Violence against women is fuelling HIV/Aids infection

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By Sharon Ahumuza

Posted  Friday, December 6  2013 at  02:00

During months of November and December, activists for battered women across the world work in unity to raise awareness on violence against women (VAW). VAW involves forced sexual intercourse, physical beating, excessive domestic workload, emotional and psychological harm, humiliation, threatening to harm, insults, denial of access to productive assets, harmful traditional practices such female genital mutilation, early marriages and forced marriage. Though wide spread, VAW has continued to receive inadequate attention.

As the world Health Organisation stated in (2012), VAW specifically sexual cruelty occurs as a result of power imbalances between the man and the woman. As indicated in the UDHS (2011), VAW and sexual cruelty inclusive cuts across culture, ethnicity, socio-economic status and religious affiliation. And it has serious negative repercussions on women’s sexual and reproductive health.

The UN Women report of 2012 indicated that every one in four women (70per cent) are physically or sexually abused hence exposed to HIV. Studies carried out in Sub Sahara African countries including Uganda have indicated that VAW and sexual cruelty increases rates of HIV infection among women especially those aged 15 to 49 years.

This is because biologically, women are more vulnerable to infection and forced sex further increases their risk to HIV transmission due to tears and scratches. VAW contributes to higher prevalence of HIV among women than men.

For instance UNFPA estimates that of the 33.2 million people who are living with HIV throughout the world, close to 61 per cent of those infected are women and adolescent girls. Adolescent girls aged 15-19 are six times more likely to be HIV positive compared to boys of the same age. Worse still, these young women do not get adequate knowledge on HIV/ Aids. According to the USAID report of 2012, VAW and sexual cruelty in Uganda is a significant driver of HIV infection especially among women.

With high rates of violence, it has been established that women are less able to protect themselves from HIV infection. This is largely because such women do not have the power to negotiate for safe sex or to refuse unwanted sex.

Much as Uganda is usually referred to as an example of a country that successfully brought the AIDS pandemic under control, women still find themselves at a high risk of HIV/Aids. The power imbalances in stable relationships between men and women, men having multiple sexual partners coupled with inability of women to question such acts for fear of violence are some of the reasons for increasing the risk of HIV infection.

Through the Ministry of Health, the government has developed a strategy to integrate HIV/Aids and sexual and reproductive health and maternal health services. Among the principles of service integration is focusing on human rights through which VAW is supposed to be addressed. However, this strategy in itself will not be enough to address violence against women VAW and HIV/Aids

Addressing VAW and girls in the fight against HIV/Aids may not be successful with most interventions and strategies focusing more on traditional ways of containing the epidemic, such as condom use, antiretroviral drugs, and treatment for sexually transmitted infections. The long-term prevention programmes need to address underlying social issues in addition to changing government strategy.

For better results, it is important VAW is addressed as a core issue affecting humanity, fueling the spread of HIV and limiting women from utilising the available HIV treatment and care services. This requires addressing issues related to gender, communication and relationships at family and community level.

Thus HIV interventions should go hand in hand with activities aimed at fostering positive gender-related attitudes and behaviours. It is important that such activities bring men and women together to discuss and analyse how certain factors in their own families and communities make them vulnerable to HIV.

Ms Ahumuza is a Makerere University School of Public Health-CDC Fellow attached to Aids Information Center.