INVESTIGATION OF SEXUAL VIOLENCE IN EASTERN DRC It is reasonable to expect that HIV transmission might be accelerated in the context of sexual violence in South Kivu and certainly an individual survivor’s concerns about contracting HIV are well justified. On a population level, however, existing evidence does not support an increased HIV prevalence in South Kivu. In a 2007 systematic review, Spiegel et al reported that there were no apparent differences between HIV prevalence in Eastern DRC and Kinshasa and that the HIV prevalence in Eastern DRC was lower than the prevalence at sentinel sites in Burundi and similar to the prevalence at sentinel sites in Rwanda. Furthermore, the HIV prevalence at Panzi Hospital is reported to be 4.5%.(64) Thus, there is a discrepancy between what one might expect (based on the amount of sexual violence in Eastern DRC and based on the violent and traumatic nature of the rapes) and what the existing evidence shows. This discrepancy calls for further study to understand HIV transmission among sexual violence perpetrators and survivors in South Kivu. A better understanding of these patterns will enable HIV/AIDS resources to be allocated appropriately within the context of the war, including instituting HIV testing facilities, offering HIV prophylaxis and treating active HIV/AIDS infections. SOCIAL BURDEN OF SEXUAL VIOLENCE LOSSES Material losses were extremely common in this study and most often involved cash, food, clothing or livestock. Occasionally women reported that the family home was lost during the attack, most often when it was burned to the ground. The loss of personal valuables or the family home would be devastating in any circumstance. However, this is especially true in Eastern DRC where the subsistence of most families is precarious at best. Link these material losses to the potential for lost income after rape-related injury or the potential loss of the male head of household, and the magnitude of the resource extraction is further amplified. In fact, some families likely never recover from the financial hardships that result from these attacks. Many women reported the deaths of children and / or husbands at the time they were sexually assaulted. The emotional distress caused by losing a child or spouse was immense, especially when survivors were forced to watch their family members being tortured and killed. Some women expressed enormous guilt about not being able to protect their loved ones, especially young children, from an untimely death. There was also considerable remorse about the inhumane manner in which family members were sometimes killed. For survivors, mourning the loss of family members was compounded by the physical injuries and emotional distress arising from their own experiences of sexual violence. Sexual violence survivors were also devastated by spousal abandonment. Even if not completely abandoned, many survivors seemed to have lost the support of their husbands. This observation is upheld by the finding that fewer than 1% of women were accompanied to medical care by their spouses. Loss of spousal support was also evident from the qualitative analysis where women sometimes mentioned marital discord followed sexual violence. For other women, 43