• Since early
2000, the UN Security Council has highlighted the threat posed by the
HIV/AIDS epidemic to global peace and security. It has held several
discussions on HIV/AIDS—the first time the world’s top political body
has addressed a health and development issue. In July 2000, the Security
Council passed Resolution 1308, emphasizing the need to combat the spread
of the virus during peacekeeping operations.
• The links between
AIDS and issues of security are many, and the epidemic destabilizes
societies in profound ways. As parents and workers succumb to AIDS-related
illnesses, the structures and divisions of labour in households, families,
workplaces and communities are disrupted, with women bearing an especially
heavy burden. From there, the effects cascade across society, reducing
income levels, weakening economies and undermining the social fabric.
• The economic
and developmental impact can be especially dramatic. It is estimated
that gross domestic product (GDP) growth shrinks by as much as 1-2%
annually in countries with an HIV prevalence rate of more than 20%.
Over several years, the loss of economic output accumulates alarmingly.
Calculations show that heavily affected countries could lose more than
20% of GDP by 2020.
• The epidemic
increases the strain on state institutions and resources, while undermining
the social systems that enable people to cope with adversity. In badly
affected countries, education and health systems are compromised, economic
output shrinks and state institutions, such as the judiciary and police,
are undermined. In some societies, increased social and political instability
• The epidemic
thrives in settings already marked by high degrees of socioeconomic
insecurity, social exclusion and political instability. Individuals
subjected to those conditions—migrant workers, displaced people, refugees
and ostracized minorities worldwide—face much higher risks of infection.
it is often the absence of economic security that propels people into
sex work for a living, and many end up in prison, where they face a
higher risk of infection.
• In regions
hit by famine, repression or violent conflict and war, populations are
more at risk of HIV infection. Social systems are disrupted, families
are separated and communities are displaced. This social dislocation
and rampant insecurity create fertile settings for HIV transmission.
• In the worst
affected countries, HIV is spreading fastest among those under 24 years
of age—especially among women and girls, who tend to have less access
to the information and services they need to protect themselves against
• According to
recent studies, adolescent girls in several African countries are five-to-six
times more likely to be HIV-positive than boys their own age. Women
and girls are also less able to control the terms on which they have
sex, and face greater risks of sexual coercion and violence. The use
of rape as an instrument of war and repression adds another serious
dimension. As the epidemic’s grip strengthens, instability and insecurity
are likely to worsen, creating a vicious cycle.
AIDS in the military
and emergency operations
• In the past
decade, HIV/AIDS has emerged as a major threat in emergency settings.
Humanitarian operations can place both relief workers and local populations
at greater risk of infection. The increased likelihood of sexual violence
and prostitution among refugee populations broadens and accelerates
the spread of HIV.
• In conflict
situations, children and young people are especially vulnerable to HIV/AIDS.
Those unable to escape conflict zones face high risks of sexual abuse,
forced military recruitment and prostitution. The uncertainty and insecurity
experienced by children in refugee camps also encourage earlier sexual
activity, typically in the absence of sexual health education and related
services. It is therefore essential that young people (especially refugee
children and former combatants) caught in the midst of wars and other
emergencies be reintegrated into their communities and societies.
• The military
is an increasingly important factor in the epidemic, although most armies
and governments are reluctant to reveal HIV statistics. Military personnel
are at high risk of exposure to sexually transmitted infections (STIs),
including HIV. In peacetime, STI rates among soldiers are estimated
to be two-to-five times that among the civilian population. In times
of conflict, the discrepancy is even larger. In some countries with
adult HIV prevalence rates of 20%, it is estimated that as many as 50%
of military personnel could be HIV-positive.
• Conflict resolution
and peacekeeping measures are important elements of strategies designed
to contain HIV/AIDS. In settings of war and conflict, the main perpetrators
of sexual abuse and exploitation are the young men who staff regular
armed forces and other armed groups. Even in peacetime, the likelihood
of unsafe commercial sex appears to rise in the presence of military
bases or units.
is the need to step up HIV prevention and care in armies and in international
peacekeeping forces. Confidential and voluntary counselling and testing
can be expanded and health care for soldiers improved. Examples set
by senior officers and officials can help offset the secrecy, stigma
and shame that cloak the epidemic.
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