World AIDS Day: Violence against women and HIV

World AIDS Day is coming up, and loyal readers will remember Miranda’s shoutout last year about why HIV and AIDS is a feminist issue. I’m not going to try and tour all the issues around women and HIV and AIDS, partly because that’s WAY too big for a blog post, but also because I’m not an expert. If that’s what you’re after, this fantastic resource on women, HIV and AIDS from Avert has lots of great information and clear explanations.

Picture CC Terriem, 2011

So why am I writing this at all? Over the last nine months I’ve gotten interested in the interactions between violence against women, gender roles and HIV, which I confess is mostly down to my job at Womankind Worldwide.

It struck me that even though I’ve been working with different organisations tackling violence against women in the UK for years, I don’t remember HIV ever being mentioned. It’s just not something I’d ever really thought about. But then, I had also failed to really think about, you know, the rest of the world. This job has been an eye-opener, and I heartily encourage other feminists in the UK, the US, and Western Europe to look up and see what’s happening in the places you don’t see on TV.

“This epidemic unfortunately remains an epidemic of women,” Michel Sidibé, Executive Director of UNAIDS said in 2010. At the end of 2009, women accounted for just over half of all adults living with HIV worldwide. In some areas of the world the proportion is much higher, for example in sub-Saharan Africa it is 60%. High levels of HIV among women in these areas are both caused by and causes of violence against women.

Violence, HIV and Women’s Health

Violence against women (you remember, that really prevalent thing that occurs in all countries in the world) interacts with the HIV epidemic in several cheery ways. This paraphrased from a World Health Organisation briefing:

• Sexual abuse in childhood is associated with risk-taking behaviour later in life, increasing an individual’s lifetime risk of contracting HIV.
• Rape exposes women to HIV, and the chances of a woman contracting HIV via a forced sexual encounter are probably increased due to the physical trauma.
• Violence and fear of violence can stop a woman insisting on condom use or refusing unwanted sex, leaving her with no means of protecting themselves.
• Fear of violence, abandonment or stigma can dissuade women from learning their status or from sharing it with their partners, and can also effect HIV control, treatment, and programmes aiming to prevent mother to child transmission.

Women’s health has been the subject of more discussion in development circles in recent years, thanks in large part to the Millennium Development Goals, one of which (MDG5) is focused on maternal health. Women’s health doesn’t begin and end with children though, so I’ve been pleased to see greater recognition of the impact of gender-based violence appearing under MDG6, which is dedicated to ending the spread of diseases including HIV infection and the associated illnesses it can cause. Next step, an MDG which is focused on reducing levels of violence against women? Something which has a pretty damaging effect on women’s health in its own right.

Ghana

Through work recently I was lucky enough to meet some of the women and men fighting to reduce violence against women and women’s vulnerability to HIV infection in rural Ghana. Although Ghana isn’t the country worst affected by the HIV epidemic, of the 240,000 HIV+ adults living in Ghana, almost 60% are women. Women in Ghana also experience high levels of violence: 1 in 3 women has experienced some form of physical violence in their lifetime, and 20% of women report that they first experienced sex against their will. (Stats)

In addition there are a number of harmful traditional practices that contribute to the spread of HIV among women, as well as the cultural acceptability of men having several partners and the right to demand sex. Traditional practices, such as widow inheritance (where a widow is forced to marry her dead husband’s relative), or polygyny (22% of married women are in polygynous unions) increase the likelihood of contracting HIV.

Women living with HIV or AIDS in Ghana also face enormous stigma and go to extraordinary lengths to find support and keep their status secret. One reason is that belief in witchcraft is widespread, and HIV infection or death from AIDS-defining illnesses is sometimes blamed on the malign influence of a witch. Incidentally if you’re interested to know more about what happens to women accused of witchcraft in Ghana I recommend watching The Witches of Gambaga:

‘Witch’ persecution is also alarmingly common in Nepal.

Reading about all this every day at work would get a bit depressing if it wasn’t for our amazing partners – health workers, educators, lawyers and activists – who are working for change for individuals, and local and global communities. Part of that change is recognition of the complex interactions between HIV and AIDS and violence against women, and the need for targeted, local, gender-sensitive interventions and support. UK feminists can help by looking up, and recognising that HIV is a feminist issue on a global scale.