Women and HIV/AIDS:
Confronting the Crisis

This report, published jointly by UNIFEM, UNFPA and UNAIDS, concludes that women are bearing the brunt of the HIV/AIDS epidemic and that strategies to reverse it cannot succeed unless women and girls are empowered to reclaim their rights. Noting that half of all people infected with HIV are women, the report documents the devastating and often invisible impact of AIDS on women and girls and highlights the ways discrimination, poverty and gender-based violence help fuel the epidemic.
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Not a Minute More:
Ending Violence Against Women Violence against women is arguably the world's most prevalent, pervasive, and systemic problem. It is a problem without borders, a universal scourge on women and their families that knows no boundaries of geography, culture or wealth. It has grown to epidemic proportions around the world, devastating lives, fracturing communities and prohibiting development. At least one in three women worldwide will be beaten, coerced into sex, or otherwise abused in her lifetime — with the abuser usually someone known to her.
According to UN Secretary-General Kofi Annan, it is "perhaps the most shameful human rights violation." Unless tackled systematically at all levels of society with zero-tolerance policies and a concerted effort by the international community and governments to make it socially unacceptable and a crime, gender-based violence will stall any real progress towards equality, development and peace.
Some Progress: Two Steps Forward, One Step Back
In the last two decades, women's organizations have taken the lead in moving the issue from the shadows into the public eye, taking innovative steps to focus world attention on the problem. Initiatives ranging from providing medical, legal, counselling and protection services, to drafting and lobbying for legislation, raising awareness and changing attitudes through advocacy, education and training, and building national, regional and international end-violence networks have led to dramatic changes in norms, laws, policies and practices in many countries.
These efforts have been supported by international standards and policies that recognize violence against women as a human rights abuse, such as the 1981 Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) that obliges states parties to the convention to take all appropriate means to eliminate violence against women; the UN Declaration on the Elimination of Violence Against Women, adopted by the UN General Assembly in 1993; and the Beijing Platform for Action of the UN Fourth World Conference on Women in 1995, which explicitly acknowledges that the human rights of women include their right to have control over and decide freely on matters related to their sexual and reproductive health and sexuality, free of discrimination, coercion and violence. In 1996, the UN General Assembly also established the UNIFEM Trust Fund in Support of Actions to Eliminate Violence Against Women; this is a unique grant-making mechanism that provides support to catalytic programmes in developing countries working to prevent gender-based violence.
Today, following global and regional commitments and treaties and the tireless efforts of activists, at least 45 nations have passed new laws that explicitly prohibit domestic violence, while more than 21 countries are drafting new laws. Twenty-five countries have adopted laws and policies addressing female genital mutilation, 16 countries have passed distinct legislation on sexual assault, 14 countries have adopted laws on sexual harassment, and another 46 have incorporated provisions related to sexual harassment in non-specific legal codes. Continued advocacy and NGO-government dialogues have led to responses that directly address female survivors of violence, such as special female police stations, community policing, gender-sensitive training for law-enforcement officials and the judiciary, women's and people's courts, and one-stop crisis centres.
International Day for the Elimination of Violence Against Women
and the Sixteen Days of Activism Global Campaign
In December 1999, at their 54th Session, the UN General Assembly adopted a resolution declaring November 25th the International Day for the Elimination of Violence Against Women. This was in recognition of the magnitude of the problem and the urgent need for serious commitment by the world community to make finding solutions a key priority.
The origins of November 25th go back to 1960, when the Mirabal sisters, activists from the Dominican Republic, were violently assassinated for their political activism. The sisters, known as the "Unforgettable Butterflies," became a symbol of the crisis of violence against women in Latin America. November 25th was the date chosen to commemorate their lives and promote global recognition of gender-based violence, and has been observed in Latin America since the 1980s.
