Intersections between Gender-Based Violence & HIV/AIDS
By Bernedette Muthien
article examines the intersections between gender violence (GBV) and
HIV/AIDS respectively in South Africa, given the extent of both, and
what services if any are available to address both. More significantly,
what is the impact of HIV/AIDS on (largely female) survivors of gender
violence (rape/sexual assault and domestic violence), what are their
needs, and how can these be met.
Africa is at present confronted with two key epidemics: HIV/AIDS and
GBV. When GBV is combined with HIV/AIDS, these two scourges are even
more lethal than each when viewed as mutually exclusive. Since the prevalence
of HIV/AIDS in South Africa is at least 10% of the population nationwide,
it can be assumed that women who are subjected to coercive sexual intercourse,
from stranger rape to sexual intercourse in relationships subject to
domestic violence (DV), are at greatest risk of being infected with
HIV, in part due to their lack of power to negotiate safer sex practices.
The UN Population Council asserts that women's "HIV status is strongly
associated with partner violence":
HIV-positive women were 2.68 times more likely than HIV-negative women
to have experienced a violent episode by a current partner… young
HIV-positive women (18-29 years) were ten times more likely to report
partner violence than young HIV-negative women. [Horizons, 2001: 3]
The two distinct fields of GBV and HIV/AIDS respectively are traditionally
dichotomised. This means for example that a survivor of GBV would first
need to access an organisation dealing with the violence, and then a
separate organisation dealing with HIV/AIDS (for voluntary counselling
and testing, for example). Even organisations working on GBV specifically
are dichotomised according to the type of violence they deal with. This
specialisation by service providers adds to the burden, emotional and
financial, of the survivor of GBV, who has to travel to, and seek support
from, various disparate organisations, which often are not in communication
with one another.
evolves in part from women's subordinate status, and is crosscutting:
25% of women are abused (Medical Research Council, 1999); one in every
four deaths is due to femicide (MRC, 2003); 52,860 rapes and attempted
rapes were reported during 2000 (South African Police Services); with
statistics highly conservative due to the extent of under-reporting.
49th World Health Assembly of 1996 declares violence against women a
public health priority. The Provincial Department of Health also affirms
"that violence (including sexual violence against women, men and
children) is one of the most pervasive and common public health problems
and deserves to be prioritised in the allocation of resources and in
the services available to such survivors."
all forms of GBV are to be combated more effectively, and both the risk
and treatment of HIV infection addressed in relation to the critical
intersections between GBV and HIV, it is important to view GBV as inclusive
and multivariegated. Service provision should address GBV as holistic
and all forms of GBV as intrinsically interrelated, and should necessarily
incorporate HIV and other STIs.
addition, due to women's subordinate status in society, women's choices
are severely limited. In a patriarchal system women are disempowered
both by the oppressive system and by their own internalisation of its
values, and hence women often tend to remain in relationships that are
violent physically, psychologically and/or economically. Even treatment
of HIV/AIDS is gendered, with women bearing the costs of HIV, as carers
of the sick and orphans, and are more exposed to infections due to their
physiology, and more vulnerable to violence due to power dynamics and
the different roles women take on in communities which prejudice them.
Socio-economic factors increase poor women's risks of HIV infection
and vulnerability to GBV. Thus economic status, geographic location
(urban-rural), access to education and information, exacerbate women's
subordinate status in society, and the choices available to combat both
GBV and HIV/AIDS.
providers unanimously note that infant and child rape has been prevalent
long before the 1980s when HIV/AIDS became public knowledge, and that
this is found in all countries.
the first time a survey of this kind included specific questions on
same-sex GBV, intended to determine the extent of rape of lesbians and
bisexual women by men on account of their sexuality, or "curative
rape", known to be pervasive from anecdotal evidence. We discovered
that the spectrum of GBV also applies to same-sex relationships. The
silence and stigma about sexualities (homophobia and heteronormativity),
is compounded by the silence and stigma about GBV, with services largely
heteronormative and geared towards heterosexual women. This may be compounded
by the political implications of debunking conventional idealisms about
lesbian relationships, and adds multiple burdens on queer women. Hence
GBV organisations should cater for women of all sexualities, and queer
organisations should address GBV.
no one concrete strategy emerges, respondents identified the following
strategies, which has been sorted into three different levels:
Macro level: Increased government commitment, government resource allocation,
and an interdepartmental government approach. Education (and broader
sexualities training) from an early age. Educators should be trained
to screen for and prevent generic abuse, and be trained to not be abusers
themselves. Sensitising health care and social services workers. An
intersectoral partnership between government, NGOs and research institutions.
Laws should be implemented.
Meso level: Development of educational programmes and materials, especially
for youth; improved crisis intervention and more holistic service provision;
monitoring and combating negative media stereotypes. Campaigns should
ensure that services and resources are available.
Micro level: Training in sexualities and STIs; destigmatisation of issues;
and greater community and individual involvement. Respondents from rural
and peri-urban areas noted how critical it is that resources reach them,
including the "deep rural" areas (where there are absolutely
no services like accessible roads, running water, nearby police stations
or health care services).
The report has been written on behalf of the Gender Project, Community
Law Centre, University of the Western Cape. Muthien is an independent
scholar-activist, based in South Africa and works in the areas of gender,
human rights and conflict resolution. This report served as critical
impetus for action on these issues for various organisations, with a
number of GBV service providers now incorporating both HIV and sexualities
in their existing programmes.
For the full report, or further information,
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