Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Emerging Themes in Epidemiology
Published in: Emerging Themes in Epidemiology 1/2004

Open Access 01-12-2004 | Analytic perspective

Conflict and HIV: A framework for risk assessment to prevent HIV in conflict-affected settings in Africa

Authors: Nancy B Mock, Sambe Duale, Lisanne F Brown, Ellen Mathys, Heather C O'Maonaigh, Nina KL Abul-Husn, Sterling Elliott

Published in: Emerging Themes in Epidemiology | Issue 1/2004

Login to get access

Abstract

In sub-Saharan Africa, HIV/AIDS and violent conflict interact to shape population health and development in dramatic ways. HIV/AIDS can create conditions conducive to conflict. Conflict can affect the epidemiology of HIV/AIDS. Conflict is generally understood to accelerate HIV transmission, but this view is simplistic and disregards complex interrelationships between factors that can inhibit and accelerate the spread of HIV in conflict and post conflict settings, respectively. This paper provides a framework for understanding these factors and discusses their implications for policy formulation and program planning in conflict-affected settings.
Appendix
Available only for authorised users
Literature
1.
2.
3.
United Nations Program on HIV/AIDS (UNAIDS): Report on the global HIV/AIDS epidemic: 4th global report 2004 Geneva: UNAIDS; 2004.
4.
Smallman-Raynor MR, Cliff AD: Civil war and the spread of AIDS in central Africa. Epidemiol Infection. 1991, 107 (1): 69-80.CrossRef
5.
6.
Foster G, Williamson J: A review of current literature of the impact of HIV/AIDS on children in sub-Saharan Africa. AIDS. 2000, 14 (suppl 3): S275-S284.PubMed
7.
Barnett T, Whiteside A: AIDS in the Twenty-First Century: Disease and Globalization New York: Palgrave; 2002CrossRef
8.
Khaw A, Salama P, Burkholder B, Dondero T: HIV risk and prevention in emergency-affected populations: a review. Disasters. 2000, 24: 181-197.CrossRefPubMed
9.
Salama P, Dondero TJ: HIV surveillance in complex emergencies. AIDS. 2001, 15 (S3): S4-12. 10.1097/00002030-200104003-00002.CrossRefPubMed
10.
UNAIDS, World Health Organization (WHO): Epidemiologic Fact Sheets on HIV/AIDS and Sexually Transmitted Infections, 2000, Update. Angola Geneva: UNAIDS/WHO; 2002.
11.
Blaikie P, Cannon T, Davis I, Wisner B: At Risk: Natural Hazards, People's Vulenrability, and Disasters London and New York: Routledge; 1994.
12.
UNAIDS, (WHO): Epidemiologic Fact Sheets on HIV/AIDS and Sexually Transmitted Infections, 2000 Update. Cambodia. Geneva: UNAIDS/WHO; 2002.
13.
14.
15.
Beck N, King G, Zeng L: Improving quantitative studies of international conflict: a conjecture. American Political Science Review. 2000, 54: 1.
16.
17.
WHO Regional Office for Africa: Epidemiological Surveillance Update for the WHO African Region 2002 Country Profiles HIV/AID. Harare, Zimbabwe WHO; 2003.
18.
Kingma SJ: AIDS prevention, testing and care in current military practice. International Conference on AIDS. 1996, 11 (1): 47.
19.
20.
Office National de la Population (ONAPO) [Rwanda] et Macro International (1994): Rwanda: Demographic and Health Survey, Final Report Calverton, Maryland USA: Macro International; 1992.
21.
Gustafson P, Gomes VF, Vieira CS, Jensen H, Seng R, Norberg R, Samb B, Naucler A, Aaby P: Tuberculosis mortality during a civil war in Guinea-Bissau. JAMA. 2001, 286 (5): 599-603.CrossRefPubMed
22.
Green B: Post-traumatic stress disorder: symptom profiles in men and women. Current Medical Research and Opinion. 2003, 19 (3): 200-4.CrossRefPubMed
23.
Casper RC, Redmond DE, Katz MM, Schaffer CB, Davis JM, Koslow SH: Somatic symptoms in primary affective disorder. Present and relationship to the classification of depression. Archives of General Psychiatry. 1985, 42: 1098-1104.CrossRefPubMed