The 16 Days of Activism Against Gender Violence is an annual global campaign started in 1991 by the Center for Women's Global Leadership (CWGL) at Rutgers University in the United States. The campaign begins on November 25th, runs through World AIDS Day on December 1st and ends on Human Rights Day on December 10th. Since it was started, more than 1,700 organizations in 130 countries have participated, using the annual campaign as an organizing strategy to call attention to gender-based violence and better resources to combat it.
Each year CWGL, the campaign's coordinator, consults with women's human rights advocates worldwide to propose a theme on which to focus advocacy efforts. The theme for 2004 is “For the Health of Women, For the Health of the World: No More Violence,” with specific emphasis on the intersection between violence against women and the spread of HIV/AIDS. The theme complements the theme of World AIDS Day 2004, on "Women and AIDS," and also follows on the attention received at the International AIDS Conference in Bangkok in July 2004 on the growing disproportionate impact of HIV/AIDS on women and girls.
For more information, please visit Not a Minute More, UNIFEM's web pages on November 25th and the 16 Days of Activism Against Gender Violence.
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Not a Minute More: Ending Violence Against Women
This publication surveys gender-based violence on a global level. Expert consultants conducted regional analyses of violence against women throughout the world and produced this unique book that provides a succinct but thorough picture of the violence experienced by women, and initiatives to combat the problem. The book provides examples of good practices as well as of efforts that did not meet the goals set out for them — and explores why not. It looks at the challenges ahead, and asks what the most fruitful next steps might be. read more » |
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The Link Between Violence Against Women and HIV/AIDS Infection
[More resources and information are available on UNIFEM's Gender and HIV/AIDS Web Portal and the Eldis Development Gateway Web Special on key issues for the 16 Days Campaign.]
Violence against women is both a cause and a consequence of HIV infection, and a key factor in women's increasingly disproportionate vulnerability to HIV infection than men. The circumstances underpinning the correlation between violence against women and HIV/AIDS are a complex weave of social, cultural, and biological conditions, all of which point to an increased risk for women and girls.
HIV/AIDS Infection as a Consequence of Sexual Violence Against Women
Current research indicates that intimate partner violence ranges anywhere from 10 to 69 per cent, and that in some countries one in four women may experience sexual violence by an intimate partner in her lifetime [1]. HIV transmission risk increases during violent or forced-sex situations. The abrasions caused by forced penetration facilitate entry of the virus, a fact that is especially true for adolescent girls, whose reproductive tracts are less fully developed [2].
According to a study published in 2004, women who are beaten or dominated by their partners are more likely to become infected by HIV than women who live in non-violent households. The research was based on 1,366 South African women who attended health centres in Soweto and who agreed to be tested for HIV and interviewed about their domestic situations. After being adjusted for factors that could distort the outcome, the figures showed that women who were beaten by their husbands or boyfriends were 48 per cent more likely to become infected by HIV than those who were not. Those who were emotionally or financially dominated by their partners were 52 per cent more likely to be infected than those who were not [3]. A smaller study in Tanzania found that HIV-positive women were more than two and one-half times more likely to have experienced violence by their partner than HIV-negative women [4].
Both men and women are victims of stereotypes and norms about sexual behaviour which may lead to unsafe sex and/or non-consensual sex. Dominant social expectations and uneven power roles predicated on masculine attitudes towards sexual relations prevent communication, joint decision-making and women's ability to negotiate condom use. A recent study on sexual violence and risk of HIV infection in South Africa highlighted widespread perceptions among youth about intimate partner violence. Conducted in more than 5,000 classrooms for 10- to 19-year-olds, the study revealed that 60.8 per cent of 10- to 14-year-old males and 55.2 per cent of 15- to 19-year-old males believed that sexual violence did not include forced sex with someone they knew. For females, 62 per cent of 10- to 14-year-olds, and 58.1 per cent of 15- to 19-year-olds held the same belief [5].
