It seems an uncanny coincidence that the International Day for Eliminating Violence against Women and World AIDS Day are only a few days apart. When looking at the inextricable link between violence against women and HIV/AIDS, this ‘uncanny coincidence’ begins to unravel. The placement of the two days becomes very fitting when looking at the HIV epidemic through the eyes of women.
On the 25th of November we have White Ribbon Day, the symbol for the International Day for the Elimination of Violence against women. Of particular focus for white ribbon day is intimate partner violence which affects 30% of women globally.
Australia is not immune to intimate partner violence, with a staggering one in three women having experienced physical and or sexual violence by someone who is known to them. Further, partner violence is the leading contributor to death, disability and ill health for Australian women aged 15-44. The aim of White Ribbon Day is to make violence against women visible.
A few days later on 1st December is World AIDS Day. It is the day of HIV/AIDS awareness with cities and individuals being showered and decorated in the synonymous red ribbon. As most are aware, there are many layers to World AIDS Day. It not just about raising awareness of issues surrounding HIV and AIDS it is a day to show support for people living with HIV and to commemorate those who have been lost through the epidemic. The aim of the red ribbon is to make HIV/AIDS visible. Sound familiar?
HIV infection can be a cause and a consequence of violence against women. The link between violence against women and increased HIV infection risk is not by any means a new topic in the HIV sector. Investigating the link has been the interest of many studies coming out of India, Africa and America. These studies are important pieces in identifying why women are especially vulnerable to HIV and why they are disproportionately represented in some countries. Since half of PLHIV globally are women, linkages between violence against women and HIV infection are vital in understanding this vulnerability.
Globally, women make up over 50% of people living with HIV. In Australia that figure is much lower with women making up around 10% of all PLHIV. Even though the numbers of Australian women living with HIV are lower than the global estimate, we need to keep WLHIV visible. After all, HIV does not discriminate.
There are a number of reasons which make women who are experiencing violence more vulnerable to HIV infection:
- Lack of control: Women experiencing violence may have a limited ability to control their sexual autonomy, including contraception and the ability to negotiate barrier protection and/or risk reduction
- Patriarchal systems and constructs: Gender inequities surrounding women’s roles also exacerbate inability to exert control over their bodies and bodily autonomy
- Isolation: Violence, or the fear of violence also impede on women disclosing, seeking testing or care in relation to their sexual health
- Physiological reasons: HIV transmission risk increases during violent or forced-sex situations such as through cuts and abrasions through forced penetration.
White and Red Ribbon Days call for reflection. It is also important to remember and reflect on the fact that violence does not discriminate and is inflicted on all gender identities. The close proximity between the White and Red Ribbon Days remind us that we should also be reflecting on the interconnected issues that surround HIV. If we do not consider the role violence has in HIV transmission, we will be unable to target our HIV prevention efforts, especially for women.