24.
Bolton P, Ndogoni L: Cross-cultural Assessment of Trauma-Related Mental Illness. CERTI Project. Johns Hopkins University and World Vision International, Baltimore. Payson Center for International Development and Technology Transfer, Tulane University, New Orleans 2000
25.
Wollants E, Schoenenberg M, Figueroa C, Shor-Posner G, Klaskala W, Baum MK: Risk factors and patterns of HIV-1 transmission in the El Salvador military during war time. AIDS. 1995, 9: 1291-1292.CrossRefPubMed
26.
Mendelson JM, Carballo M: A policy critique of HIV/AIDS and demobilization. Conflict, Security, and Development. 2001, 1 (2): 73-92.CrossRef
27.
WHO: HIV/AIDS in Asia and the Pacific Region Geneva: WHO; 2001.
28.
Abebe Y, Schaap A, Mamo G, Negussie A, Darimo B, Wolday D, Sanders EJ: HIV prevalence in 72 000 urban and rural male army recruits, Ethiopia. AIDS. 2003, 17 (12): 1835-40.CrossRefPubMed
29.
30.
Asenkeyne OM, Lomongin J, Otim C: Struggling for survival in the era of HIV/AIDS in refugee camps in Kotido district (Uganda) experience. In Proceedings of the XIII International Conference on AIDS: July 2002; Durban. Abstract MoPeD2643
31.
32.
UNAIDS: Aids & Mobility. In Refugees and AIDS Geneva: UNAIDS Best Collection; 1997.
33.
Akwir M, Arkangel A, Moluma D, Idro JW, Homsy J: Vulnerability of refugee women to HIV/AIDS infection in refugee camps in northern Uganda. In Proceedings of the XII World AIDS Conference, June 1998; Geneva. abstract 44209. Reviewed in Hankins CA, Friedman SR, Zafar T, Strathdee SA: Transmission and prevention of HIV and sexually transmitted infections in war settings: implications for current and future armed conflicts AIDS 2002, 16: 2245–2252
34.
35.
USAID: Rebuilding Postwar Rwanda: The Role of the International Community. Evaluation Special Study, Report No. 76 Washington, DC: USAID/CDIE; 1996.
36.
African Rights: Rwanda: Death, Despair and Defiance London: African Rights; 1995.
37.
Mock N, Drapcho R: DHS and Conflict in Africa. Findings from a Comparative Study and Recommendations for Improving the Utility of DHS as a Survey Vehicle in Conflict Settings, Working Paper. MEASURE/Evaluation Project. 2000, http://​www.​certi.​org
38.
Semba RD, Miotti PG, Chiphangwi JD, Saah A, Canner J, Dallabetta G, Hoover DR: Maternal vitamin A deficiency and mother-to-child transmission of HIV-1. Lancet. 1994, 343: 1593-1597.CrossRefPubMed
39.
Hussey G, Hughes J, Potgieter S, Malan H, Kessow G: Vitamin A status and supplementation and its effect on immunity in children with AIDS XVII International Vitamin A Consultive Group 81 1996
40.
Hussey GD, Klein M: A randomized, controlled trial of vitamin A in children with severe measles. New England Journal of Medicine. 1990, 323: 160-4.CrossRefPubMed
41.
Shankar AH, Genton B, Semba RD, Baisor M, Paino J, Tamja S, Adiguma T, Wu L, Rare L, Tielsch JM, Alpers MP, West KP Jr: Effect of vitamin A supplementation on morbidity due to Plasmodium falciparum in young children in Papua New Guinea: a randomized trial. Lancet. 1999, 354: 203-209.CrossRefPubMed
42.
Bendich A: Antioxidant vitamins and immune responses. In Nutrition and Immunology Edited by: Chandra R. New York: Liss; 1998: 125-47.
43.
Baum MK, Shor-Posner G, Lu Y, Rosner B, Saudberlich HE, Fletcher MA, Szapocznik J, Eisodorfer C, Buring JE, Hennekens CH: Micronutrients and HIV-1 disease progression. AIDS. 1995, 9: 1051-1056.CrossRefPubMed
44.
Greenburg BL, Semba RD, Vink PE, Farley JJ, Sivapalasingam M, Steketee RW, Thea DM, Schoenbaum EE: Vitamin A deficiency and maternal-infant transmission of HIV in two metropolitan areas in the United States. AIDS. 1997, 11: 325-332.CrossRef
