Conflict, HIV and AIDS: A new dynamic in warfare?

Global Change, Peace and Security

Volumn 21, Issue 1, 2009, Pages 99-114

  McInnes, Colin ^a  

^a ABERYSTWYTH UNIVERSITY   (United Kingdom)

Author keywords

Africa; AIDS; Conflict; HIV; Security

Indexed keywords

EID: 76749157047     PISSN: 14781158     EISSN: 14781166     Source Type: Journal    
DOI: 10.1080/14781150802659440     Document Type: Article

References (178)

1. This article uses terminology which differentiates between the human immune-deficiency virus (HIV), a virus which is transmitted by human to human contact, and AIDS, which is not a virus but a syndrome of infections and diseases which develops as the immune system is weakened by HIV. Since the article is concerned with the spread of the virus, its primary focus is on HIV; but it is the syndromic condition referred to as AIDS which results in death. The distinction between HIV and AIDS has also become more commonplace as the development of and access to anti-retroviral therapies has improved such that people living with HIV are not necessarily AIDS patients, making the previous terminology of HIV/AIDS questionable.
2. Paul B. Spiegel et al., 'Prevalence of HIV Infection in Conflict-affected and Displaced People in Seven Sub-Saharan African Countries', The Lancet 369 (June 2007): 2187, 2191;
3. Jeff Gow, 'The HIV/AIDS Epidemic in Africa: Implications for US Policy', Health Affairs 21 (May/June 2002): 65.
4. Stefan Elbe, 'HIV/AIDS and the Changing Landscape of War in Africa', International Security 27 (Fall 2002): 174.
5. Dennis Altman, 'AIDS and Security', International Relations 17 (December 2003): 421.
6. Duane Bratt, 'Blue Condoms: The Use of International Peacekeepers in the Fight against AIDS', International Peacekeeping 9 (Autumn 2002): 72;
7. Peter Fourie and Martin Schonteich, 'Africa's New Security Threat: HIV/AIDS and Human Security in Africa', African Security Review 10 (2001): 6, http://www.iss.co.za/Pubs/ASR/10No4/Fourie.html, subsequent page references are to online version;
8. Jeff Gow, 'The HIV/AIDS Epidemic in Africa', 65;
9. N.A. Betsi et al., 'Effect of an Armed Conflict on Human Resources and Health Systems in Cote d'Ivoire', AIDS Care 18 (May 2006): 36;
10. S. Verstegen, HIV/AIDS: Waking up to the Challenge, Working document prepared by Conflict Research Unit, Clingendael Institute for the Netherlands Ministry of Foreign Affairs Special Ambassador for HIV/AIDS, March 2005: 24;
11. Vinh-Kim Nguyen and Katherine Stovel, The Social Science of HIV/AIDS: A CriticalReview and Priorities for Action, Report Prepared by the Social Science Research Council Working Group on HIV/AIDS, October 2004: 11-12;
12. Nancy B. Mock et al., 'Conflict and HIV: A Framework for Risk Assessment to Prevent HIV in Conflict-affected Settings in Africa', Emerging Themes in Epidemiology 1 (October 2004), available from BioMed Central, subsequent page references from the open access version, http://www.ete-online.com/content/1/1/6 (accessed 12 May 2008).
13. Timothy Docking, AIDS and Violent Conflict in Africa USIP Special Report 75, http://www.usip.org (accessed 12 May 2008), 7.
14. UN Security Council [UNSC] Press Release SC/6781, 10 January 2000, http://www.un.org/News/Press/docs/2000/20000110.sc6781.doc.html (accessed 13 May 2005).
15. Statement by Sir Jeremy Greenstock, Permanent Representative of the United Kingdom, in the Security Council, 19 January 2001, 'The Impact of HIV/AIDS on Peace and Security', http://www.ukun.org; (accessed 11 December 2002)
16. Tom Porteous (Africa Command) to Mark Lyall Grant, HIV/AIDS and Conflict, UK Foreign Office, 14 June 2002, RESTRICTED, released to author under UK Freedom of Information Act request;
17. Spiegel et al., 'Prevalence of HIV Infection', 2187.
18. UNSC Resolution [UNSCR] 1308, July 2000, 2, http://www.un.org/Docs/sc/unsc_resolutions.html (accessed 11 December 2002).
