HIV Incidence Prior to, during, and after Violent Conflict in 36 Sub-Saharan African Nations, 1990-2012: An Ecological Study.

OBJECTIVES: The 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. METHODS: We 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. RESULTS: We 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. CONCLUSIONS: Our 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.

Israeli and Palestinian families in the peace process: sources of stress and response patterns.

The Israeli-Palestinian peace process is characterized by its unknown outcomes and consequences for the families involved. The purpose of this study was to identify family processes under conditions of prolonged uncertainty. Data were collected from both Israeli and Palestinian families in the West Bank by means of semi-structured interviews. Qualitative and quantitative analyses showed cross-cultural differences in the perception of the situation; different kinds of concerns and sources of stress; different coping responses; and differences in dyadic interaction patterns and intrafamily processes. The findings are discussed in social-contextual terms, particularly the ways in which political and cultural contexts shape the perception of the situation and family processes under prolonged stressful conditions.

A triple burden for health sector reform: 'post'-conflict rehabilitation in Uganda.

While conflict continues to threaten health development in many countries, relative peace has been secured in others. The transition from war to peace carries important political and economic opportunities for the reappraisal of social policy in general, and of health policy in particular. The health systems of countries recovering from prolonged periods of conflict often carry a double burden: the inheritance of an inappropriate and unaffordable health system developed in the pre-conflict era, and the particular, long-term effects of conflict on health and health services. This paper reports on the particular policies designed to rehabilitate the Ugandan health system, and argues that they exacerbated, rather than alleviated, the health crisis inherited in 1986. In this way they posed a third burden. By analyzing the context and process of policy formulation in the immediate post-conflict period, it explores the rationale which lay behind the adoption of these policies and identifies potential strategies for strengthening policy development in these unstable, resource-poor and health-deprived situations.

Familias afectadas por la violencia

Apresenta entrevistados contando sobre violências sofridas por eles ou por algum membro da família ou conhecidos. Crianças, mulheres e homens retratam suas tristezas e desesperanças; a falta de acesso a educação, a saúde e segurança. Agente social analisa os resultados da violência na sociedade e a responsabilidade do Estado