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Violence against women plays a crucial and devastating role
in increasing the risk to women of HIV infection. It is a key
reason why women are more vulnerable to HIV infection than
men. It is both a cause and a consequence of infection, and as
such is a driving force behind the epidemic. The circumstances
underlying the correlation between violence against women and
HIV and AIDS are a complex weave of social, cultural, and
biological conditions.
This Eldis guide examines the links between violence
against women (VAW) and HIV and AIDS, highlighting key issues,
research and resources. It outlines how HIV and AIDS is a
consequence of VAW, how VAW is precipitated by HIV, the
economic factors that increase women's vulnerability and the
interaction between VAW and conflict. It also offers
strategies and actions for ending VAW and reducing HIV and
AIDS infection.
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The term "violence against women" means any act
of gender-based violence that results in, or is likely
to result in, physical, sexual or psychological harm or
suffering to women, including threats of such acts,
coercion or arbitrary deprivation of liberty, whether
occurring in public or in private life.
Violence against women is a manifestation of
historically unequal power relations between men and
women, which have led to domination over and
discrimination against women by men and to the
prevention of the full advancement of women, and that
violence against women is one of the crucial social
mechanisms by which women are forced into a subordinate
position compared with men.
- UN Declaration on the Elimination of
Violence against Women, 1993 |
Consequences and
causes
HIV and AIDS infection as
a consequence of violence against women
HIV-transmission risk increases
during violent or forced-sex situations. The abrasions
caused through forced penetration facilitate entry of the
virus - a fact that is especially true for adolescent girls,
whose reproductive tracts are less fully developed (UNAIDS).
While the full extent of violence against women is not known,
current research indicates that in some countries one in four women may experience sexual violence
by an intimate partner in her life time (WHO).
Added to this is the violence that women experience from
strangers.
According to a study published in
2004, (Dunkle et al) women who are
beaten or dominated by their partners are much more likely to
become infected by HIV than women who live in non-violent
households. This research was based on 1,366 South African
women who attended health centres in Soweto and agreed to be
tested for HIV and interviewed about their home lives. After
being adjusted for factors that could distort the outcome, the
figures showed that women who were beaten by their husbands or
boyfriends were 48 per cent more likely to become infected by
HIV than those who were not. Those who were emotionally or
financially dominated by their partners were 52 per cent more
likely to be infected than those who were not. A smaller study
in Tanzania found that HIV-positive women were over two and a
half times more likely to have experienced violence by their
partner than HIV-negative women (Maman).
Both men and women are victims of stereotypes and norms
about masculine behaviour which may lead to unsafe sex and/or
non-consensual sex. Power roles and dominant social
expectations prevent communication, joint decision-making and
negotiation of condom use. A recent study
on sexual violence and risk of HIV infection in South
Africa, conducted in over 5,000 classrooms for 10 to 19
year-olds, highlighted widespread perceptions about intimate
partner violence. It showed that 60.8 per cent of 10-14 year
old and 55.2 per cent of 15-19 year old males believed that
sexual violence does not include forcing sex with someone you
know. For females 62 per cent of 10-14 year olds and 58.1
percent of 15-19 year olds held the same belief
(Andersson et al).
Several studies from different
parts of the world indicate that up to one third of adolescent
girls reported that their first sexual experience was coerced.
Many are married at a young age to older men, and the power
inequities inherent in these relationships can lead to
violence or the threat of it (UNIFEM). The risk of violence
and sexual abuse is high among girls who are orphaned by AIDS,
many of whom face a heightened sense of hopelessness along
with a lack of emotional and financial support. In a study in
Zambia,
Human Rights Watch found that among girls who had been
orphaned by AIDS, hundreds were being sexually assaulted by
family members or guardians or forced into sex work to
survive (Human Rights Watch).
Violence against women precipitated
by HIV infection
Fear of violence is an undermining factor in terms
of seeking treatment. Women may hesitate to be tested for HIV
or fail to return for the results because they are afraid that
disclosing their HIV-positive status may result in physical
violence, expulsion from their home or social ostracism.
Studies from many countries, especially from sub-Saharan
Africa, have found these fears to be well founded. Anecdotal
evidence based on stories by women both emotionally and
physically abused upon disclosure, reported by the media and
related in other settings, further attest to this reality for
many women.
In Tanzania, a study of voluntary counselling and
testing services in the capital found that only 57% of women
who tested HIV-positive reported receiving support and
understanding from partners. In Botswana women have admitted to
health professionals that they are afraid of their partner's
reaction if he finds out they are HIV-positive. That fear has
kept them from being tested, from returning for their results
if they are tested, from participating in Prevention of Mother
to Child Transmission (PMTCT) and treatment programmes, and
for those who agree to be treated, from adhering to the
regimen because they are trying to hide their pills (UNAIDS).
This
VAW and HIV and AIDS key issues guide continues with
information on:
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