19. UNAIDS, 2007 AIDS Epidemic Update (Geneva: UNAIDS/WHO, 2007), 1, 4, 7, 15-20.
20. Colin McInnes and Kelley Lee, 'Health, Security and Foreign Policy', Review of International Studies 32 (January 2006): 5-23;
21. Colin McInnes, 'HIV/AIDS and National Security', in AIDS and Governance, ed. Nana Poku, Alan Whiteside and Bjorn Sandkjaer (Aldershot: Ashgate, 2007), 93-110;
22. Colin McInnes, 'HIV/AIDS and Security', International Affairs 82 (March 2006): 315-26;
23. Elbe, 'HIV/AIDS and the Changing Landscape of War'; Stefan Elbe, The Strategic Implications of HIV/AIDS, Adelphi Paper 357 (Oxford: OUP for IISS, 2003);
24. Stefan Elbe, 'Should HIV/AIDS be Securitized?', International Studies Quarterly 50 (March 2006): 119-44.
25. Elbe, 'Should HIV/AIDS be Securitized?'
26. Spiegel et al., 'Prevalence of HIV Infection';
27. McInnes, 'HIV/AIDS and Security';
28. McInnes, 'HIV/AIDS and National Security';
29. Alex de Waal, 'HIV/AIDS and the Military', Background paper to expert seminar and policy conference AIDS, Security and Democracy, Clingendael Institute, The Hague, 2-4 May 2005;
30. Tony Barnett and Gwyn Prins, 'HIV/AIDS and Security', International Affairs 82 (March 2006): 359-68.
31. Paul B. Spiegel, 'HIV/AIDS among Conflict-affected and Displaced Populations: Dispelling Myths and Taking Action', Disasters 28 (September 2004): 323.
32. UNAIDS, On the Front Line, 3rd ed. (Geneva: UNAIDS/WHO, 2005), 26.
33. UNAIDS, AIDS Epidemic Update: December 2005 (Geneva: UNAIDS/WHO, 2005), 24.
34. Spiegel et al., 'Prevalence of HIV Infection', 2192.
35. Alex de Waal argued that the evidence from other African conflicts (Sierra Leone, Sudan, Somalia, Uganda, northern Ethiopia and 'even' the DRC) was suggesting that far from conflict spreading HIV, with a number of exceptions, the reverse might actually prove to be the norm.
36. de Waal,'HIV/AIDS and the Military', 8.
37. Spiegel, 'HIV/AIDS among Conflict-affected Populations', 322-5; Netherlands inistry of Foreign Affairs, 6;
38. De Waal, 'HIV/AIDS and the Military', 8-9.
39. In its 2007 annual report on the spread of the disease for example, UNAIDS (not for the first time) recognised that previous estimates had been significantly in error due to the difficulties in obtaining data. As a consequence it reduced its estimate of people living with the disease from c.39 m in 2006 to c.33 m in 2007. UNAIDS, 2007 AIDS Epidemic Update (Geneva: UNAIDS/WHO, 2007), 3.
40. Spiegel A et al., 'Prevalence of HIV Infection', 2193. Global Change, Peace & Security 101
41. For a discussion of this orthodoxy see McInnes, 'HIV/AIDS and Security';
42. McInnes, 'HIV/AIDS and National Security'.
43. International Crisis Group, HIV/AIDS as a Security Issue in Africa: Lessons from Uganda (Kampala/Brussels: ICG, 2004), 1. For a more extensive discussion on this and the reasons behind it,
44. McInnes, 'HIV/AIDS and Security';
45. McInnes, 'HIV/AIDS and National Security'.
46. Eric G. Bing et al., 'HIV/AIDS Behavioural Surveillance among Angolan Military Men', AIDS Behaviour, accessed from PubMed PMID 17641966, http://www.plosmedicine.org (accessed 12 May 2008);
47. A. Pistorius, G. Gergen and B. Willershausen, 'Survey about the Knowledge of the HIV Infection amongst Recruits of the German Military', European Journal of Medical Research 30 (April 2003): 154-60;
48. E. van der Ryst et al., 'HIV/AIDS Related Knowledge, Attitudes and Practices among South African Military Recruits', South African Medical Journal 91 (July 2001): 587-91;
49. Harley Feldbaum, Kelley Lee and Preeti Patel, 'The National Security Implications of HIV/AIDS', PLoS 3 (June 2006), 171;
50. Elbe, 'HIV/AIDS and the Changing Landscape of War'.
51. UNAIDS, On the Front Line, 3rd ed., 12. For example shortly after of the UN Security Council discussion on HIV/AIDS, the Congolese military, the South African Defence Forces and the Nigerian military all released data on HIV infection rates.
