Vienna 2010: The intersection: violence against women & girls and HIV

Violence against women and girls is a problem of pandemic proportions. At least one out of every three women or up to 1 billion women around the world have been beaten, coerced into sex, or otherwise abused in her lifetime – with the abuser usually someone known to her.

Violence and the fear of violence are emerging as an important risk factor contributing to the vulnerability to HIV infection for women. The extent to which individuals who are HIV infected, particularly women, are vulnerable to violence is also an issue of concern.

A growing number of studies have documented the high prevalence of intimate partner violence and sexual violence against women worldwide. This violence can contribute to women’s increased risk of HIV infection both directly through forced sex and indirectly by constraining women’s ability to negotiate the circumstances in which sex takes place and the use of condoms.

In addition, sexual abuse during childhood seems to be associated with high-risk behaviors in later stages of life that may also increase the risk of HIV. However, many questions remain as to the extent of this increased risk and the precise interactions between different forms of violence against women (VAW) and HIV/AIDS. Further research is needed to understand exactly how these two areas overlap. The extent to which interventions can effectively address both problems also requires further research and collaboration between those working on VAW and those working on HIV/AIDS.

Violence, or the threat of it, not only causes physical and psychological harm to women and girls, it also limits their access to and participation in society because the fear of violence circumscribes their freedom of movement and of expression as well as their rights to privacy, security and health. The onset of the HIV/AIDS pandemic found a bosom friend in the pandemic of violence against women. The intersection of the two pandemics remains a testimony of the cost of ignoring calls to end violence against women.

The HIV/AIDS pandemic now wears a woman’s face. It remains a stark reminder that violation of rights in one sphere leads to more serious violations in other spheres, resulting in compounded situations. Just as violence against women increases their risk to HIV, it is also a consequence of HIV sero-status.

At the plenary session during the second day of the VIII International AIDS Conference in Vienna, Everjoice Win, Head of Women’s Rights at ActionAid International in Harare, described the magnitude of violence perpetrated against women and girls around the world and drew strong links between this violence and HIV. Gender inequality fuels both.

Win called to recognize and prioritize VAW as a human rights violation; and for the recognition and prioritization of violence against women in the AIDS response. She called for donors to address the intersection between HIV and violence and for investment in more research to build an evidence base on how they are a cause and consequence of each other. She urged governments to implement strong and well enforced anti-violence laws and stressed the need for greater investment in women’s economic, social and political empowerment.

Violence against women interacts with the HIV epidemic in many ways, all to the detriment of women:

• Women can be infected with the HIV virus through forced sex: the chances of a woman contracting HIV via a forced sexual encounter are probably increased since forced sex often involves trauma and tissue tearing which can provide an open door to the virus.

• Sexual abuse in childhood (a form of VAW) is associated with risk-taking behavior later in life, increasing an individual’s lifetime risk of contracting HIV.

• Violence and fear of violence can prevent a woman, even one in a consensual union, from insisting on condom use or refusing unwanted sex. Since condom use and abstinence are currently the only dependable and widely available means of avoiding HIV infection, this leaves women with no means of protecting themselves.

• Fear of violence, stigma, and abandonment can dissuade women from learning their HIV infection status – or, if they do learn it, from sharing it with their partners.

• Since violence can affect women’s willingness to be tested, it can also have a detrimental effect on HIV control, treatment, and prevention of mother to child transmission programmes.

The links between VAW and HIV/AIDS highlight the importance of addressing VAW for HIV/AIDS prevention and care. It is thus important to improve collaboration between HIV and VAW groups, exchange experiences and expertise and learn form existing initiatives.

Ishdeep Kohli-CNS