Question from the moderator:

“Over the last decade since the establishment of the Security Council mandate on conflict-related sexual violence (CRSV), we have gained greater knowledge about the patterns and trends of CRSV and understand that this is a problem in conflicts around the world. From the standpoint of your mandate, could you give us more information regarding the nexus between CRSV and the prevalence of HIV?”

Response [approx. 5 minutes]:

• Thank you for this question and allow me to begin by expressing my appreciation to UNAIDS and the African Union for organizing this important event.

• As you rightly noted, my mandate as Special Representative on Sexual Violence in Conflict, was established by the Security Council almost a decade ago, to mainstream sexual violence prevention into international security policy, and to serve as a political advocate for combatting an atrocity that has been called “history’s greatest silence” and “the world’s least-condemned crime of war”.

• In this capacity, I chair an interagency network known as UN Action Against Sexual Violence in Conflict, in which UNAIDS is an active member.

• In 2011, UNAIDS partnered with my Office to advocate for and conceptualize a Security Council resolution on the nexus between conflict-related sexual violence and HIV prevalence, namely resolution 1983. This framework calls attention to the impact of HIV in conflict and post-conflict situations, which are characterized by mass population movements, widespread sexual violence, and limited access to medical care. It further notes that the disproportionate burden of HIV/AIDS on women is a persistent obstacle to gender equality and calls upon Member States to strengthen the capacity of national health systems and civil society networks to provide sustainable assistance to women living with, or affected by, HIV, and to address the social stigma and discrimination associated with this disease.

• Resolution 1983 called for concerted efforts to combat conflict-related sexual violence, as part of reducing women’s risk of exposure to HIV; measures to curb the transmission of HIV from mother to child in conflict-affected settings where services are scarce; and encouraged the inclusion of HIV prevention, treatment and care in peacekeeping mandates.

• In 2012, UN Action organized a conference to further explore the intersections between sexual violence in conflict and HIV transmission, in order to identify priorities for research, policy and practice. The resulting report noted that the links between sexual violence, associated injuries, and HIV transmission are significant for understanding the epidemic’s impact on women in conflict-affected regions such as sub-Saharan Africa, where women comprise 57% of adults living with HIV.

• It further noted that in conflict situations, the same conditions that increase the risk of sexual violence also facilitate the spread of HIV, including: the use of rape as a tactic of war, torture, “ethnic cleansing” and genocide; the frequency of gang-rape by highly-mobile troops; injuries and abrasions resulting from rape, including from the use of weapons and objects; the rise in prostitution and proliferation of brothels in proximity to military bases; recourse to so-called “survival sex” due to poverty and desperation; mass displacement and the attendant breakdown of family and community structures; human trafficking as part of the political economy of war, in which women’s bodies are treated as commodities to be used, abused and traded by armed and criminal groups; high-risk behaviors by front-line combatants, including unprotected sex with multiple partners; as well as the collapse of public health infrastructure, which limits the availability and accessibility of services, including emergency reproductive care and anti-retroviral treatment.

• We now understand that armed conflict creates conditions that allow HIV/AIDS to flourish, including rampant rape, gang-rape, sexual slavery, forced prostitution, forced pregnancy, trafficking and exploitation, in environments where Rule of Law and public health institutions may have virtually collapsed.

• In some extreme cases, such as the 1994 Rwandan Genocide, sexual violence was deliberately used as a vector of ethnically targeted HIV transmission.

• In other settings, such as eastern DRC, fear of AIDS has caused husbands to abandon their wives following sexual assault by members of militia groups.

• Indeed, for many victims, the fear of rape is swiftly followed by fear of rejection. Stigma and the risk of reprisals, combined with difficulty accessing services, leads to chronic underreporting. In the Central African Republic in 2017, for example, just 26% of sexual violence survivors sought assistance within the 72-hour window in which post-exposure prophylaxis and emergency contraception are effective.

• In Nigeria, I met with women and girls who had been abducted and held captive by Boko Haram. Many returned pregnant and/or HIV-positive. They described facing social stigma and exclusion due to their so-called “Boko Haram babies” and their actual or perceived HIV status.

• By isolating the victims and cutting them off from medical care and psychosocial support, stigma promotes the silent spread of HIV/AIDS.

• Gender-responsive strategies are needed, including: HIV awareness training for members of the security sector, coupled with training on the prohibition of sexual violence under international law; outreach efforts to sensitize communities on the need to seek medical attention within 72 hours of an incident; efforts to bolster the institutional capacity, reach and resources of health systems and to enhance safe, timely and confidential access to testing, counseling, and emergency sexual and reproductive care; capacity-building of medical personnel and traditional health-workers to respond appropriately; engagement with religious and customary leaders to combat harmful social norms and stigma; and greater commitment to amplifying the voices of women in public health, peace and security policy.

• Violence and HIV suffered by women also has a negative effect on their children, as well as on their economic security, locking whole families into cycles of poverty, poor health, and vulnerability to further violence. The SDGs provide us with a blueprint for a better world. It is critical to ensure that women, even in remote and war-torn regions, are not left behind, or excluded from the dividends of sustainable development.

• In all of these efforts, intensified AU-UN cooperation is critical – this is why my mandate has adopted a Framework of Cooperation with the African Union, and it is also why we have gathered here today.

Thank you.

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