52. rd ed.) UNAIDS claims that HIV/AIDS is the fifth highest reason to be invalided out of the Indian military and the second highest cause of death in its navy (p. 12). Although Russia has released figures which suggest that HIV prevalence in its armed forces is roughly in line with national trends, UNAIDS remains sceptical of this considering it might be an underestimation of the problem (p. 31ff). A number of Western militaries, including the UK, do not screen recruits or survey them for HIV prevalence.
53. For example, UNAIDS, Technical Update: AIDS and the military, May 1998 (Geneva/New York: UNAIDS, 1998); UNAIDS, HIV/AIDS Prevention and Care among Armed Forces and UN Peacekeepers: The Case of Eritrea (Geneva/New York: UNAIDS, 2003), 8.
54. UNAIDS, On the Front Line, 1st ed. (Geneva/New York: UNAIDS, 2003), 5-6;
55. US National Intelligence Council, The Global Infectious Disease Threat and Its Implications for the United States, National Intelligence Estimate NIE99-17D (Washington: CIA, 2000), http://www.cia.gov/cia/publications/nie/report/nie99-17d.html;
56. Lindy Heinecken, 'Facing a Merciless Enemy: HIV/AIDS and the South African Armed Forces', Armed Forces and Society 29 (Winter 2003): 784;
57. Robert L. Ostergard Jr., 'Politics in the Hot Zone: AIDS and National Security in Africa', Third World Quarterly 23 (April 2002): 343; International Crisis Group (ICG), HIV/AIDS as a Security Issue (Brussels: ICG, 2001), ii; Lessons from Uganda, 2-3
58. Mark Schneider and Michael Moodie, The Destabilising Impact of HIV/AIDS (Washington: Center for Strategic and International Studies, 2002), 2;
59. Paolo Tripodi and Preeti Patel, 'The Global Impact of HIV/AIDS on Peace Support Operations', International Peacekeeping, 9 (Autumn 2002): 54, table 1.
60. For example Docking, AIDS and Violent Conflict, 7. But in contrast
61. de Waal, 'HIV/AIDS and the Military', 7.
62. K.S. Subramanian, Impact of Conflict on HIV/AIDS in South Asia (2002), 50, available at http://aidsportal.org/store/770.pdf.
63. P.W. Singer, 'AIDS and International Security', Survival 44 (Spring 2002): 150-51. Though Ciantia sounds a note of caution, Filippo Ciantia, 'HIV Seroprevalence in Northern Uganda', Journal of Medicine and the Person 2 (December 2004): 174.
64. UNAIDS, On the Front Line, 3rd ed., 11.
65. Netherlands Ministry of Foreign Affairs (NMFA), HIV/AIDS, Security and Democracy, Seminar Report, Clingendael Institute, 4 May 2005, 5.
66. On possible initiatives to prevent the spread of HIV/AIDS in militaries, see UNAIDS Uniformed Services Programming Guide (Geneva: UNAIDS, 2003).
67. Martin Foreman, Combat AIDS: HIV and the World's Armed Forces (London: Healthlink Worldwide, 2002), 37-48.
68. UNAIDS Initiative on HIV/AIDS and Security: Third Quarterly Report (2002), http://www.who.int/hac/techguidance/pht/UNAIDS_initiative_HIV_security/en/ (accessed 29 July 2005);
69. ICG, Lessons from Uganda,3, 8-9, 14. The UN's AIDS awareness card is available from Awareness@unaids.org. For details on the card see UNAIDS, Uniformed Services Programming Guide, 12.
70. UNAIDS, Uniformed Services Programming Guide, 13;
71. UNAIDS, On the Front Line, 3rd ed., 10, 37;
72. UNAIDS, HIV/AIDS Prevention and Control: An Experience of the Royal Thai Army (Geneva: UNAIDS, 2004); UNAIDS, HIV/AIDS Prevention and Care, 9.
