The 'feminization' of the HIV epidemic has resulted in more women than men living a statistical association between experiences with violence and HIV infection: In the United Republic of Tanzania, women seeking voluntary counseling and Bridges to End Gender Based Violence as Strategy for HIV/ AIDS Prevention. Linkages between HIV/AIDS and GBV It is more difficult for women to refuse sex when in a relationship, to get their partners to be faithful, or to use a condom. A study in South Africa found that women who have been forced to have sex are. Addressing the links between poverty, gender-based violence and Conference on HIV/AIDS held in Durban, South Africa, which for the first.
The two regions were selected because of high HIV prevalence above national figure of 5. Iringa is a source while Dar-es-Salaam is major destination for trafficked girls. A two stage sampling procedure was used. The first stage involved purposive selection of three districts representing urban, peri-urban and rural setting and random selection of one ward in each district to participate in the study. In each of the participating districts, the following key stakeholders were purposively selected for interview: The second stage involved selection of health facilities, safe houses, famous pubs, bars and brothels located in the three districts.
Pubs and bars were selected randomly from lists of similar facilities in the study ward in each district while all safe houses and brothels located in the study districts were selected. All GBV survivors found in the selected safe houses, brothels, pubs and bars were invited to participate in the study if they were meeting the eligibility criteria which included suffering from at least one GBV event in a life time, aged 18 — 49 years and willing to participate.
Three district hospitals, six randomly selected health centres 2 from each study ward and two regional hospitals from each region participated in the study. A total of 37 health care providers were randomly selected and invited to participate in the study 3 from each district hospital and health centre and 5 from each regional hospital.
In depth interviews were used to generate data from government officials, key opinion leaders, and selected community members. Interviews were conducted under supervision of the authors by trained research assistants who were able to communicate in both Swahili and English. Probing was applied during the interview wherever necessary to enrich the data collected and help in understanding the issues in detail [ 13 ].
Focus group discussions were used to collect data from GBV survivors, PLHIV groups, community groups youth, adult male and female groups because it is the best method for generating data from several people in a short period of time given the time constrain in accomplishing this study [ 14 ].
Focus group discussions were conducted in Swahili and were moderated by trained and native Swahili speaking research assistants. The focus groups were homogeneous in nature taking into account age groups, sex, education and HIV status.
The researcher wanted participation from each participant while avoiding lack of cohesion and side conversations which usually occur in large groups, hence six participants were allocated per group [ 1516 ].
The focus group discussions were conducted in meeting rooms with privacy. A total of 28 in-depth interviews and 16 focus group discussions were conducted and were adequate to reach saturation point where there was no new emerging issue.
Linkages between HIV/AIDS and GBV
A standardized questionnaire was used to collect quantitative data from GBV survivors and health care providers. The questionnaires were administered to the respondents by trained research assistants that were fluent in both Swahili and English.
As with sexual assault, sexual coercion often involves unequal power relations, which limit the extent to which a woman or girl can exercise control over condom use or take other measures to protect herself from HIV infection.
To the extent that these men fail to use protection, they put girls at risk of contracting HIV.
Adolescent girls who have experienced sexual coercion may also be more likely to be non-users of contraception and to have unintended pregnancies. Intimate Partner Violence In cases of intimate partner violence, inequality of power within the sexual relationship is linked to the risk of HIV transmission Jewkes et al.
For example, when intimate partner violence is present fear of violence and abuse can prevent women and girls from negotiating safe sex, even when they fear a partner may be HIV-positive. This is especially dangerous given that abusive men are more likely than non-abusive men to have multiple sex partners, be adulterous, and to have STI symptoms Dunkle et al.
Child Marriage Because of biological factors, young wives are more physically vulnerable than mature women to contracting sexually transmitted infections, including HIV, from an infected partner—a danger which only increases given the fact that young girls are even less likely to be able to negotiate safe sex with their partners than older women Ward, A study conducted in Rwanda found that 25 percent of girls who became pregnant at age 17 years or younger were infected with HIV, even though many reported having sex only with their husbands.
Additionally, a study conducted in Uganda found that girls aged 13 to 19 years who were HIV positive were twice as likely to be married as girls who were HIV negative Otoo-Oyortey and Pobi, cited by Ward et al.
Access to HIV prevention services among gender based violence survivors in Tanzania
Trafficking Epidemics of sexually transmitted infections, including HIV, have increased the demand for sex with children, who are believed to be less likely to be infected than adults. While overall data is not available on the risk of HIV transmission related to trafficking, sexual exploitation is a high-risk factor for HIV Ward, This is because of the unsterilized instruments sometimes used to perform such procedures, and also because the scarred or dry vulva of a woman who has undergone female genital mutilation is more likely to be torn during intercourse, which can facilitate transmission from an infected partner Centre for Reproductive Rights, cited in Ward, Data and Trends Population Reference Bureau Other Harmful Traditions Traditional practices across the world that both support and intensify violence against women and girls can contribute to HIV transmission.
Polygamy is when a person has more than one spouse. In most parts of the world, the most common practice of polygamy is polygyny, where a husband has multiple wives. Unprotected sex with multiple concurrent partners is a proven risk factor for HIV transmission and in cases of polygyny the husband may not use condoms with his wives.
Wife inheritance is when a widow is given to a male family member of the deceased husband. Cases of wife inheritance usually involve unequal power relations where a woman or girl may be forced into the practice.
This lack of power may increase the chances of sexual assault or coerced sex. These unequal power relations can also limit the extent to which a woman or girl can exercise control over condom use or take other measures to protect herself from HIV infection.
With this practice emphasis is placed on the sex being unprotected. This practice increases HIV risk factors through: Discrimination in Property and Inheritance Laws In some parts of the world property ownership is traditionally passed patrilinearly. Women fearing violence are less able to protect themselves from infection: They do not have the power to negotiate for safe sex or to refuse unwanted sex, they do not get tested for HIV, and they fail to seek treatment after infection.
A survey found that about 60 percent of HIV-positive women chose not to receive treatment at a Zambian clinic because they feared violent behavior and abandonment by their family.
- Gender-Based Violence Increases Risk of HIV/AIDS for Women in Sub-Saharan Africa
- Access to HIV prevention services among gender based violence survivors in Tanzania
In a study on sexual violence and HIV in South Africa, 16 percent of males and 14 percent of females in the toyear-old age group would not share a positive diagnosis with their family. Several forms of male dominance, while supported in greater numbers by men, are also widely accepted by women.
Understand the linkages between HIV/AIDS and violence against women and girls
For example, the South African HIV and sexual violence study observed that, among toyear-olds, 28 percent of males and 27 percent of females believed that a girl did not have the right to refuse sex with her boyfriend. In addition, the unequal power dimension is distorted further by large age differences in relationships. It is common for women in sub-Saharan Africa to marry at a young age or have older intimate partners who are sexually more experienced.
A study in Zambia found that only 11 percent of married women believed they had the right to ask their husband to use a condom, even if they knew he was infected with HIV.