, war might disrupt such transmission patterns because people are less mobile (Reuters, 6/28).

Spiegel said that the study's results should not be applied to all conflicts worldwide, adding that every case "must be examined individually and context is very important." In addition, Spiegel said that the results should not be interpreted to mean that HIV is not a cause for concern in conflict areas. He called for effective prevention programs to protect refugees against HIV and added that prevention programs should be implemented in postconflict periods to curb the spread of the virus. According to the study's authors, previous reports of high HIV prevalence in conflict areas are because of poor surveillance methods and 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 the ground. "Our experience from the field clearly shows that there is a huge link between vulnerability to HIV and conflict," he said, adding, "We have seen community-based health systems breaking down" (Reuters, 6/28).

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