Women who suffer violence at the hands of their male partners are more likely to become infected with the HI virus, a new South African study confirms.
"Women who are beaten or dominated by their partners are nearly 50 percent more likely to become infected with HIV, compared with women who live in non-violent households," says the study entitled,`Gender-based violence, relationship power, and risk of HIV infection in women attending antenatal clinics in South Africa'. The study was conducted jointly by US and South African academics.
To fully understand how HIV, gender-based violence and gender-based inequality relate to each other in intimate partnerships, the researchers captured and compared a range of abusive experiences and explored connections between violence, inequality and risk behaviour.
The cross-sectional study interviewed 1,366 women who sought antenatal care at four health centres in the township of Soweto outside Johannesburg.
Private interviews were conducted in local languages and included assessments of sociodemographic characteristics, experience of gender-based violence, the South African adaptation of the Sexual Relationship Power Scale (SRPS) and risk behaviours.
After adjustments were made to ensure validity, the figures showed that women who were abused by their husbands or boyfriends were 48 percent more likely to become infected by HIV than their counterparts.
"We postulate that abusive men are more likely to have HIV and impose risky sexual practices on partners," reported the study.
According to UNAIDS and WHO, 58 percent of HIV-positive adults in sub-Saharan Africa are female.
"Violence against women and HIV cannot be divorced," Cookie Edwards, Coordinator of the Network on Violence Against Women in the province of KwaZulu-Natal, told PlusNews.
Edwards and her team have been forming intersect coalitions across the continent since 2002 to focus attention on the link between HIV and violence against women.
The most direct link is visible in partnerships where the woman is afraid to negotiate safe sex with her partner.
"Even if women are educated about safe sex and HIV, it is not necessarily possible for them to negotiate their sexual relationship if they are threatened with violence. They may be physically forced to have sex; having sex because she is afraid to refuse; or being forced to do something degrading or humiliating - and other circumstances, like rape, definitely places the woman at risk," said Edwards.
Edwards advocates the immediate training of people trying to assist women in communities. "The majority of the organisations working to protect and mobilise women are ill-equipped to do counselling. As a victim of a violent act, if I go to an organisation that runs a programme and I find out that I am HIV positive, or my partner is, does the organisation have the capacity to deal with it? A secondary victimisation occurs when she can't get the service she so desperately needs".
"We want the organisations that are ... interested in learning how they can be of service in their communities to be trained, so that they can provide a comprehensive, effective service for victims of violence, and the ramifications of possibly contracting the HI virus," said Edwards.
The Network supports the call for a deeper understanding of women's exposure to the risk of acquiring the HI virus. "Research on connections between social constructions of masculinity, intimate partner violence, male dominance in relationships, and HIV risk behaviours in men, as well as effective interventions, are urgently needed," the study notes.
Research on the link between gender-based violence and women's risk to HIV remains limited, with almost all existing information coming from the United States.
From 27 to 28 May the Network on Violence Against Women will hold a conference in KwaZulu-Natal to bring together organisations and other role players to explore the link between gender-based inequality, violence and HIV, and discuss possible interventions.