What Puts Women at Risk? – Violence Against Women (VAW)

Using data gathered from 1,100 women at risk of HIV infection, Health Canada indicates that over 67% reported sexual or physical violence by a current or past partner, while 33% had been victims of childhood sexual abuse and 15% of childhood physical violence.1

The World Health Organization (2009) defines Violence against Women (VAW) as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life.” 2  VAW is rooted in a history of systemic gender inequality, which includes the cultural, political and economic practices that contribute to and perpetuate unequal power relations between women and men.

What is the relationship between VAW and HIV?

Violence Against Women resulting from gender-based inequality intersects with HIV infection in a variety of direct and indirect ways.

Direct links between VAW and HIV:

Studies have shown that male-to-female HIV transmission is two to four times higher than female-to-male HIV transmission. 1 This is due to several biological factors:

  • Concentrations of HIV are higher in semen than in vaginal fluids.
  • The vagina has a much larger area of exposed sensitive skin where HIV can survive longer than on the penis.

Anal penetration without a condom poses the highest risk for spreading HIV.

Other links between VAW and HIV:

VAW and gender-based inequality not only leaves women vulnerable to HIV infection, but an HIV-positive diagnosis also brings with it risks of violence. In a qualitative Canadian study of 20 HIV-positive Aboriginal women, it was found that disclosing their HIV status often led to them being:

  • Threatened with legal action, such as being sued or having children taken away
  • Targeted for sexual violence

Links between VAW, HIV, Race and Sexual Identity

Not all women experience violence in the same way, or to the same degree. Within Canada and around the world, gender inequality intersects with racial discrimination and homophobia/transphobia to create an environment that enables violence to be perpetrated against Aboriginal women, women of colour and LGBTQ individuals at alarming rates.

Recommendations for Service Providers

The relationship between Violence Against Women and HIV infection is clear – and this means that service providers working in either sector are in a unique position to address the realities of this relationship head-on. Both the World Health Organization and the Canadian Aboriginal AIDS Network recommend further integrating violence prevention and HIV-related services in order to:

  • Identify women in violent situations and assist them in accessing other services (legal support, shelter etc.)
  • Educate women on the links between VAW and HIV
  • Prevent or reduce negative health outcomes of violence (unwanted pregnancy, STIs, HIV)
  • Provide more comprehensive sexual health information, care and advice in order to support women in developing safer sex negotiation, violence management and decision-making skills

Finally, the often intrusive nature of HIV/STI testing can act as a trigger for survivors of sexual abuse and violence.

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1 HIV/AIDS and Health Determinants, A Discussion Paper for the Ministerial Council on AIDS, prepared by Martin Spigelman Research Associates, January 2002 — data based on Deamant, 1996

2 World Health Organization (2013). 16 Ideas for Addressing Violence Against Women in the Context of the HIV Epidemic: A Programming Tool.