Several studies from different parts of the world indicate that up to one-third of adolescent girls reported that their first sexual experience was coerced. Many are married at a young age to older men, and the power inequities inherent in these relationships can lead to violence or the threat of it [6]. The risk of violence and sexual abuse is high among girls who are orphaned by AIDS, many of whom live with a heightened sense of hopelessness brought on by a lack of emotional and financial support. A Human Rights Watch study in Zambia found that among girls who had been orphaned by AIDS, hundreds were being sexually assaulted by family members or guardians or forced into sex work to survive [7].
HIV Infection as a Cause of Violence Against Women
Violence and the fear of violence have a direct impact on women seeking testing and/or treatment for HIV/AIDS. Women may hesitate to be tested for HIV or fail to return for their results because they are afraid that disclosing their HIV-positive status may result in physical violence, expulsion from their home or social ostracism. Studies from many countries, especially from sub-Saharan Africa, have found these fears to be well-founded. In Tanzania, a study of voluntary counselling and testing services in the capital found that only 57 per cent of women who tested HIV-positive reported receiving support and understanding from partners [8]. In Botswana, women have admitted to health professionals that they are afraid of their partner's reaction if he should find out that they are HIV-positive. That fear has kept them from being tested, from returning for their results if they are tested, from participating in Prevention of Mother-to-Child Transmission (PMTCT) treatment programmes, and, for those who agree to be treated, from sticking to the necessary treatment regimen because they have to hide their medication [9].
Economic Factors That Increase Women's Vulnerability
Women's limited economic security may increase the likelihood of their engaging in high-risk behaviour, such as commercial sex work or transactional sex. Many economically dependent women stay in high-risk, violent marriages. Widows also face imposing obstacles — many are stripped of their property and left to support themselves and their children without adequate means of support or access to employment. These factors combine with violence, or the threat of violence, to create an environment where women are forced into having unprotected sex with HIV-positive men and are unable to seek treatment or information on HIV/AIDS [10].
Violence Against Women During Conflict
Violence against women, used as a weapon during times of conflict to humiliate the enemy and destroy the social fabric of communities, exponentially increases women's vulnerability to HIV infection. As difficult as it may be for women who experience violence during peacetime, the challenges during conflict are even greater, as police and judicial systems crumble and health infrastructure and other services decline. Both UN Security Council resolution 1325 on Women, Peace and Security and resolution 1308 on HIV and Conflict note that women and girls are disproportionately vulnerable to HIV infection during conflict and post-conflict periods. This is not only because they are frequently sexually abused by various armed groups, but because they may be fleeing their homes, may have lost their families and their livelihood, and may have little or no access to health care and prophylaxis. Women are often also subjected to repeat assaults, such as gang rape, where the exposure to multiple partners further increases their risk of infection.
In Rwanda, during the 1994 genocide, hundreds of thousands of women were raped, many by men who were HIV-positive [11]. Along the eastern border of the Democratic Republic of the Congo, an ongoing civil war has destroyed lives, villages and livelihoods. Now the area is thought to be on the verge of a major HIV epidemic. Some 60 per cent of the militia who roam the countryside raping, torturing and mutilating thousands of women and girls are believed to be HIV-positive, and virtually none of the women have access to services and care [12]. Globally, up to two million women are trafficked every year, many of them at great risk of sexual abuse, and all at risk of HIV infection.
Action to End Violence Against Women and Reduce HIV/AIDS Infection
Recognition of the link between violence against women and the spread of the HIV/AIDS epidemic is increasing with more and more measures being taken the world over to address the issue head on. Promising approaches include the involvement of growing numbers of men who are emerging as advocates, mobilizing other men in their communities to examine perceptions of masculinity and sexual behaviour that contribute to violence against women and the risk of HIV transmission. Countries such as South Africa, Kenya, Nigeria, India, Brazil and Nicaragua have seen a proliferation of men's organizations working on the issue in recent years.
