Violence against women place them at HIV risk


In many parts of the world, women are increasingly becoming infected with HIV/AIDS, and about 60 percent of women living with the virus live in Sub-Saharan Africa.

Back in 2006, the United Nations reported that one in every three women around the world has been beaten, coerced into sex, or otherwise abused in her lifetime, usually by someone known to her.

This puts women and girls, who suffer from gender inequality, at greater risk of HIV/AIDS and discrimination. They are often unable to discuss with their sexual partners about abstinence, faithfulness, and condom use.

Violence, or fear of violence, also makes it difficult for women to disclose their HIV status and access essential HIV prevention, care, and treatment services.

They may also avoid HIV testing due to fear of violence and abandonment, if they are found to be HIV-positive.

In most communities, women are held responsible for causing AIDS and other sexually transmitted infections (STIs) and shunned once they contract any of these diseases.

Numerous studies from around the globe confirmed links between violence against women and HIV. Some studies show that women, who have experienced violence, are more likely to have HIV infection.

A study released on the online journal titled ‘Women and Health’ last week, the researchers from The Miriam Hospital and the University of Rochester in United States claim to have found a definitive link between violence among intimate partners and increased risk of HIV infection.

They note that sexually transmitted diseases, including HIV, are an important public health problem for women in Africa and the world at large.

The study found that each year, 27 percent of new HIV infections are in women, and heterosexual transmission accounts for 83 percent of those infections.

The same study has attributed 12 percent of HIV/AIDS infections among women to relationships involving intimate partner violence (IPV).

Past studies have linked male-perpetrated IPV with sexual risk behaviours, including an increase in the number of sexual partners, trading money or drugs for sex, and inconsistent use of condoms.

While researchers agree that IPV affects sexual risk among women, little is known about the mechanisms by which IPV leads to risky sexual behaviour.

Dr Theresa Senn, the co-author of the study and senior research scientist at Miriam Hospital’s Centres for Behavioural and Preventive Medicine, concludes that women in violent relationships fear asking their partners to use a condom.

“Our findings suggest that women involved in violent relationships fear that their partner might respond with violence if asked to use a condom, which in turn, leads to less condom use for these women,” Senn says about the findings.

The researcher suggests that the issue of women protecting themselves from unwanted pregnancy and sexually transmitted infections, including HIV, is not as easy as just telling their partners to put on a condom.

“The potential consequences of asking their partner to wear a condom are more immediate and potentially more severe than an unintended pregnancy or STI,” Senn says.

Participants in this study were recruited from upstate New York public clinic that treats sexually transmitted diseases. They completed a computerised questionnaire that asked them about risky sexual behaviour, intimate relationships, and related co-variants and confounding variables.

Specific findings from the study indicate that 17 percent of the sample reported IPV in the past three months.

Recent IPV was associated with fear of violent consequences to requests for condom use; this fear, in turn, was associated with inconsistent condom use. Women who reported IPV also reported greater difficulties in negotiating safer sex behaviors with their abusers. For women in violent relationships, fear of violent consequences appeared to hinder women's ability to protect themselves against HIV infection.

Senn recommends health care providers involved in HIV prevention and sexual risk reduction interventions to address IPV and, more specifically, the fear of IPV when negotiating safer sex as part of more comprehensive care provision to women.

“For women in violent relationships, counselling to use a condom and training in condom assertiveness skills are unlikely to increase condom usage.

“Women in violent relationships may need additional counseling about healthy relationships, and assistance developing a safety plan. Further, we may need to develop interventions for couples or for men who are violent,” Senn says.

This study confirms how most women are suffering in silence at the hands of their abusive partners.

And Kristan Schoultz, director of Global Coalition on Women and AIDS once said “for us to eliminate HIV and AIDS, there is a need for long-term interventions which address structural factors, gender inequalities and harmful gender norms are essential if one is to reduce violence against women and HIV”. But such long-term interventions must be preceded by short-term interventions such as encouraging women, especially those in abusive relationships to speak out publicly, other than continue suffering in silence.

February 2014
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