73. Stuart J. Kingma and Rodger D. Yeager, 'Military Personnel: On the Move and Vulnerable to HIV/AIDS and Other Infectious Diseases', unpublished paper (Rolle, Switzerland: Civil-Military Alliance to Combat HIV and AIDS, 2005), 10-11.
74. Lindy Heinecken, 'Facing a Merciless Enemy', 286.
75. de Waal, 'HIV/AIDS and the Military', 3; NMFA, HIV/AIDS, Security and Democracy, 6.
76. Oumar Ba et al., 'HIV/AIDS in African Militaries: An Ecological Analysis', Medicine, Conflict and Survival 24 (May 2008): 88-100, quotation from abstract.
77. P.W. Singer, 'AIDS and International Security', Survival 44 (Spring 2002): 147.
78. UNAIDS, Uniformed Services Programming Guide, 7-10;
79. UNAIDS, On The Front Line, 3rd ed., 12, 26-37;
80. NIE 99-17D, The Global Infectious Disease Threat; ICG, HIV/AIDS as a Security Issue, 20-21;
81. Ostergard, 'Politics in the Hot Zone', 343;
82. Peter Chalk, 'Infectious Disease and the Threat to National Security', Jane's Intelligence Review (September 2001): 49;
83. Alan du Pont, HIV/AIDS: A Major International Security Issue, Asia Pacific Ministerial Meeting October 2001 (Canberra: Commonwealth of Australia, 2001), 7; Verstegen, HIV/AIDS, 16;
84. Bratt, 'Blue Condoms', 71;
85. Schneider and Moodie, The Destabilising Impact, 6;
86. Tripodi and Patel, 'The Global Impact of HIV/AIDS', 54-7;
87. Elbe, 'HIV/AIDS and the Changing Landscape of War', 164.
88. Ba et al., 'HIV/AIDS in African Militaries'.
89. Bratt, 'Blue Condoms', 71;
90. UNAIDS, 'AIDS and Conflict: A Growing Problem Worldwide', in 2004 Report on the Global AIDS Epidemic (Geneva: UNAIDS/WHO, 2004), http://www.unaids.org/bangkok2004/GAR2004_html/GAR2004_12_en.htm#P1704_379265 (accessed 29 July 2005);
91. Rene Bennett, The Correlation between Conflict and the Spread of HIV/AIDS to Women, http://www.sit-edu-geneva.ch/conflicthiv_and.htm (accessed 29 July 2005), 14.
92. Sonal Singh et al., 'HIV in Nepal: Is the Violent Conflict Fuelling the Epidemic?', PLoS Med 2 (July 2005): 2-3, http://www.plosmedicine.org (accessed 12 May 2008)
93. Quoted in Bennett, Correlation, 14.
94. Spiegel A et al., 'Prevalence of HIV Infection', 2007.
95. Richard Walker, 'UNHCR Study Challenges Assumptions about Refugees and HIV Spread', AIDSPortal news, http://www.aidsportal.org/News_Details.aspx?id1/45215&nex1/451 (accessed 12 May 2008); UNAIDS, 'AIDS and Conflict'.
96. De Waal, 'HIV/AIDS and the Military', 8.
97. UNAIDS, 'AIDS and Conflict'.
98. Fatou Mbow and Douglas Webb, 'HIV/AIDs Affected Children in Conflict Settings and Parliamentarian Inaction', Conflict Trends 1 (2007): 48, http://www.accord.org.za/downloads/ct/ct_2007_1.pdf (accessed 12 May 2008).
99. Global Coalition on Women and AIDS, 'Sexual Violence in Conflict Settings and the Risk of HIV', Violence Against Women and HIV/AIDS, Information Bulletin Series no. 2 (2004): 1.
100. UNICEF, Children, Armed Conflict and HIV/AIDS (New York: UNICEF, 2003), 2-3;
101. Mock et al., 'Conflict and HIV', 7;
102. Subramanian, Impact of Conflict on HIV/AIDS, 49;
103. Nguyen and Stovel, The Social Science of HIV/AIDS, 11;
104. Mbow and Webb, "HIV/AIDS Affected Children", 50.
105. Human Rights Watch, The War within the War: Sexual Violence against Women and Girls in Eastern Congo (New York: Human Rights Watch, 2002).
