Guest Writings
02/08/04 HIV, War & Sexuality by Satya Sagar

Five days of non-stop jaw, jaw, jaw at the recently concluded International AIDS Conference in Bangkok and my head was buzzing with the terminology of war, war, war. There is a 'battle' being waged against HIV/AIDS, there are people 'combating' the pandemic, bureaucrats are turning into 'warriors' and preparing 'strategies' for 'campaigns'.

And yet for all this jingoist prattle, there was little discussion there of the real armed conflicts going on in Iraq, Afghanistan, Palestine or anywhere and their impact on the global HIV/AIDS crisis. Pray, what is the connection some may ask?

The answer is plenty and ranges from the way war devastates health systems thus accelerating the HIV pandemic to how social prejudices on gender and sexuality issues exacerbate both violent conflict and the problems of those living with HIV.

At the very outset one can look at the role war and conflict have historically played in the spread of HIV/AIDS, particularly on the African continent.

Last year in a study of the HIV epidemic in Guinea-Bissau , the putative epicenter of the disease-a team of Belgium researchers concluded that it remained a low-level infection for many years, spreading widely only in the 1960s – a period which coincided with the country's war to gain independence from Portugal.

According to their analysis a number of factors prevalent in wartime – such as mass immunizations with unsterilised needles – could have helped the virus spread rapidly. One can safely add that the breakdown of healthcare systems, the forced migration of populations, the breakdown of community support structures during times of conflict are clearly other reasons for the spread of HIV.

What holds for Guinea-Bissau is also true for much of sub-Saharan Africa, which currently has the highest prevalence of HIV in the world (70 percent of 42 million global cases), thanks to decades of poverty- both caused by and also the cause of conflict. The 1990s, which saw a major surge of HIV/AIDS, also witnessed a steady climb in violence across sub-Saharan Africa, with the number of states at war or with significant lethal conflicts doubling from 11 in 1989 to 22 in 2000.

One can deduce the other obvious link between HIV and conflict by simply looking at the way militarization around the globe gobbles up scarce resources that would be much better spent on healthcare and providing the poor with access to basic services.

In 2003 global military spending touched an all-time high of over 956 billion dollars, while the United Nations estimates that just 11 billion dollars are necessary to provide water and sanitation for the people in developing countries, annually.

The discrepancy between such spending on armaments and militarization is glaringly evident when one looks at the comparatively small sum of money required to carry out prevention, care and treatment for the millions of people living with HIV/AIDS.

According to a series of recent studies carried out by UNAIDS, in 2003 the countries of Asia-Pacific required one billion dollars to finance a comprehensive response to the pandemic in the region but only 200 million dollars was available from all sources combined, including the public sector. All of which is of course peanuts compared to the staggering 125 billion dollars spent by the United States in its occupation of Iraq alone since March last year.

But going beyond all such macro-level links between HIV and war there are still more connections that go the level of individual/group behaviour and have to do with the dynamics of gender relations in our societies and above all with the way sexuality is defined, understood or tolerated.

In the case of the HIV/AIDS pandemic the role played in spreading the disease by the subjugation of women, the deep rooted prejudices against people exercising alternative sexual choices and the false linkage of 'morality' with issues of sexuality are well known. Again, while the pandemic, has evoked some sterling responses of public compassion and community cooperation, the sad fact is that in most societies it has also brought out the worst forms of intolerance and discrimination against those living with HIV, particularly women.

My argument is that it is the same kind of intolerance and paranoia that is at work in the emergence of violent and virulent forms of nationalism and religious fundamentalism around the globe today. Fundamentalists of all kinds- Christian, Hindu, Muslim and Buddhist- who usually advocate quasi-fascist solutions to social and political problems also typically happen to have the same super-conservative approach to HIV/AIDS, gender and sexuality.

Is it for example a mere coincidence that both Bush Jr and Bin Laden, the chief antagonists in the violent 'clash of barbarisms' that we are witnessing globally now, share similar views on everything from the rights of women, gays and lesbians to their position on how best to tackle the HIV/AIDS crisis? And do their prejudices on these issues have something to do with the levels of bloodlust and aggression they have shown as being amply capable of? You bet they do.

Sure, I have never heard Little Bush demanding that women be put behind the veil. But look closer at his position on abortion and there you have- in the context of his own society- the equivalent of the Taleban whipping women for accidentally showing their ankles.

