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Understanding sexual violence, HIV/AIDS and conflict

Rates of HIV transmission are often presumed to increase in situations of violent conflict, due to high levels of sexual violence, poverty and displacement which create a high risk environment for the spread of HIV. Claims of a link between sexual violence and HIV infection have been supported by prevalence data amongst specific groups who suffered a high incidence of violence during war time.

Rates of HIV transmission are often presumed to increase in situations of violent conflict, due to high levels of sexual violence, poverty and displacement which create a high risk environment for the spread of HIV. Claims of a link between sexual violence and HIV infection have been supported by prevalence data amongst specific groups who suffered a high incidence of violence during war time. A study in Rwanda found that seropositivity(1) was 60-80% among women who had been raped during the 1994 genocide, compared to 13.5% of the general population.(2)
However, other studies have challenged this claim, pointing out that conditions of violent conflict can both raise and lower transmission rates and emphasising that high prevalence rates for specific at-risk groups should not be extrapolated to the entire population.

These varying viewpoints reflect assumptions about types of behaviours and their impact on transmission. It is often assumed that one-off, opportunistic rape is the only form of sexual violence in conflict contexts. However, it also includes other forms such as sexual slavery and other strategic and deliberate attacks over time. There is evidence that both long-term exposure to the virus and violent sexual activity are associated with increased risk of transmission.
Clearly, rigorous analysis of available data is important in understanding sexual violence and HIV transmission within conflict environments. However, we also need a ‘gender approach’, exploring the social and cultural dimensions of sexual relationships within conflict settings to help the design of measures for effective prevention.

Sexual violence in the Great Lakes

During the wars which have been fought in the African Great Lakes region for the past 20 years various patterns of sexual violence have been identified. In Rwanda, much of the reported sexual violence has been associated with the genocide, although domestic violence has emerged as a concern more recently. During the LRA war in Uganda, army personnel allegedly perpetrated widespread rape of men and women, while rebel militias were accused of abducting male and female children, with girls forced to serve as ‘wives’ of commanders. Similarly, rape by military personnel (both from the national army and from local militias) has been widespread in the Democratic Republic of the Congo (DRC) and Burundi, and there have also been reports of coercion ranging from abduction to violent force to economic enticement.

Common features found across the region include the sheer number of rapes, the extreme brutality of sexual encounters, the continuation of sexual violence after the war has ended, including ‘civilian rape’ and the ‘double violation’ whereby victims encounter stigma and are disowned by their families and communities after suffering sexual violence. Sexual violence in the region has attracted media attention, contributing to the emergence of well-funded international interventions. Although many individual projects have been effective, the overall impact has been limited. This has been partly because of assumptions about who the victims and perpetrators are. There has been a narrow range of types of support offered to victims, poor coordination between agencies, and greater focus on medical and psychosocial recovery with less attention to legal and economic support. Target beneficiaries have primarily been adult women, frequently ignoring the broader range of victims including young women and girls, as well as men and boys.

Most damagingly, inroads have not been made into the phenomenon itself, which in many parts of the region (notably DRC) continues at similar levels to the past. Long-term solutions for preventing sexual violence have not been identified, as the focus has been on response rather than prevention. Efforts at prevention, where they exist at all, have been focused on containment (through legal reform, for example) rather than on understanding the factors that have contributed to the outbreak of sexual violence. A possible explanation for this neglect is that the discourse around sexual violence in the Great Lakes has been dominated by the notion of sexual violence as a ‘weapon of war’. As long as we assume sexual violence to be perpetrated by marauding men of arms, we feel impotent to challenge or eradicate it.

It is beginning to become clear, however, that the ‘weapon of war’ explanation is insufficient to explain either the extent or the form of the phenomenon, and that much sexual violence in such settings is carried out not by armies or militias but by non-military civilians. This raises the question of who the perpetrators are, and what creates the conditions in which they carry out these crimes.

