World AIDS Day: Twin scourges – GBV and HIV

By Linda Musariri Chipatiso and Kevin Chiramba

Today I regret ever getting married to my husband and I always curse the day I accepted his love proposal. The whole drama started when my husband decided to be unfaithful through having extra marital relationships. His promiscuous behaviour caused me a lot of pain as it tortured me emotionally. 

I was not able to caution him to stop what he was doing because whenever I try he used to assault me. The continuation of the unbearable situation caused me to suffer from stress and I went to the clinic to seek medical help. Since it was mandatory for everyone who visits the clinic to be tested for HIV, I was tested and officially diagnosed HIV positive.

I went on medication and I told my husband but he refused to go to the hospital. He cited me as the cause of that calamity that had befallen us and he said he cannot live with a woman who is HIV positive. After I disclosed my status to my husband, he tried all means possible to chase me away from our matrimonial home but I resisted the move. He started physically assaulting me and several times I used to sleep outside after being locked out. I maintained my stance and I declared that I will never leave behind the properties I worked for to be enjoyed by my husbands’ girlfriends.

Mary’s* story is one of the many sad reflections of the links between HIV and gender based violence (GBV) that comes into sharp focus on World Aids Day – 1 December, right in the middle of the Sixteen Days of Activism on Gender Violence.

The Sustainable Development Goals (SDGs) and the updated SADC Protocol on Gender and Development aim to end both scourges by 2030. The Joint United Nations Programme on HIV and AIDS (UNAIDS) has a 90 by 90 by 90 plan for 2020: 90% of all people living with HIV will know their HIV status; 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; 90% of all people receiving antiretroviral therapy will have viral suppression.

UNAIDS estimates that 78 million people have become infected with HIV while 35 million have died from AIDS-related illnesses. UNAIDS estimates that from 2002 to 2012, expanded access to HIV treatment averted 4.2 million deaths. Concerted prevention campaigns have contributed to a 58% reduction in new HIV infections.

Approximately 68 percent of people infected with HIV worldwide live in sub-Saharan Africa. According to the United Nations, women constitute more than half of all people living with HIV in the region. According to the SADC Gender Protocol Barometer 2017, about 15.3 million people in SADC are living with HIV and this is more than 40% of the 36.7 million people living with HIV globally.

The highest rates of HIV and AIDS infections among 15-to-49-year-old women occur in Botswana, Lesotho, Swaziland, and South Africa where the virus disproportionately affects women. Statistics show that women have become the face of HIV and AIDS in sub-Saharan Africa, as more than half of the people living with the virus in the region are women. In comparison to their male counterparts, women are more susceptible to HIV because of biological differences in susceptibility and reduced sexual autonomy.

Gender Links has conducted Violence Against Women studies in six countries in the SADC region which revealed lifetime experiences of violence ranging from 24% in Mauritius to 79% in Zambia. The most recent study by Gender Links in Seychelles included violence against men for the first time. More than half of the women (58%) and 43% of men who participated in the study had experienced some form of GBV at least once in their lifetime.

There is a growing body of research showing the nexus between GBV and HIV among the general population and key populations such as female sex workers, men who have sex with men (MSM), drug addicts, migrants as well as prisoners among others. However, there is increasing evidence on the link between HIV and GBV particularly intimate partner violence. The vast majority of women diagnosed with HIV are said to have contracted the virus through heterosexual sex in intimate relationships.

Many countries in the SADC region do not know the magnitude of GBV in their countries, thus making it difficult for them to respond to this scourge. It can arguably be said GBV undermines the efforts being made to address the HIV epidemic. The VAW studies conducted by Gender Links in six SADC countries showed significant associations between experiencing intimate partner violence and having a HIV positive status. Different studies have found similar results in various settings.

Many a times the risk of HIV infection is increased directly through sexual violence or indirectly through increased risky behaviour or inability to negotiate safer-sex practices with a partner.

Young girls also face the immense burden of the epidemic when exposed to forced sexual intimacy. When children are sexually abused they are more likely to engage in HIV risky behaviours in adulthood. Boys who witness or experience family violence are more likely to perpetrate or experience GBV including rape.

Gender norms around masculinity and sexuality also put men at increased risk of HIV by creating stigma and discrimination that can prevent them from seeking and accessing services. Rates of HIV testing and treatment utilisation are lower among men compared to women.

In the Gender Links Seychelles study, a higher proportion of men compared to women disclosed that they had never tested for HIV. It is evident that men and boys are also affected by gender expectations that may encourage risk-taking behaviour and discourage accessing health services. Prevention strategies need to address the unequal power between men and women, and norms and traditional practices that put women and girls at a higher risk of exposure to HIV. Equally important is to include men in these interventions.

(Kevin Chiramba is a senior programme officer at Gender Links and Linda Musariri Chipatiso is an independent researcher. both have played key roles in the GBV indicators studies. This article is part of a special series being offered by Gender Links for the Sixteen Days of Activism).

Author: Linda Musariri Chipatiso and Kevin Chiramba