En analysant les dimensions de sexe et de genre des guerres civiles au Libéria et en Sierra Leone, les chercheurs montrent les liens entre les conflits et l'incidence des violences sexuelles contre les femmes ainsi que les risques d'exposition au VIH/sida dans les deux pays. Cette analyse examine également ces liens dans le contexte des transitions post-conflit et conclut que les réponses à la violence basée sur le genre sont nécessaires à la prévention du VIH.
The wars in Liberia (1989-96, 1999-2003) and Sierra Leone (1997-2002) … had multiple and severely adverse consequences for human security and social well-being in both countries. Two of the most direct and health-harming impacts were sexual violence against women and HIV transmission, which disproportionately affected young women and girls.
The two wars were particularly characterized by widespread and vicious forms of sexual violence on the part of all the warring factions and militias and created several other related conditions, such as large-scale population displacements, destabilization of sexual norms and acute economic desperation that made both the military and civilian population more vulnerable to HIV/AIDS.
Moreover, contrary to conventional wisdom, the transition from war to relative peace seemed to foster the persistence of women's exposure to chronic sexual violence, despite the cessation of mass-atrocity sexual crimes with potential implications for increased HIV transmission.
When subjected to age-differentials, HIV prevalence in both countries, to some extent, can be linked to partner violence, and "exploitative transactional sexual relations between older and rich(er) men and several much younger and poor(er) women". .. Since women in abusive or exploitative, unequal sexual relationships are more likely to be infected by HIV, their rights and protection should constitute an important aspect of post-conflict transitions.
The adult HIV prevalence trends for Liberia and Sierra Leone estimated by WHO and UNAIDS on the basis of blood samples from antenatal clinic attendees between the early 1990s and 2005 show a slow but steady rise in HIV infection rates with few notable spikes (for Liberia) during the years of armed conflict followed by a leveling off in the post-conflict period for both countries.
[It is] important for donors and policy-makers to integrate responses to gender-based violence into the support and decisions regarding HIV/AIDS prevention and treatment programmes, particularly in post-conflict contexts, where young and poorer women remain particularly vulnerable.
The continuing extraordinary prevalence of HIV… particularly among women demonstrates that campaigns, scaled-up HIV testing and antiretroviral treatment are not enough. Women must be empowered with legal rights, sufficient food and economic opportunities to gain agency of their own lives. Men must be educated and supported to acknowledge women's equal status and throw off the yoke of socially- and culturally- sanctioned discriminatory beliefs and risky sexual behavior.
Programmes to combat HIV/AIDS and SVAW need to go beyond individual behaviors by addressing social and economic vulnerabilities, mobilizing communities and new partnerships and providing additional opportunities, resources and services to address the specific needs of women and girls.
Such efforts must be systematically integrated to be effective and sustainable, given the mutually reinforcing relationship between SVAW and HIV/ AIDS. In particular, integrating the strategies to reduce SVAW into ongoing and planned HIV prevention and treatment programmes in post-conflict Liberia and Sierra Leone is likely to enable these health interventions to achieve their full potential and at the same time tackle a broader human rights and public health issue.
Despite the complexity of the intersections between armed conflict, post-conflict transitions and adult HIV prevalence… the evidence is clear about the higher risks of HIV infection faced by individual women who are frequently exposed to sexual violence.
Post-conflict transition in Liberia and Sierra Leone appears to have mainly produced a change in the forms and profile of the main perpetrators of Sexual Violence Against Women (SVAW), especially adolescents and pre-adolescents.
Overall levels of chronic SVAW remain quite high. It is therefore worrying that Liberia and Sierra Leone… attract far more external funding for HIV prevention and treatment programmes, which do not even modestly integrate responses to Gender Based Violence and other critical gender equity issues.
The required multi-sectoral responses to SVAW struggle to attract funding even after both countries have devised well thought-out national action plans for combating SVAW. This predicament calls into question the extent to which international assistance in post- conflict West Africa is informed by the evidence of the needs on the ground.
It is important to reiterate that overall levels of SVAW do not necessarily decline drastically even after many years of post-conflict transition. That in itself is a human rights, reproductive health and social welfare issue serious enough to raise questions about the validity of the presumed opportunities presented by post-conflict transitions to remake societies on the basis of human dignity and social justice.