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, 2004). While the full extent of violence against women is not known, current research from the World Health Organization indicates that in some countries one in four women may experience sexual violence by an intimate partner in her life time. Added to this is the violence that women experience from strangers.

According to a study published in the Lancet in 2004, 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.

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.

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, 2004). 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.