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Violence and HIV
PDI
2004-09-30

While the true extent of violence against women around the world is unknown, current research indicates that violence at the hands of spouses or intimate partners ranges anywhere from 10 to 69 percent, and one in four women may experience sexual violence from a partner in her lifetime. The figure doesn't even include violence at the hands of strangers.

Economic disruption, war or conflict also exacerbate gender-based violence, the document says. Globally, up to 2 million women are trafficked every year, many of them at great risk of sexual abuse and all at risk of HIV infection.

Being identified as HIV-positive also places a woman at greater risk of violence, from being beaten by a partner, abandoned, or thrown out of the home. Many women say they are afraid to ask their partners to change their sexual behavior or use protection, even if they suspect their partners are engaged in risky behavior.

This fear of the consequences of "finding out," or of being labeled a "loose" woman, has kept women from being tested, from returning for their results if they are tested, or from participating in treatment programs.

Even those who agree to be treated have difficulty adhering to the regimen "because they are trying to hide their pills." At the same time, says the document, "while violence and the fear of violence make it hard for women to access prevention, treatment and care, the very fact that they are living with violence seems to increase their susceptibility to HIV."

The document cites the findings of a recent study, conducted in South Africa and one of the first to show a firm link between violence and HIV, that women who are beaten or dominated by their partners are much more likely to become infected by HIV than those living in non-violent house holds.

Data gathered by the study showed that women who were beaten by their husbands or boyfriends were 48 percent more likely to become infected by HIV than those who were not. Those who were emotionally or financially dominated by their partner were 52 percent more likely to be infected than those who were not.

The increased vulnerability is tied to several issues, the document states. One is lack of control, for as it pointed out: "Male condoms or other protection are irrelevant when a woman is being beaten or raped." Another is physiological susceptibility. The WHO reports that during "forced vaginal penetration, abrasions and cuts commonly occur, thus facilitating the entry of the virus-when it is present-through the vaginal mucosa."

The risk is even greater for young girls. Their reproductive tracts "are not fully developed and are therefore prone to tearing during sexual activity." They are also more prone to sexual coercion, with up to one-third of adolescent girls reporting in several studies that their first sexual experience was coerced. Many girls are also 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.

Even more heartbreaking is that 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 Zambia, for instance, human rights groups found that hundreds of young girls whose parents died from AIDS were being sexually assaulted by family members or guardians or forced into sex work to survive.

Unless the link between gender-based violence and HIV is broken, "it will be hard to reverse the epidemic," the three UN agencies say. While the challenges are daunting, there are many models already in place that use a variety of approaches: utilizing the health care system, human rights protection, education, legal reform and working with community groups.

One thing is clear, though, the document notes. While men are the instigators of violence, they are also essential to the solution.

In many parts of the world, there are men's groups involved in examining men's own attitudes and behaviors, to see how these should be altered the better to put women and men, young and old, less at risk of infection. "I realized it was impossible to work around issues of gender when you haven't started with yourself," said a young man working as a peer counselor in South Africa. (Source: Philippine Daily Inquirer, 29 September 2004)

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