A/HRC/32/41 they are at risk of grave physical injuries as well as health consequences, such as sickness resulting from malnutrition or disease. Girls may be exposed to further health problems related to sexual violence, pregnancy and childbirth. Also significant is the impact on children’s mental health related to post-traumatic stress disorder, anxiety, depression or other mental health issues. Trafficking of women and girls for sexual exploitation 31. Conflict-related sexual violence takes many forms. Women and girls seeking to survive in conflict zones are often compelled to exchange sexual services and even to “marry” for food, shelter, protection or safe passage. 26 UNHCR has affirmed that women in conflict situations are vulnerable to a range of discriminatory practices that exacerbate their dependence (for example, receiving smaller food rations or not having rations cards or other identity documents in their own name) and are disproportionately exposed to sexual violence.27 For women and girls abducted into military service, sexual assault is often a feature of their experience. Rape has been used as a tactic of war to humiliate and weaken the morale of the enemy, ethnically cleanse the population, destabilize communities and force civilians to flee.28 Widespread or systematic sexual assault by government and/or opposition or rebel forces has been documented in multiple modern conflicts, including successive annual reports of the Secretary-General on conflict and related sexual violence since 2009 in which he has identified incidents and patterns of sexual violence in conflictaffected countries employed by parties to armed conflict, primarily against women and girls but also against boys and men (see, for example, S/2015/203). 32. The trafficking of women and girls for sexual exploitation, including sexual slavery, forced marriage, forced prostitution and forced pregnancy, features within the broader picture of sexual violence perpetrated against the civilian population during and in the wake of conflicts. The nexus between trafficking in persons and sexual violence is further affirmed in a statement by the President of the Security Council (S/PRST/2015/25) in which the President underscored the urgency of efforts to deter, detect and disrupt trafficking in persons, including by terrorist and violent extremist groups. Recently, an egregious pattern of abductions from their homes or schools of women and girls who are subsequently forced to marry and/or serve as sex slaves has been reported in conflictaffected settings, though some forms of this phenomenon have also been a feature of armed conflicts in the past. Such exploitation, which in some cases involves trafficking for forced marriage and sexual enslavement by extremist groups such as Islamic State in Iraq and the Levant, Boko Haram and their affiliates, is believed to be a strategy to generate revenue as well as to recruit, reward and retain fighters. 29 In order to prevent such abductions, families 26 27 28 29 See, generally, Wolte, “Armed conflict and trafficking in women”. Elisabeth Rehn and Ellen Johnson Sirleaf, Women, War, Peace: The Independent Experts’ Assessment on the Impact of Armed Conflict on Women and Women’s Role in Peace-Building (New York, United Nations Development Fund for Women, 2002), p. 6. See Security Council resolutions1820 (2008), 1888 (2009), 1960 (2010), 2106 (2013) and 2242 (2015). See also Women2000 – Sexual Violence and Armed Conflict: United Nations Response, April 1998. Secours catholique-Caritas France and Peyroux, “Trafficking in human beings”, p. 19. See also the joint statement of the Special Rapporteur on the sale of children, child pornography and child prostitution; the Special Rapporteur on contemporary forms of slavery, including its causes and its consequences; and the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health on their visit to Nigeria, available from www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=16983&LangID=E. See also Security Council resolution 2242 (2015) in which the Council recognized that sexual violence was both a tactic of war and a tactic of terrorism. 9