Data support the need to address not only HIV/AIDS and IPV, but also their intersection:
- For women living with HIV/AIDS, violence is especially prevalent: in a meta-analysis, over half of women living with HIV had experienced IPV, considerably higher than the national prevalence among women overall
- Violence and HIV are particularly prevalent among transgender women. A systematic review found a mean of 58% of transgender women reported violence at home, with a mean HIV prevalence of 28%.
- Compared to women who have not experienced violence, women with a history of IPV are more likely to report HIV risk factors, including unprotected sex, injection drug use and alcohol abuse.
- Women who experience IPV are less likely than other women to display high levels of self-efficacy for HIV prevention,12 and more likely to miss health care appointments.
- Among women living with HIV/AIDS, trauma, abuse and violence are associated with less use of antiretroviral medication, decreased medication adherence, and increased risk of death.
- HIV infection may trigger or augment physical violence, particularly against women; one large study reported that over one in five women living with HIV reported physical harm since HIV diagnosis, with half of these events attributed to being HIV-positive.
- The relationship between tissue damage and HIV susceptibility emphasizes the importance of understanding how genital tract injury associated with sexual violence can increase the risk for HIV infection.
- Research suggests a synergistic relationship between violence and HIV that results in health outcomes worse than either condition alone, referred to as a “syndemic” relationship.
“Since most infections among women occur through heterosexual sex, their risk is predicated on the risk behaviors of their male partners. This raises complex policy and research questions, as negotiating safer sexual practices can be especially challenging for women who may be vulnerable to physical violence, and emotionally or economically dependent on men.”
The above is an excerpt of a report by a working group formed by President Obama in March 2012, to explore the intersection of HIV/AIDS, violence against women and girls, and gender-related health disparities.
Download report: Full Vaw HIV Working Group Report Final