Citation

Supervie V, Halima Y, Blower S. AIDS 2010; 24(18): 2841-2847.

Affiliation

aSemel Institute of Neuroscience & Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, California, USA bGlobal Campaign for Microbicides, USA cSchool of International Studies, American University, Washington, District of Columbia, USA. *Current address: INSERM U943 Paris & UPMC Univ-Paris 6, UMR S943, Paris F75013, France.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/QAD.0b013e32833fed78

PMID

20859191

PMCID

PMC2978669

Abstract

OBJECTIVES:: To quantify the potential impact of mass rape on HIV incidence in seven conflict-afflicted countries (CACs), with severe HIV epidemics, in sub-Saharan Africa. DESIGN:: Uncertainty analysis of a risk equation model. METHODS:: A mathematical model was used to evaluate the potential impact of mass rape on increasing HIV incidence in women and girls in Burundi, Democratic Republic of Congo (DRC), Rwanda, Sierra Leone, Somalia, southern Sudan and Uganda. The model was parameterized with data from UNAIDS/WHO and the US Census Bureau's International Database. Incidence data from UNAIDS/WHO were used for calibration. RESULTS:: Mass rape could cause approximately five HIV infections per 100 000 females per year in the DRC, Sudan, Somalia and Sierra Leone, double the number in Burundi and Rwanda, and quadruple the number in Uganda. The number of females infected per year due to mass rape is likely to be relatively low in Somalia and Sierra Leone at 127 [median (interquartile range [IQR] 55-254)] and 156 [median (IQR 69-305)], respectively. Numbers could be high in the DRC and Uganda: 1120 [median (IQR 527-2360)] and 2172 [median (IQR 1031-4668)], respectively. In Burundi, Rwanda and Sudan, the numbers are likely to be intermediate. Under extreme conditions, 10 000 women and girls could be infected per year in the DRC and 20 000 women and girls could be infected per year in Uganda. Mass rape could increase annual incidence by approximately 7% [median (IQR 3-15)]. CONCLUSION:: Interventions and treatment targeted to rape survivors during armed conflicts could reduce HIV incidence. Support should be provided both on the basis of human rights and public health.

Language: en