Introduction Since its detection in the early 1980s, HIV and AIDS have claimed 32.7 million lives. The HIV epidemic continues to plague the world with its most devastating effects felt in Eastern and Southern Africa. The exposure, vulnerability, and impact of HIV have been prominent among military personnel due to environmental, demographic, and socioeconomic characteristics. Policies have been developed to mitigate its exposure, vulnerability, and impact on the military. However, there are disparities across these policies, especially on recruitment, enlistment, and deployment. These contentions inspired this evaluation, which was designed to provide vital information and insights for militaries developing new HIV policies, for example, the Ghana Armed Forces (GAF). Materials and Methods Content analyses of key documents and secondary resources from South Africa (SA), the USA, and the United Nations and International Labour Organizations were undertaken. The key documents evaluated included HIV and AIDS policies of the SA National Defence Force (SANDF), the U.S. DoD, UN Department of Peacekeeping Operations, and International Labour Organization (ILO); national HIV and AIDS policies; and legislations of SA and the USA. Results The SANDF policy permits the recruitment of HIV-positive applicants while the U.S. DoD policy does not. Mandatory pre-employment health assessments including HIV testing is conducted for prospective applicants. Again, discrimination against persons living with HIV (PLHIV) is discouraged by national policies and legislations of both countries and the ILO policy. At the same time, the SA national policy permits discrimination based on requirement of the job.On deployment, the SANDF policy explicitly permits deployment of HIV-positive service members, while the U.S. DoD policy cautiously does so. Both policies support mandatory pre-deployment health assessments in line with the UN peacekeeping policy and medical standards even though voluntary confidential HIV counseling and testing is recommended by the UN. All HIV-positive service members are retained and offered treatment and care services; however, the U.S. DoD policy retires unfit service members after 12 months of consecutive non-deployment. Further, the UN policy repatriates service members with pre-existing medical conditions and pays no compensation for death, injury, or illness, which is due to pre-existing medical conditions or not mission-related. Conclusions First, the contents of the military policies are not very diverse since most militaries do not enlist or deploy PLHIV except few countries including SA. Implementation and interpretation is however inconsistent. Some militaries continue to exclude PLHIV despite the existence of policies that permit their inclusion. Second, discrepancies exist among the military policies, national legislations, and international policies. The UN policy is not coherent and empowers the military to exclude PLHIV. Also, potential costs to be incurred, in the form of compensation and repatriation, seem to be a major factor in the decision to deploy HIV-positive service members. Harmonization of military HIV policies to ensure uniform standards, interpretation, and implementation and the coherence of the UN policy are essential to guide countries developing new policies, for example, GAF.

中文翻译：

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艾滋病毒阳性军人的招募、入伍和部署：对南非和美国国家以及国际政策的评估


简介 自 20 世纪 80 年代初发现以来，艾滋病毒和艾滋病已夺去了 3270 万人的生命。艾滋病毒流行继续困扰着世界，东部和南部非洲的破坏性影响最为严重。由于环境、人口和社会经济特征，军事人员中艾滋病毒的暴露、脆弱性和影响非常突出。已经制定了政策来减轻其暴露性、脆弱性和对军队的影响。然而，这些政策之间存在差异，特别是在招募、入伍和部署方面。这些争论激发了本次评估，该评估旨在为制定新的艾滋病毒政策的军队（例如加纳武装部队（GAF））提供重要信息和见解。材料和方法对来自南非（SA）、美国、联合国和国际劳工组织的关键文件和二手资源进行了内容分析。评估的关键文件包括南非国防军（SANDF）、美国国防部、联合国维持和平行动部和国际劳工组织（ILO）的艾滋病毒和艾滋病政策；国家艾滋病毒和艾滋病政策；以及南澳大利亚和美国的立法。结果 SANDF 政策允许招募 HIV 阳性申请人，而美国国防部政策则不允许。对潜在申请人进行强制性就业前健康评估，包括艾滋病毒检测。两国的国家政策和立法以及国际劳工组织的政策再次强调，不鼓励歧视艾滋病毒感染者（PLHIV）。同时，南澳国家政策允许基于工作要求的歧视。在部署方面，南非国防军政策明确允许部署艾滋病毒呈阳性的军人，而美国国防部则对此持谨慎态度。尽管联合国建议进行自愿保密的艾滋病毒咨询和检测，但这两项政策都支持根据联合国维和政策和医疗标准进行强制性部署前健康评估。所有艾滋病毒呈阳性的军人都将被保留并提供治疗和护理服务；然而，美国国防部的政策是，不合格的军人在连续 12 个月未服役后将被退役。此外，联合国的政策是遣返患有既往病史的军人，并且不会为因既往病史或与任务无关的死亡、受伤或疾病支付任何赔偿。结论 首先，军事政策的内容不是很多样化，因为除了包括南非在内的少数国家外，大多数军队没有招募或部署艾滋病病毒感染者。然而，实施和解释不一致。尽管存在允许将艾滋病病毒感染者纳入其中的政策，但一些军队仍然将其排除在外。其次，军事政策、国家立法和国际政策之间存在差异。联合国的政策不一致，并授权军队排除艾滋病毒感染者。此外，以补偿和遣返形式出现的潜在费用似乎是决定部署艾滋病毒阳性军人的一个主要因素。协调军事艾滋病毒政策以确保统一的标准、解释和实施以及联合国政策的一致性对于指导各国制定新政策（例如 GAF）至关重要。