106. Subramanian, Impact of Conflict, 50.
107. Singer, 'AIDS and International Security', 152-3.
108. Dan Thomas, 'AIDS 2006: Conflict Makes Girls and Women even more Vulnerable to HIV', http://www.unicef.org/aids/index_35317.html (accessed 12 May 2008);
109. UNAIDS, 'AIDS and Conflict'; Bennett, Correlation, 13;
110. Verstegen, HIV/AIDS, 4; [No author], 'The Democratic Republic of Congo [DRC]: A Country Raped by All Types of Men', Women's World 34 (1999): 22-3.
111. Catherine Newbury and Hannah Baldwin, Aftermath: Women in Postgenocide Rwanda (Washington, DC: Center for Development and Information Evaluation, no date given).
112. Global Coalition on Women and AIDS, 'Sexual Violence', 1.
113. UNICEF, Children, Armed Conflict.
114. Bennett, Correlation, 19.
115. Elbe, 'HIV/AIDS and the Changing Landscape of War'.
116. Quoted in Bennett, Correlation, 21. Though given the comparatively low rate of HIV at the time, and the presumed poor health of AIDS patients if they were in hospitals, one may question how many such 'battalions' there were and how much impact they had.
117. Spiegel et al., 'Prevalence of HIV Infection', 2191. Though note that the numbers of rape victims here may be too small to be statistically significant (53 individuals of whom 8 were HIV positive).
118. E. Kayirangwa et al., 'Current Trends in Rwanda's HIV/AIDS Epidemic', Sexually Transmitted Infections 82 suppl1 (2006): i27, http://www.stijournal.com (accessed 20 October 2008).
119. Paula Donovan, 'Rape and HIV/AIDS in Rwanda', The Lancet 360 supplement (2002): s18.
120. UNAIDS, 2007 AIDS Epidemic Update, 18.
121. See data contained in annual UNAIDS AIDS epidemic updates, http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/ (accessed 12 May 2008).
122. Aranka Anema et al., 'Widespread Rape does not Directly Appear to Increase the Overall HIV Prevalence in Conflict-affected Countries: So Now What?', Emerging Themes in Epidemiology 5 (2008), http://www.eteonline.com/content/5/1/11 (accessed 15 September 2008).
123. Robert L. Ostergard, Matthew R. Tubin and Erin Schweber, 'The Relationship between HIV/AIDS and Rape: Evidence from South Africa', Paper presented to annual ISA Conference, San Francisco, March 2008, 1.
124. Tom Ellman, Heather Culbert and Victoria Torres-Feced, 'Treatment of AIDS in Conflict-affected Settings: A Failure of Imagination', The Lancet 365 (January 2005): 2. The authors provide no evidence of their own but rather point to the 2001 ICG study (HIV/AIDS as a Security Issue) as exemplifying this concern. The ICG study forms an important part of the literature establishing the orthodox case for HIV as a national security issue and developing the link between HIV and conflict.
125. Bratt, 'Blue Condoms', 72.
126. Mock et al., 'Conflict and HIV';
127. Bennett, Correlation, 15;
128. Subramanian, Impact of Conflict, 51;
129. Anthony B. Zwi, Antonio Ulgalde and Patricia Roberts, 'Effect of War and Political Violence on Health Services', Encyclopedia of Violence, Peace and Conflict, Vol.1 (New York and London: Academic Press, 1999), 683-5;
130. Bratt, 'Blue Condoms', 71-2;
131. Elbe, "HIV/AIDS and the Changing Landscape of War', 172.
132. Ellman et al., 'Treatment of AIDS', 2, 4, although the authors also point out that the movement of people living with HIV or AIDS to refugee camps may make ARTs easier to administer.
133. Tony Barnett, 'Mapping the Future of HIV/AIDS, Security and Conflict in Africa', Paper presented to Justice Africa/LSE AIDS Joint NGO/Academic Seminar, King's College London, 6 December 2005, 1.
134. Betsi et al., 'Effect of Armed Conflict', 359-64.
135. Zwi et al., 'Effect of War', 682.
136. Betsi et al., "Effect of Armed Conflict', 363.
137. Mock et al., 'Conflict and HIV'.
138. Verstegen, HIV/AIDS, 5.
139. Fourie and Schonteich, "Africa's New Security Threat'", 7.
140. 'Peacekeeping' here is used in a broad sense, encompassing what are sometimes termed 'peace support operations' and humanitarian interventions as well as the more traditional monitoring of peace agreements.