In many countries, health centres have been established that not only treat survivors of violence, but also include services such as counselling and legal referrals. Although still limited in number, they have potential as an important source of HIV education and treatment. Another response involves advocacy campaigns over the past few decades in most regions of the world, which have resulted in legal reform — domestic violence has been criminalized; laws have recognized the rights of women who have been trafficked; and in a few countries, marital rape has been recognized as a crime. These responses contribute in turn to reversing the risk of HIV transmission.
Useful Websites
Notes
[1] WHO, 2002. World Report on Violence and Health, Geneva, 1999
[2] UNAIDS, Report on the Global AIDS Epidemic, 2004
[3] Dunkle, Kristin L et al. 2004. ”Gender-based violence, relationship power, and risk of HIV infection in women attending ante-natal clinics in South Africa”, Lancet, 363 (9419)
[4] Maman, S et al. 2002. “HIV-positive women report more lifetime partner violence” American Journal of Public Health, 92 (8)
[5] Anderson, et al, 2004 “National cross sectional study of views on sexual violence and risk of HIV infection and AIDS among South African school pupils” British Medical Journal
[6] See UNAIDS.UNFPA.UNIFEM, 2004: Women and HIV/AIDS: Confronting the Crisis, Page 46
[7] Human Rights Watch, 2002. Suffering in Silence: The Links Between Human Rights Abuses and HIV transmission to Girls in Zambia.
[8] Maman, S, 2002
[9] UNAIDS, Report on the Global AIDS Epidemic, 2004
[10] Just Die Quietly: Domestic Violence and Women's Vulnerability to HIV in Uganda
[11] Amnesty International, 2004. Marked for Death: Rape Survivors living with HIV/AIDS in Rwanda.
]12] Human Rights Watch. 2002. The War Within the War: Sexual Violence Against Women and Girls in Eastern Congo. p. 2. (http://www.hrw.org/reports/2002/drc/)
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UNIFEM Commemorates November 25th
The following are activities and events organized or supported by UNIFEM to commemorate November 25th and the 16 Days of Activism Campaign.
Latin America and the Caribbean
In Ecuador, UNIFEM is partnering with national women's institutions, CONAMU, the municipality of Quito and Amnesty International to organize cinema forums, workshops of gender equality and violence against women for youth, a concert, educational fair, art exhibitions and an academic debate involving prominent researchers on the issue from around the Andean region. In Bolivia, together with UNFPA, UNIFEM will release advertisement jingles on the theme of ending violence against women. Activities in Colombia, Peru and Venezuela will include dissemination of audiovisual materials, information kits, stickers and posters to the public to raise awareness of gender-based violence, as well as a media campaign involving advertisements, radio spots and press conferences. For more information, contact sofia.zaragocin@undp.org
A public commemoration event involving music and art will take place in Cuauhtémoc, Mexico on 27 November, organized by Inmujeres, UNIFEM and the Equality and Social Development organization. The same week will also have workshops and seminars organized around family violence, and gender and HIV/AIDS issues. For more information, contact amaia.perez@undp.org
Commonwealth of Independent States
UNIFEM is supporting local NGO activities in Kazakhstan, Kyrgyzstan and Tajikistan during the 16 Days campaign, which highlight the correlation between violence against women, HIV/AIDS and trafficking in women and girls. Events include public discussion forums, press conferences in each province, exhibitions of literature on gender issues and an electronic forum to connect activists in the region with global activities and activists involved in the 16 Days campaign. Central Asian NGOs also plan to organize a regional conference — "Let's Stop Human Trafficking" — to develop a joint strategy to tackle the issue. As part of a UNIFEM programme on "Gender and HIV/AIDS," a national forum will take place in Kyrgyzstan on 23-25 November 2005 to develop a national plan of action to end violence against women, especially where it relates to and impacts on HIV-transmission. For more information contact yelena.kudryavtseva@undp.org or unifem@infotel.kg
In Moldova, UNIFEM is using the 16 Days campaign to raise awareness of the importance of the adoption of the Gender Equality Law, and how it is interlinked with eliminating violence against women. An open lecture and workshops will be held in collaboration with government and civil society partners, alongside a press conference and interviews on a local TV talk show. For more information, contact val_bodrug@mdl.net