45.
Nduati RW, John GC, Richardson BA, Overbaugh J, Welch M, Ndiya-Achola J, Moses S, Holmes K, Onyango F, Kreiss JK: Human immunodeficiency virus type 1-infected cells in breast milk: association with immunosuppression and vitamin A deficiency. Journal of Infectious Diseases. 1995, 172: 1461-1468.PubMedCentralCrossRefPubMed
46.
John GC, Nduati RW, Mbori-Ngacha D, Overbaugh J, Welch M, Richardson BA, Ndinya-Achola J, Bwayo J, Krieger J, Onyango F, Kreiss JK: Genital shedding of human immunodeficiency virus type 1 DNA during pregnancy: association with immunosuppression, abnormal cervical or vaginal discharge and severe vitamin A deficiency. Journal of Infectious Diseases. 1997, 175: 57-62.PubMedCentralCrossRefPubMed
47.
Burns DN, FitzGerald G, Semba R, Hershow R, Zorilla C, Pitt J, Hammill H, Cooper E, Fowler MG, Landesman S: Vitamin A Deficiency and Other Nutritional Indices During Pregnancy in Human Immunodeficiency Virus Infection: Prevalence, Clinical Correlates, and Outcome. Clinical Infectious Diseases. 1999, 29: 328-34.CrossRefPubMed
48.
Burger H, Kovacs A, Weiser B, Grimson R, Nachum S, Tropper P, van Bennekum AM, Elie M, Blaner W: Maternal serum vitamin A levels are not associated with mother-to-child transmission of HIV-1 in the United States. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1997, 14 (4): 321-326.CrossRefPubMed
49.
Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM: Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. AIDS. 1999, 13: 1517-1524.CrossRefPubMed
50.
Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, Kapiga S, Mwakagile D, Essex M, Spiegelman D: Randomized trial of vitamin supplements in relation to vertical transmission of HIV-1 in Tanzania. Journal of Acquired Immune Deficiency Syndromes. 2003, 23: 246-254.CrossRef
51.
Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, Kapiga S, Mwakagile D, Essex M, Spiegleman D: Randomized control trial of vitamin supplements in relation to transmission of HIV-1 through breasfeeding and early child mortality. AIDS. 2002, 16 (14): 1935-44.CrossRefPubMed
52.
Semba RD: The role of vitamin A and related retinoids in immune function. Nutrition Reviews. 1998, 56 (S2): S38-S48.PubMed
53.
54.
Ingham R: AIDS: knowledge, awareness and attitudes. In Sexual Behavior and AIDS in the Developing World. Edited by: Cleland J, Ferry B, Bristol, Pennsylvania: Taylor & Francis, Inc; 1995, 43-74.
55.
Office National de la Population (ONAPO) [Rwanda] and ORC Macro: Rwanda: Demographic and Health Survey, Final Report 2000 Kigali, Rwanda and Calverton, Maryland USA: Ministere de la Sante Publique, Office National de la Population et ORC Macro; 2001.
56.
Caraël M: Sexual behavior. In Sexual Behavior and AIDS in the Developing World. Edited by: Cleland J, Ferry B. Bristol, Pennsylvania: Taylor & Francis, Inc; 1995, 75-123.
57.
Anderson RM, Gupta S, Ng W: The significance of sexual partner contact networks for the transmission dynamics of HIV. Journal of Acquired Immune Deficiency Syndromes. 1990, 3: 417-429.PubMed
58.
Anderson RM, May RM, Boily MC, Garnett GP, Rowley JT: The Spread of HIV-1 in Africa: sexual contact patterns and the predicted demographic impact of AIDS. Nature. 1991, 352: 581-589.CrossRefPubMed
59.
Fleming DT, Wasserheit JN: From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections. 1999, 75: 3-17.PubMedCentralCrossRefPubMed
60.
Leroy V, Ladner J, Nyiraziraje M, De Clercq A, Bazubagira A, Van de Perre P, Karita E, Dabis F: Effect of HIV-1 infection on pregnancy outcome in women in Kigali, Rwanda, 1992–1994: Pregnancy and HIV Study Group. AIDS. 1998, 12 (6): 643-50.CrossRefPubMed