Bush Jr's position on sexual and reproductive rights of women has been dubbed as nothing less than a 'war on women' by the International Planned Parenthood Federation (IPPF), the world's largest voluntary organization working in182 countries on these issues.

Back in 2001, in one of his first actions on taking office, President Bush reinstated the Global Gag Rule – which cut off U.S. international aid money from any family planning organization that engaged, directly or indirectly, in abortion-related activities. According to the IPPF since then, Bush has formulated a strategy to stifle reproductive rights and access to reproductive health care services. They include sinking large sums of money into medically unproven abstinence-only sexuality education and nominating religious ideologues to important scientific posts and decrying the use of condoms.

Now, don't ask me how someone so vocally 'caring' about the unborn can be so callously responsible for the deaths of thousands upon thousands of innocent civilians in Iraq and Afghanistan. For Bush Jr -like for all necrophilic fundamentalists everywhere- the motto seems to be 'worship the dead and crucify the living'.

Similarly, I have not heard Bin Laden utter anything on gay and lesbian rights either in his routine broadcasts from the caves. But his response is easy to imagine- 'behead the blasphemous lot'! A command, which translated into American English, sounds very similar to the fundamentalist vehemence of Bush Jr. on the subject! Well, what else was it when earlier this year the US President endorsed a constitutional amendment to ban gay marriages?

But what exactly is it about allowing people the right to choice of sexual partners that raises the hackles of fundamentalists of all religious hues everywhere? Why is having a 'tough' position on issues of sexuality so central to the construction of an image of 'morality' or 'piety'?

I am not a scholar on the subject (or any other for that matter) but I can take a guess that it is probably because 'moral' hegemony over sexuality and sexual behavior is so integrally connected to the ability of elites in any society to control the populations under them. And it is here that relation between HIV, war and sexuality goes to a much deeper level.

In the case of HIV/AIDS we know how the disease is linked to things going wrong with two of the most intimate actions possible between any two human beings- sexual relations and the exchange of blood. In many ways militarism (and fascism) are also about sex and blood, arising in societies which are unwilling to deal with the diversity of sexual relations in a sane and tolerant manner and which harbor racist notions of the 'purity' or 'impurity' of blood.

Let me give the example of Indian society and its politics over the past decade or more. There is no doubt to anyone who has followed the rise of rightwing religious fundamentalism and jingoist nationalism in my country that, at very individual levels, it is related to the inability of a section of my countrymen to deal with issues of sexuality (them being a unique mix of the Brahmin and the British Victorian) or shake off their truly Nazi notions of 'foreign blood' (read minority Muslims and Christians) 'polluting' the national 'bloodstream'.

So together with sparking off the nuclear arms race with Pakistan, carrying out pogroms against minorities and institutionalizing religious violence in general- Hindu fundamentalists are marked by their medieval attitudes towards women and sexuality. Over the past decade they have:

  • Glorified the practice of 'sati' or self-immolation by Hindu widows forced to jump into the funeral pyre of their dead husbands (while not advocating the same for men who lose their wives)
  • Talebanised Hindu society (imposing 'dress codes' for Hindu women),
  • Intolerantly stifled any discussions on alternative sexual behaviour (attacking movie halls showing a film on lesbianism)
  • Used rape of minority women in religious sectarian riots as a 'weapon of war' (including videotaping the rape in several such riots)

With all this is it really surprising that today if there is any one country in Asia that faces the prospect of a sub-Saharan Africa type explosion of HIV/AIDS that is India. With over 5 million cases, it is second only to South Africa in terms of the numbers of people living with HIV/AIDS anywhere in the world.

Throw into this volatile mix yet another statistic that shows India becoming the second largest importer of arms in the world after China last year and you get an idea of what the priorities of the country's elites really are. Anyone who wants to understand the connection between HIV, war and various issues surrounding sexuality, I suggest, should immediately board a flight to New Delhi.

The message is simple, and not just for India but everywhere: the 'war' against HIV/AIDS and the 'battle' for the rights of women and sexual minorities are closely linked to the ending of all wars and battles and the movement for global peace. Militarism is the ultimate expression of human intolerance and often arises at a personal level from an inability to deal with sexual and racial diversity. It is the most intimate enemy of humankind and the greatest threat to every freedom we have ever fought for or aspire to win in the future.

Satya Sagar is a writer, journalist and videomaker based in Thailand. He can be contacted at

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