The archetypal aggressive male

The one-dimensional model of the aggressive male fails to provide an explanation of the root causes of sexual violence during and after conflict. It does not account for the social rejection suffered by raped women nor does it explain the continuation of violence after fighting has ended. The suggestion that ‘civilian’ men committing rape are demobilised soldiers having difficulty adjusting to civilian life is highly speculative. This model assumes that sexual violence of this intensity was unknown before the war, although there is virtually no firm evidence on which to make a comparison. It is possible that the dominance of this model in the international response contributes to the failure to bring sexual violence under control.

The gender literature is divided in its interpretation of sexual violence in war. One view holds that war is by definition ‘war on women’, and that rape in war functions as part of a ‘scorched earth’ approach, causing terror and destabilising the social fabric and identity of a community by forcing its women into extreme vulnerability. Other researchers describe a more complex reality, in which both men and women can be seen both as victims and as perpetrators. Literature on post-conflict changes in gender relations suggests that where women make gains during wartime a backlash often follows, implying that the underlying values that deny women a role in decision making have deep roots.

Individuals can be shaped by their context and their experiences, and war can have the effect of narrowing the range of options through which the values that are critical to a person’s sense of identity and self-esteem can be lived. If this is the case, then does a conflict environment enhance violent sexual behaviour? There is a suggestion that in northern Uganda the deprivations of war have prevented men from attaining their ideals of manhood, leading to violent behaviour towards others as well as various forms of self-harm.(3) Interviews with Congolese rank-and-file soldiers suggest that, for them, the military establishment provides a backdrop of suffering and frustration against which violence appears comprehensible.(4) These findings suggest the possibility that perpetrators can be seen as being in some way victims of their situations. This would mean that strategies to alter these contextual factors may help to change behaviour.

Understanding the context in which perpetrators grow up and are socialised, the problems they face and how they conceptualise them, the sorts of rewards and sanctions they receive from those around them and how these are reinforced by international actors would enable identification of strategies that cut to the root of the problem rather than just reacting to its consequences.

The image of the powerful man and his vulnerable woman victim raises the question as to whether brutal and violent rape is really a separate phenomenon. Should we rather see it as one end of a continuum linking it with other forms of coercive sex, as well as with a range of other oppressive relationships? And is it really an issue of man versus woman, or are both victims in different ways of the same patriarchal power dynamics? Does the one-dimensional depiction of ‘woman as victim’ help to perpetuate the very power imbalances it seeks to undermine?

A ‘gender approach’ to sexual violence in conflict

A gender lens can contribute powerfully to strategies for addressing HIV/AIDS, sexual violence and violent conflict. Considering gender within a socio-psychological framework is more powerful than the current archetypal model. We need to address not just the everyday behaviour of men and women but also the structures within which power relations operate, as well as their ideological underpinnings. Such an approach might lead to more holistic policies and strategies, with a broader range of interventions, better coordination and synergy between them, and a stronger emphasis on mechanisms that involve agencies and local communities acting together in a shared search for solutions.

HIV transmission is driven by relationships whose intimate nature brings to the fore people’s deepest feelings about their identity and values. Effective HIV prevention programmes have emphasised the importance of building relationships based on mutual respect. During conflict, when moral underpinnings are compromised, these foundations are essential for the prevention of both sexual violence and HIV transmission. Understanding the social and cultural context describing these relationships is a step towards effective prevention, both of the HIV virus itself and of sexual violence.

Judy El-Bushra is Manager of the Great Lakes Programme at International Alert.

This article is extracted from a longer report available from ASCI.

(1) showing a serological reaction indicating the presence of the disease.

(2) Nduwimana, F. 2004. ‘The Right to Survive: Sexual Violence, Women and HIV/AIDS’. Rights and Democracy, Montreal

(3) Dolan, C. (2002) ‘Collapsing masculinities and weak states – a case study of northern Uganda’ in Cleaver (ed) Masculinities matter! men, gender and development London, Zed Press.

(4) Eriksson Baaz, M. and Stern, M. Why do soldiers rape? Gender, violence and sexuality in the DRC Armed Forces, unpublished paper, Goteborg University.


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