61.
Human Rights Watch (HRW): Shattered Lives: Sexual Violence During the Rwandan Genocide and Its Aftermath. HRW, Africa, Women's Rights Project 1996 [http://​www.​hrw.​org].
62.
63.
Swiss S, Jennings PJ, Aryee GV, Brown GH, Jappah-Samukai RM, Kamara MS, Schaack RD, Turay-Kanneh RS: Violence against women during the Liberian civil conflict. JAMA. 1998, 279 (8): 625-629.CrossRefPubMed
64.
Amowitz LL, Reis C, Lyons KH, Vann B, Mansaray B, Akinsulure-Smith AM, Taylor L, Iacopino V: Prevalence of war-related sexual violence and other human rights abuses among internally displaced persons in Sierra Leone. JAMA. 2002, 287 (4): 513-21.CrossRefPubMed
65.
van der Straten A, King R, Grinstead O, Serufilira A, Allen S: Couple communication, sexual coercion and HIV risk reduction in Kigali, Rwanda. AIDS. 1995, 9 (8): 935-44.CrossRefPubMed
66.
United Nations Population Fund (UNFPA): Presentation of Findings: Survey of Reproductive Health Among Internally Displaced Persons, Angola. USAID, Angola; 2000
67.
Bulterys M, Musanganire F, Chao A, Saah A, Dushimimana A: Traditional mourning customs and the spread of HIV-1 in rural Rwanda: a target for AIDS prevention?. AIDS. 1994, 8 (6): 858-9.CrossRefPubMed
68.
Drain P, Smith J, Hughes J, Laperin D, Holmes K: Correlates Of National HIV Seroprevalence: An Ecologic Analysis of 122 Developing Countries. Journal of Acquired Immune Deficiency Syndromes. 2004, 35 (4): 407-420.CrossRefPubMed
69.
Boerma JT, Gregson S, Nyamukapa C, Urassa M: Understanding the Uneven Spread of HIV Within Africa: Comparative Study of Biologic, Behavioral, and Contextual Factors in Rural Populations in Tanzania and Zimbabwe. Sexually Transmitted Diseases. 2003, 30: 779-787.CrossRefPubMed
70.
Auvert B, Buve A, Ferry B, Carael M, Morison L, Lagarde E, Robinson NJ, Kahindo M, Chege J, Rutenberg N, Musonda R, Laourou M, Akam E, Study Group on the Heterogeneity of HIV Epidemics in African Cities: Ecological and individual level analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection. AIDS 2001, 15 (supple 4): S15-S30. 10.1097/00002030-200108004-00003.CrossRefPubMed
71.
Complex Emergency Response and Transition Initiative (CERTI): Preventing and Coping with HIV/AIDS in Post-Conflict Societies: Gender-Based Lessons from Sub-Saharan Africa. Durban, South Africa. In Background Briefing from the 2001 Tulane University/ACCORD/USAID Symposium: October 2001; Pretoria, South Africa, CERTI; 2001.
72.
73.
Walker N, Garcia-Calleja JM, Heaton L, Asamoah-Odei E, Poumerol G, Lazzari S, Ghys PD, Schwartlander B, Stanecki KA: Epidemiological analysis of the quality of HIV sero-surveillance in the world: how well do we track the epidemic?. AIDS. 2001, 15: 1545-1554.CrossRefPubMed
Metadata
Title
Conflict and HIV: A framework for risk assessment to prevent HIV in conflict-affected settings in Africa
Authors
Nancy B Mock
Sambe Duale
Lisanne F Brown
Ellen Mathys
Heather C O'Maonaigh
Nina KL Abul-Husn
Sterling Elliott
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Emerging Themes in Epidemiology / Issue 1/2004
Electronic ISSN: 1742-7622
DOI
https://doi.org/10.1186/1742-7622-1-6

Other articles of this Issue 1/2004

Emerging Themes in Epidemiology 1/2004 Go to the issue

Analytic perspective

The role of the applied epidemiologist in armed conflict

Editorial

Emerging Themes in Epidemiology: Form and function

Analytic perspective

Assessing the impact of humanitarian assistance in the health sector

Editorial

The birth of Emerging Themes in Epidemiology: a tale of Valerie, causality and epidemiology

Editorial

Epidemiology in conflict – A call to arms