THE SECURITY PERSPECTIVE
Security can be seen from personal and organisational angles, affecting all inhabitants in a society. HIV has brought attention to the personal security, not only to stay safe from the infection, but also to be able to live, work and study despite ones HIV status.
Migration and internal movement of people from conflict areas or as a part of urbanisation (sometimes caused by HIV/AIDS in countries heavily affected) affect people's security situation in the new setting.
This perspective focuses on the security issues connected to AIDS. In the term security I mean situations where people are put at risk in their life from armed forces, a life where people for example had to flee from their homes and every day-situation, and to seek new possibilities within their country or in another country. Historically it is known that the rates of sexual transmitted infections (STI) are two to five times higher among uniformed persons (e.g. police, soldiers) and that there are more sexual violations committed in times of insecurity. This is mainly because uniformed persons hold a higher degree of power over people who left their original cultural setting and/or enters into new unfamiliar areas and meet new people. This power can wrongfully be used to satisfy their sexual needs. Clarifying, it does not need to be forced sex; there could be an underlying consent, however the consent often depends on the unequal relation of powers between the two persons. Then again, reports have shown that in some conflicts, known HIV positive soldiers are assigned with the task to rape as many women as possible among the enemy side, and in this way HIV is used as a weapon in war. We can also add another angle of this perspective. In communities heavily affected by AIDS, competing tribes (or similar) could take the opportunity to expand their territory by escalating the conflicts in order to gain power over the weakened counterpart.
When people migrate from their homes, away from conflict areas, they become insecure and dependent on their new surrounding. Without any money, other valuables or difficulties in finding a job, the risk increases for women to be forced into prostitution, or if living in a refugee camp, women, girls and boys might be at risk of rape or other types of abuse, leading to increased health risks, including STI/HIV transmission. According to Spiegel (2004), reports indicate an up to six times higher probability for women to contract HIV in a refugee camp than in the general population outside the camp. Unfortunately, factors that may decrease HIV transmission in such situations are rarely considered in humanitarian assistance planning surrounding refugee camps. This is something that is hard to understand, especially since the UN General Assembly Special Session on HIV/AIDS in 2001 called upon:
’All United Nations agencies, regional and international organisations, as well as non-governmental organisations (NGOs) involved in the provision and delivery of international assistance to countries and regions affected by conflicts … to incorporate as a matter of emergency HIV/AIDS prevention, care and awareness elements into their plans and programmes.’
If a country is in a conflict or post-conflict situation, it is more difficult to structure and organise a proper HIV prevention work, and to distribute or provide access to anti-retroviral therapies (ART).
It is important to stress that there is no data supporting the assumption that people coming from conflict areas to new environments fuel the HIV epidemic. To assume this would only be a part of an alienation process and prejudice towards ’newcomers’. The focus should instead be on how these persons can be protected, and on what information activities that should be conducted in order to transfer adequate knowledge on how to protect themselves from diseases like HIV and STIs. We also need to remember the many persons living with HIV and who are not aware of their HIV status (as I discussed above).
Abraham Maslow’s (1943) theories about human needs also include security factors and how these needs affect people’s actions have made contribution to the creation of theories concerning motivation. In a simple and shortened way, Maslow’s theory can be described like this:
People have different needs, which can be sorted in a hierarchy. When basic needs are satisfied, we turn to other needs – “climb the needs ladder” – and try to satisfy those. The needs are:
Biological and Physiological: These include shelter, oxygen, food, water, sex, rest and elimination, all of which are vital to a person's life or essential to survival.
Security or Safety: This involves not only actually being secure and safe, but also the feeling of safety and security. This is something people typically learn from their childhood and is an essential part of the groundwork for developing other skills and moving up to the next step of the ladder.
Social (Love/Belonging): This involves developing friendships and eventually relationships. It involves emotionally based relationships in general, such as friendship, sexual intimacy, and having a supportive and communicative family.
Esteem: Here people learn to develop self-esteem and confidence. According to Maslow, all humans have a need to be respected, to have self-respect, and to respect others. People need to engage themselves in order to gain recognition and have an activity or activities giving the person a sense of contribution, be it in a profession or hobby.
Self-Actualisation: Is according to Maslow the highest level you can reach. Maslow writes the following of self-actualising people:
They embrace the facts and realities of the world (including themselves) rather than denying or avoiding them.
They are spontaneous in their ideas and actions.
They are creative.
They are interested in solving problems; this often includes the problems of others. Solving these problems is often a key focus in their lives.
They feel closeness to other people, and generally appreciate life.
They have a system of morality that is fully internalised and independent of external authority.
They have discernment and are able to view all things in an objective manner. Prejudices are absent.
In short, self-actualisation is reaching one's fullest potential.
Most people accomplish the first two levels in their lifetime. While self-actualisation is a useful concept to many, others insist there is no proof that every individual has this capacity or even the goal to achieve it.
Individuals have all the needs listed above. However, it is just the unsatisfied needs which are motivating, that activates people to satisfy the needs. Very simplified, people move further on the hierarchy scale of human needs when the lower needs are satisfied.
When for example the physiological needs are satisfied, one tries to satisfy the need of security. You can at the same time look upon this scale from qualitative aspects. If I am in the position of putting myself at risk in weapon armed situations and/or taking health risk, how can I strive for love and/or provide a better situation for my home?
How do YOU relate to the ranking of needs? In which level are you today, and in what level do you think people you will meet in HIV prevention activities are?
Finally, the security perspective needs to acknowledge the security situation for people living with HIV or AIDS (PLWHA). Society must deal with this for the sake of all its inhabitants. For the benefit of PLWHA we call this stigma prevention/reduction, and for the benefit of non-infected we call this human rights, since we need to enforce everyone with knowledge and information on how to prevent ourselves from getting (re-)infected and knowledge about how HIV is NOT transmitted.