ArticlePloS one2015
HIV Incidence Prior to, during, and after Violent Conflict in 36 Sub-Saharan African Nations, 1990-2012: An Ecological Study.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review evaluating HIV prevalence among conflict-affected populations, 2005-2020.AIDS reviews · 2021Pooled it
- Predictors of HIV infection: a prospective HIV screening study in a Ugandan refugee settlement.BMC infectious diseases · 2016Trial
- Contextual Drivers of HIV Vulnerability and Retention in Care in the Central African Republic: An Ecological Analysis.AIDS and behavior · 2026Article
- HIV/AIDS in Conflict-Affected Countries, 2024-2025.Journal of epidemiology and global health · 2026Article
- Assessing the relationship between armed conflict and infectious disease incidence in Six Sub-Saharan Countries: Implications for Emergency Departments in conflict areas.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2025Article
- HIV Pre-exposure Prophylaxis (PrEP) Uptake and Persistence in Wartime Ukraine: Analysis of Data from a Scaled PrEP Program.AIDS and behavior · 2025Observational
- A Scoping Review of Factors Associated with HIV Acquisition in the Context of Humanitarian Crises.AIDS and behavior · 2024Article
- Left behind on the path to 90-90-90: understanding and responding to HIV among displaced people.Journal of the International AIDS Society · 2022Article
- The Impact of Armed Conflict on the Prevalence and Transmission Dynamics of HIV Infection in Libya.Frontiers in public health · 2022Article
- Awareness and Utilization of HIV Testing and Prevention Services Among Female Sex Workers in Dnipro, Ukraine: Implications for Prevention Program Strengthening From the Dynamics Study.Frontiers in reproductive health · 2022Article
- Conflict and Risky Health Behavior: Evidence from Mexico's Drug War.Journal of development economics · 2021Article
- Sexual and Gender-Based Violence Among Refugees and Internally Displaced Persons in the Democratic Republic of the Congo: Post-Conflict Scenario.Risk management and healthcare policy · 2020Article
- Program implementation gaps and ethical issues in the prevention of HIV infection among infants, children, and adolescents in sub-Saharan Africa.Pediatric research · 2020Review
- Assessing the influence of conflict on the dynamics of sex work and the HIV and HCV epidemics in Ukraine: protocol for an observational, ethnographic, and mathematical modeling study.BMC international health and human rights · 2019Observational
- What drives mortality among HIV patients in a conflict setting? A prospective cohort study in the Central African Republic.Conflict and health · 2019Article
- A scoping review of the associations between mental health and factors related to HIV acquisition and disease progression in conflict-affected populations.Conflict and health · 2018Article
- Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to determine the association between violent conflict and HIV incidence within and across 36 sub-Saharan Africa countries between 1990 and 2012.
methodsWe used generalized linear mixed effect modeling to estimate the effect of conflict periods on country-level HIV incidence. We specified random intercepts and slopes to account for across and within country variation over time. We also conducted a sub-analysis of countries who experienced conflict to assess the effect of conflict intensity on country-level HIV incidence. All models controlled for level of economic development, number of refugees present in the country, and year.
resultsWe found that, compared to times of peace, the HIV incidence rate increased by 2.1 per 1000 infections per year (95%CI: 0.39, 3.87) in the 5 years prior to conflict. Additionally, we found a decrease of 0.7 new infections per 1000 people per year (95%CI: -1.44, -0.01) in conflicts with 25 to 1000 battle-related deaths and a decrease of 1.5 new infections per 1000 people per year (95%CI:-2.50, -0.52) for conflict with more than 1000 battle-related deaths, compared to conflicts with less than 25 battle-related deaths.
conclusionsOur results demonstrate that HIV infection rates increase in the years immediately prior to times of conflict; however, we did not identify a significant increase during and immediately following periods of violent conflict. Further investigation, including more rigorous data collection, is needed, as is increased aid to nations at risk of violent conflict to help in the fight against HIV/AIDS in sub-Saharan Africa.
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