13 July 2000
In breaking the silence about AIDS at the XIII International AIDS Conference in Durban, South Africa, this week, the World Health Organization (WHO) is also breaking the silence about how violence contributes to the AIDS epidemic.
"Violence against women is an important contributor to HIV’s spread," said Dr Gro Harlem Brundtland, Director-General of WHO, speaking at a symposium on Tuesday, 11 July. "We will not achieve progress against HIV until women gain control of their sexuality."
For the first time, these issues are on the agenda of the International AIDS Conference. Violence within intimate relationships is now being recognized as a barrier to effective HIV prevention and care. Violence not only fuels the AIDS epidemic but can also be a consequence of it.
In studies from the United States and Kenya, for example, around one-fifth of women with HIV reported having experienced violence as a result of their HIV status. Husbands, partners, family members, and communities count among the perpetrators of such violence.
"Some women do not want to reveal their HIV status because of fear of violence, emotional abuse, or abandonment," explained Dr Pamela Hartigan, acting Director of WHO’s recently formed Department of Violence and Injury Prevention in Geneva.
"First, women are at particular risk for AIDS because of cultural norms that reinforce inequality between the sexes and put women in subservient positions," Dr Hartigan said. "Then others are at risk because women who become infected with HIV feel powerless to discuss their test results with their partner."
The fear of violence or the experience of it may interfere with women’s seeking voluntary testing and counselling and asking their partner to use condoms. Women with HIV may also not want to avoid breastfeeding, which can reduce mother-to-child transmission of the virus, because they fear that the people around them will be suspicious of their HIV status. Fear of disclosure also may prevent pregnant women with HIV from receiving drug therapy at childbirth, which can reduce the risk of their infants becoming infected with HIV.
The first step, according to Dr Brundtland, is to speak out against all forms of violence against women, which include domestic violence, rape, and sexual abuse. "Women must know and feel that society supports them when they say no to unwanted or unprotected sex," Dr Brundtland continued.
In Durban, WHO is conducting workshops on the relation between violence and HIV/AIDS. "In community workshops, skills-building workshops, a satellite meeting, and programmed sessions, the urgency of increasing awareness about and study of this issue is being stressed," said Ms Nadine France, Technical Officer in WHO’s Department of Violence and Injury Prevention. Conference participants are exploring how violence prevention can be incorporated into HIV prevention and care programs.
WHO is calling for further research about the worldwide incidence of partner violence and its affect on the HIV/AIDS epidemic.
For further information, please contact Gregory Hartl, WHO Spokesperson, on Tel 09 41 79 203 6715, or Ms Nadine France, Technical Officer, on Tel 083 6242777.