People living with HIV in Chad risk becoming victims of the explosion of violence in the capital, N'Djamena, in early February. During clashes between the army and groups of rebels from the east of the country, health services were damaged and many organisations working to fight the epidemic were looted.

FOSAP, a social support fund that manages HIV/AIDS money from the World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria, and AMASOT, a local social marketing organisation working to reduce HIV infections, did not escape unscathed: their offices were emptied of computer equipment, supplies and even furniture and doors.

"We had [just] installed computers to allow young people to go on various [internet] sites ... to get information on AIDS and STIs [sexually transmitted infections]," Dr Kadah Dokblama, internal controller and interim director at AMASOT, told IRIN/PlusNews.

"We have lost everything; they only left us boxes of condoms and Orasel [water for rehydration]," said one of the organisation's employees.

The National General Reference Hospital in N'Djamena, which provides HIV/AIDS services, was hit by artillery shells and automatic weapons fire during the fighting. Although the shots were not intentionally directed at the facility, the intensity of the fighting drove patients out of the hospital in panic and some did not return.

Insecurity is an ongoing obstacle to the fight against AIDS in Chad, which has an official prevalence rate of 3.3 percent. The country has experienced regular explosions of violence for several decades, distracting attention from anti-AIDS efforts, but over the last few years the political engagement of the authorities and the arrival of donors have made it possible for HIV/AIDS programmes to be launched.

"The government has made an incredible effort by trying to mobilise resources and including it [the fight against AIDS] in their budget ... [but] insecurity remains a constraint - it prevents decentralisation [of HIV/AIDS services]," said Claire Mulanga Tshidibi, UNAIDS country coordinator in Chad.

Enock Nodjikwambaye, FOSAP's administrative manager, is well aware of this problem. "Insecurity holds us back," he told IRIN/PlusNews. "We don't dare send staff [into risk areas], where we could lose people and vehicles. We have already lost one vehicle [stolen by armed fighters]; we cannot risk sending someone into a living hell."

He said around 240,000 Sudanese refugees and 180,000 displaced Chadians were living in the east of the country, but ongoing insecurity in the area was a major obstacle to the development of FOSAP's programmes.

"We finance an HIV/AIDS sub-project in Abéché [the main town in eastern Chad, about 150km from the Sudanese border] but we haven't got anyone to go and supervise it."