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AFRICA: Armies grapple with HIV among troops

Photo: UN/IRIN
"The soldiers sent on peacekeeping missions get paid much more than the average citizens or soldiers."
Kampala, 5 June 2008 (PlusNews) - After years of dragging their feet over HIV/AIDS in their ranks, African armies are slowly making strides in curbing the spread of the pandemic, senior military officers at the fourth HIV Implementer's meeting in Kampala, Uganda, admitted this week.

Since its formation in the mid-1980s, and all through the 1990s, the Uganda People's Defence Force (UPDF) lost thousands of soldiers to HIV. President Yoweri Museveni declared HIV a threat to national security as early as 1987.

But constant deployment, the heterogeneity of the army, and the fact that the troops were mainly sexually active men in their twenties, all combined to create perfect conditions for the rapid transmission of HIV in the force, according to the UPDF's Lt Col Dr Stephen Kusasira.

"The army was a mixture of educated and uneducated men from different ethnic communities who spoke different languages, so communicating the HIV message [was difficult] in the early days," he said.

"The real threat, especially at an individual level, is dampened by war," he noted. "A soldier sometimes can't see the point in wearing a condom to protect himself against HIV, which, in the era of ARVs [life-prolonging antiretroviral treatment] may never kill him, and he is more likely to die on the front line."

Kusasira added that the UPDF had been working overtime to ensure that the HIV pandemic in its ranks was managed. The army has set up eight ARV treatment centres nationwide and has two mobile treatment units for soldiers deployed to remote parts of the country.

In Lesotho, where HIV prevalence is 23 percent, the Lesotho Defence Force (LDF) has not been spared the havoc the pandemic can cause. "There has been high turnover of soldiers and low morale; our health service staff are inadequate to handle the pandemic," said Lt Irene Mateboho Selailia.

The LDF set up its HIV care and treatment programme in 1998, and has since created prevention of mother-to-child and home-based care programmes, a mobile clinic, a condom distribution programme and annual HIV screening of the troops. The military hospital was recently equipped with isolation rooms for tuberculosis patients and a 'wellness' clinic providing comprehensive HIV care.

Highly paid peacekeepers at risk

The main threat to the Benin Armed Forces (BAF) has come as a result of troops being deployed to high-prevalence countries on peacekeeping missions; HIV infection in Benin's population is about 1.9 percent.

"The HIV prevalence within our army is about 2.02 percent, but the troops are deployed to countries with prevalence as high as eight percent," said Lt Col Alain Azondekon.

"The soldiers sent on peacekeeping missions are wealthy – they get paid much more than the average citizens or soldiers, so many use the money on women in the countries they are sent to," he commented. "In 2004, nine out of ten of our troops who returned to Benin before the deployment period was over, returned because of HIV-related reasons."

Photo: Victoria Averill/IRIN
Soldiers are encouraged to use condoms
As a result, Benin has introduced HIV screening and no longer sends HIV-positive troops on peacekeeping missions. Those who go must undergo HIV prevention sensitisation upon departure, and again on arrival at their duty stations.

This appears to be working: studies show that unprotected sex among Benin's soldiers on peacekeeping operations has declined, and testing levels have jumped from 55 percent to 73 percent.

Human rights dilemmas

While they battle to overcome HIV among their troops, African militaries also have to deal with the many human rights issues - such as stigma and confidentiality - associated with HIV.

Kusasira, of the UPDF, said the army respected the right of HIV-positive soldiers to confidentiality but encouraged disclosure, particularly to commanders, in case of deployment to remote areas.

The UPDF screens new recruits and rejects HIV-positive men and women, drawing criticism from human rights bodies who feel that in the age of ARVs, an HIV-positive soldier can perform as well as any other.

"For us it is less a human rights issue and more of an economic one; caring for HIV-positive soldiers has been a huge economic burden on our resources, so we are hesitant to add to it," Kusasira said.

"But once a soldier is diagnosed HIV-positive, we give him the best treatment and care we can afford," he added. "And HIV-positive soldiers within the UPDF are not excluded from promotion or training, even after diagnosis."

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