Transmission and Prevention of HIV and Sexually Transmitted Infections in War Settings: Implications for Current and Future Armed Conflicts


Hankins, Catharine, Samuel Friedman, Tariq Zafar, and Steffanie Strathdee. 2002. “Transmission and Prevention of HIV and Sexually Transmitted Infections in War Settings: Implications for Current and Future Armed Conflicts.” AIDS 16 (17): 2245–52.

Authors: Catherine Hankins, Samuel Friedman, Tariq Zafar, Stephanie Strathdee


Armed conflicts often constitute ‘complex emergencies’, defined as situations affecting large civilian populations which combine war or civil strife with food shortages and population displacement. Wars can increase the spread of sexually transmitted infections (STI) and facilitate HIV transmission through sexual routes, injection drug use (IDU), contaminated blood transfusions and occupational injuries; furthermore,they can create synergistic conditions for interacting epidemics. Armed conflicts can influence HIV epidemic dynamics in surrounding countries and beyond, both directly by affecting HIV transmission itself and indirectly through reallocation of health-related public funds toward security and defense measures. Poverty, powerlessness and social instability, all of which facilitate HIV transmission, are extremely heightened in complex emergencies, but HIV is rarely seen as a priority. We review the effects of war on HIV and STI transmission and critically appraise short- and medium-term approaches to prevention. Our intent is to stimulate thinking about the potential for increased HIV/STI transmission in current and future armed conflicts, with particular reference to Afghanistan, and to encourage timely interventions to prevent a worsening HIV epidemic in Central and South Asia.

Keywords: Asia, HIV, sexually transmitted infections, sexually transmitted diseases, injection drug use, prevention of sexual and blood-borne transmission, war settings, Afghanistan

Topics: Armed Conflict, Economies, Poverty, Health, HIV/AIDS, Reproductive Health, Sexual Violence, Sexuality Regions: Asia, Central Asia, South Asia Countries: Afghanistan

Year: 2002

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