According to a Brown University study, HIV incidence in sub-Saharan countries shows a tendency to spike significantly five years prior to armed conflict breaking out.

Published in the journal PLOS ONE, the study analyzed the relationship between HIV incidence in 36 countries in the sub-Saharan region and armed conflict, revealing that rates of incidence are generally at their worst before hostilities begin. Specifically, there's a five-year period where HIV prevalence is high prior to the start of the bloodshed.

According to Brady Bennett, the study's lead author, this implies that something in the political, social and healthcare environments within those five years that makes the period conducive to the spread of HIV. Earlier studies have been done to examine how war affects the spread of HIV, but results have been mixed. To address this, Bennett and colleagues produced a more comprehensive set of data and rigorously analyzed the information provided.

The study followed HIV statistics from 1990 to 2012, correlating incidence rates with periods of peace and conflict in each of the 36 sub-Saharan countries involved. This made it possible for researchers to measure how incidence rates moved in every country in relation to the presence of conflict while controlling other factors like refugee influx as well as economic development.

The study found that HIV incidence grew by 2.1 for every 1,000 infections per year in the five years before conflict and dropped by 0.07 new infections for every 1,000 people per year in conflicts with 25 to 1000 deaths with battle-related causes. And as conflicts caused more fatalities, HIV incidence dropped.

For the study, conflict is defined as any violence that results in a minimum of 25 deaths related to battles.

The study doesn't explain what accounts for changes in the rates of HIV incidence in the countries involved but Bennett said the decline may have to do with data collection being undermine, which leaves a lot of new infections undetected, and not that conflict results in improvements.

Mark Lurie, a senior author for the study, said that their research points to a need to better understand the factors behind conflict because it has been identified that HIV incidence is likely to increase leading up to it.

Other authors for the study include Stephen McGarvey, Annie Gjelsvik and Brandon Marshall.

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