141. UK Foreign Office, HIV/AIDS, Security and Peace Support in Africa, Africa Conflict Prevention Pool Information Note, 21 January 2004, released on 21 September 2005 under Freedom of Information Act request.
142. Bratt, "Blue Condoms'", 68;
143. Schneider and Moodie, The Destabilising Impact, 8;
144. Chalk, "Infectious Disease', 49.
145. UNAIDS, On the Front Line, 1st ed., 6, table 2.
146. United Nations, A Comprehensive Strategy to Eliminate Future Sexual Exploitation and abuse in UN Peacekeeping Operations Report A/59/710 (New York: United Nations, 2005), paras. 3-10, 44, 62.
147. UNSC Press Release SC/8400, 31 May 2005, http://www.un.org/News/Press/docs/2005/sc8400.htm, (accessed 26 January 2006). Ironically, the ready availability of condoms to peacekeepers - distributed as a means of protecting them against HIV - was seen by some soldiers as an unofficial endorsement of sexual exploitation.
148. UNAIDS, On the Front Line, 3rd ed., 19.
149. UNSC Resolutions 1308, 1325, 1542, 1545, and 1590, all at http://www.un.org/documents/scres.htm (accessed 26 January 2006).
150. The quarterly reports from UNAIDS Office on AIDS, Security and Humanitarian Response, published by UN Nordic Office, Copenhagen; UNAIDS, On the Front Line, 3rd ed., 5, 20-26;
151. Greenstock, "The Impact of HIV/AIDS", 2.
152. On the UN's view of the success of the programme, see for example UNAIDS, On the Front Line, 3rd ed., 38; UN News Centre, "UN Makes Progress on AIDS Education for Thousands of Peacekeeping Personnel', 19 July 2005. For a discussion of this see McInnes, 'HIV/AIDS and Security';
153. McInnes, 'HIV/AIDS and National Security'.
154. Data for this comparison was taken from: UNAIDS' annual epidemic updates (see above); UN DPKO, Background Note: 31 December 2005, http://www.un.org/Depts/dpko/bnote.htm#unmil (accessed 26 January 2006); US
155. General Accounting Office, UN Peacekeeping: United Nations faces Challenges in Responding to the Impact of HIV/AIDS on Peacekeeping Operations Report GAO-02-194 (Washington, DC:USGeneral AccountingOffice, 2001).
156. UNAIDS, On the Front Line, 3rd ed., 25.
157. Ciantia, "HIV Seroprevalence in Northern Uganda", 173-4;
158. Mbow and Webb, "HIV/AIDS Affected Children", 48;
159. Nguyen and Stovel, The Social Science of HIV/AIDS, 12;
160. Mock et al., 'Conflict and HIV', 2-3.
161. Tony Barnett and Alan Whiteside, 'The Jaipur Paradigm: A Conceptual Framework for Understanding Social Susceptibility and Vulnerability to HIV', South African Medical Journal 90 (2000): 1098-101.
162. Mock et al., "Conflict and HIV", 6.
163. I am grateful to Stefan Elbe for this point.
164. Mock et al., "Conflict and HIV", 11.
165. Roger England, "The Writing is on the Wall for UNAIDS", British Medical Journal 336 (May 2008): 102. Though also note that HIV may force individuals, families and communities into poverty.
166. Ostergard et al., 'The Relationship between HIV/AIDS', 21.
167. Although evidence of malnutrition increasing the risk of acquiring HIV is limited there is a strong impact on the development of AIDS in people living with HIV.
168. Mock et al., 'Conflict and HIV', 9; UNAIDS, 'HIV, Food Security and Nutrition', Policy Brief (May 2008), http://data.unaids.org/pub/Manual/2008/jc1515a_policybrief_nutrition_en.pdf
169. Spiegel, "HIV/AIDS among Conflict-affected and Displaced Populations", 323;
170. Verstegen, HIV/AIDS, 25;
171. Mock et al., 'Conflict and HIV', 4, 7;
172. UNAIDS, "AIDS and Conflict".
173. Ostergard et al., 'The Relationship between HIV/AIDS', especially 2 and 5;
174. Ciantia, "HIV Seroprevalence", 172;
175. Mock et al., 'Conflict and HIV', 7.
176. Mock et al., 'Conflict and HIV', 8;
177. Bennett, Correlation, 20.
178. Barnett and Whiteside, "The Jaipur Paradigm".