UNITED NATIONS, New York - Efforts to prevent, control and treat HIV infections must become a standard component of the international community's humanitarian response to armed conflict and post-conflict situations, an expert meeting concluded here on Friday.

When conflicts break out, social patterns are disrupted, behaviours change and large populations are often displaced. Women and girls become more vulnerable to sexual exploitation and gender violence - at a time where health services and means of preventing infection often become scarce or unavailable. Rape and torture take place more frequently and have been used systematically in several conflicts to promote ethnic cleansing and spread fear.

The meeting, "HIV/AIDS in Conflict Situations", was a follow-up to several Security Council Resolutions, most notably Resolution 1308, in which the Council " . . . recognized that the HIV/AIDS pandemic is also exacerbated by conditions of violence and instability, which increases the risk of exposure to the disease through large movements of people, widespread uncertainty over conditions, and reduced access to medical care".

The meeting was organized by the United Nations Population Fund (UNFPA) and gathered nearly 60 experts from all United Nations humanitarian agencies and international non-governmental organizations (NGOs). The findings of the meeting will be submitted in a report to the Secretary-General.

Experts at the meeting recommended that increased financial resources as well as more technical assistance be provided to developing countries affected by conflict and HIV in order to counter their debilitating effects on vulnerable populations and economies. In sub-Saharan Africa, ravaged by both enduring conflicts and the deadly virus, there is an especially urgent need for massive assistance to combat HIV. Generations of people and decades of development gains are wasted by the virus and the devastation is being accelerated by war and fighting.

Moreover, in many countries in Africa, the young - the very people who could fight the deadly epidemic in the future - are being infected and dying. Generations are being lost to HIV/AIDS, says UNFPA Representative to Liberia, Deji Popoola.

"When we lose the young, we lose the promise of a better future. We lose knowledge, development and momentum against HIV," he said.

"We can not restart meaningful development during conflict, it is the primary impediment in the fight against AIDS. Even when peace comes, the scars left by conflict continue to impede progress: When infrastructure, hospitals and clinics are destroyed, communities suffer until they are rebuilt. But we are losing the generations that could rebuild them. The international community must act forcefully to address the deadly interaction between HIV/AIDS and conflict and it must act immediately. It is not possible to overstate the urgency here."

In order to stop HIV/AIDS from being accelerated further by armed conflicts, experts at the meeting recommended that: 

• HIV/AIDS prevention and treatment should become a standard component of the international community's humanitarian response to armed conflict, as should reproductive health services including safe delivery, family planning and safe motherhood;
• A specific set of guidelines for assistance under such circumstances should be developed;
• Voluntary counselling and testing (VCT) services should be widely available and ensure confidentiality. Safe handling of blood should be ensured at all levels;
• Special security measures should be put in place to protect women and girls from sexual and gender-based violence (e.g., designing refugee camps to prevent sexual violence.)
• Measures to reduce the risk of mother-to-child transmission of HIV should be implemented;
• Reproductive health services should be provided to adolescents who may engage in risky behaviour or experience sexual violence. Such services should reflect the increased risk of infection to young people;
• Collection of health data, whenever possible, should be undertaken at all stages of the conflict;
• Combatants and other uniformed services should be sensitized to promote gender equity and respect for women's rights and be trained to avoid infection of themselves and their partners;National and international legal frameworks should be strengthened to combat impunity and the tactics of systematic rape and abuse of women and girls;
• Income-generating opportunities as well as skills training and education should be made available, especially to the young, to fight hopelessness and risky behaviours including prostitution to survive;
• Health care providers should be trained in gender-sensitive approaches to service delivery and in the social and health risks associated with conflict situations;
• Additional funding from the international community should be allocated to address the deadly interaction of HIV/AIDS and armed conflict;
• Advocacy efforts should be undertaken to sensitize both donors and developing countries to the HIV/AIDS catastrophe that follows in the wake of armed conflict.

The meeting also singled out factors that explicitly contribute to the spread of HIV during situations of armed conflict and upheaval:

Sexual violence: Rape is often used as a weapon of war and women are often perceived as bounty. In refugee camps and other settlements with displaced people, women and girls also face the loss of personal security and risk getting raped while carrying out daily duties such as collecting firewood or water.

Breakdown in social structure and legal protection: Sexual relationships become more transitory and may involve a greater number of partners. Young people become more sexually active and marry at a much earlier age in the absence of leisure, education and employment opportunities. In such circumstances women and young girls are often sexually abused and not protected from sexual violence, resulting in a vicious circle of impunity.

Health infrastructure: The lack of health infrastructures means that access to condoms is limited, sexually transmitted infections (STIs) are not treated and drugs are not available to prevent mother-to-child transmission. Also, and especially in temporary health care facilities, trained staff and confidentiality are hard to find as are care and support for HIV infected persons. Moreover, soldiers and members of uniformed services are more likely to receive health care and treatment than their families. Women and girls have especially limited access to health facilities and confront more public discrimination because of the absence of medical and social support.

Gender inequity: The low status of women and girls in many countries make them vulnerable to sexual and gender-based violence, discrimination and infection with HIV because their ability to negotiate safe sex or abstinence becomes even more limited during times of insecurity and strife.

Basic needs and economic opportunities: Women and children sometimes exchange sex for food, resources, shelter, protection and money.

Education and skills training: More women and girls engage in risky behaviours because a lack of education and skills training leave them with few options and income-generating opportunities.

Military and peacekeeping forces: Armed forces tend to have higher rates of HIV infection than populations at large and there is often a large power gap between them and refugee women and children. The soldiers often know little or nothing about HIV/AIDS transmission and how to prevent infection.

- - -

UNFPA is the world's largest multilateral source of population assistance. Since it became operational in 1969, it has provided more than $5 billion to developing countries to meet reproductive health needs and support sustainable development efforts.

Contact Information:

William A. Ryan
Tel.: +66 2 288 2446
Email: ryanw@unfpa.org