Rwanda
To mark the 16 Days campaign, UNIFEM and NGO African Rights will launch Broken Bodies, Torn Spirits: Living With Genocide, Rape and HIV/AIDS in Kigali, Rwanda. The publication, which was supported by UNIFEM’s Trust Fund to End Violence Against Women, contains research and a series of interviews conducted over a year in 11 of Rwanda's 12 provinces with "rape survivors," many of whom are living with HIV/AIDS and other sexually transmitted infections. The study hopes to influence and improve responses to sexual violence by addressing a serious and common problem in conflict and post-conflict situations — the rapid spread of infections and disease through sexual violence. For more information, please contact donnah.kamashazi@undp.org At African Rights, contact Rakiya Omaar, rights@randatel1.rwanda1.com
Australia
The National Committee for UNIFEM, Australia, is organizing a white ribbon campaign that will give out white ribbons to all members of the state police forces. Other participants in the campaign include community leaders, sports personalities, police chiefs, religious leaders, Amnesty, the Body Shop and Saatchi and Saatchi, who will create public awareness media materials to disseminate. For more information, contact llloyd@compuserve.com
Global
Online Forum on Ending Violence Against Women: Achievements and Emerging Challenges Since Beijing
Women's human rights advocates and practitioners are invited to share their views, experiences and concerns about ending violence against women and girls. Starting 8 November, UNIFEM is moderating an online discussion to assess achievements and challenges since the Fourth World Conference on Women was held in 1995. As part of a series sponsored by the United Nations Inter-Agency Network on Women and Gender Equality and hosted by WomenWatch, this discussion will feed into the forthcoming ten-year review and appraisal of the Beijing Declaration and Platform for Action, which will focus on implementation at the national level. To register and for more information, visit the discussion website.
Building Partnerships to End Violence Against Women
UNIFEM commemorates International Day for the Elimination of Violence Against Women with an event on 17 November 2004 at the United Nations, in New York. The event will feature Mrs Nane Annan, NGO and private sector partners, and media personalities who will speak on the need for concerted efforts to combat violence against women. For event details please visit the November 25th Web Corner.
Ribbon Campaign
The NGO Committee on UNIFEM, made up of NGOs in consultative status with the United Nations, is conducting a ribbon campaign to raise awareness of violence against women and its impact on the spread of HIV/AIDS. Red ribbons signifying the fight against AIDS are being distributed through the committee's many networks — almost 3,300 have already been distributed to groups around the world. For more information, contact Jackie Shapiro, jacci007@aol.com
Public Service Announcements
UNIFEM is collaborating with the Art Center College of Design in California, USA to produce PSAs on the subject of violence against women and HIV prevention. The PSAs target a youth audience and were developed in close consultation with the Pan-American Health Organisation (PAHO) who will assist with distribution to media networks. For more information, contact rosa.celorio@undp.org
Web Focus on Gender, HIV/AIDS and Violence
UNIFEM's web portal on gender and HIV/AIDS and the ELDIS Development Gateway are collaborating to highlight the 16 Days campaign. Both websites will feature information and resources on key issues, and links to other relevant sites.
UNIFEM and PeaceKeeper Cause-Metics Launch Partnership
PeaceKeeper Cause-Metics, the first cosmetic line in history to give all of its profits after taxes to support women's health advocacy and human rights issues, has developed a PeaceKeeper UNIFEM Lip Gloss. Proceeds from the sale of the lip gloss are earmarked for UNIFEM's Trust Fund to Eliminate Violence Against Women. PeaceKeeper believes that attracting women to use their discretionary income through the purchase of popular items like cosmetics could help grow the Trust Fund as well as educate and inform women on gender-based violence and involve them in efforts to address the problem. For more information, contact Jody Weiss, jody@iamapeacekeeper.com
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