Lethal Link Between Gender Violence and AIDS

Sasaye Jeu 7 Mai 2009 - 12:18

DOMINICAN REPUBLIC:
Lethal Link Between Gender Violence and AIDS
Valeria VilardoSANTO DOMINGO, May 7 (IPS) -

When she went to the doctor, 25-year-old Francisca Barros received two pieces of earthbreaking news. The welcome news was that she was pregnant. The terrifying news: that she was HIV-positive."

I didn’t want to say anything to my husband because I was afraid of his violent reaction, and because he had never told me he was living with HIV," the young Dominican woman told IPS, saying she is treated by her family "as the one who is guilty of bringing HIV into our home."

In Caribbean island nations like the Dominican Republic, where the main route of HIV transmission is heterosexual sex, the proportion of women infected with the AIDS virus is growing in an alarming fashion, when at a global level, the percentage of women in the HIV-positive population is leveling off.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) reported that women now make up half of the population living with HIV in the Caribbean, compared to just 30 percent of the total in 1999. But among the 15-24 age group, women represent 62 percent of those living with HIV.

In the HIV/AIDS epidemic, the Caribbean is the second-most affected region in the world, after sub-Saharan Africa.

Although in a number of Caribbean nations, the HIV case detection and reporting systems leave much to be desired, the available statistics show that the virus is now spreading fastest in urban areas, although there are still more HIV-positive people in rural areas.

That phenomenon is particularly clear in the Dominican Republic and Haiti, which share the island of Hispaniola, and have the highest HIV/AIDS rates in the region, according to UNAIDS.

In the Dominican Republic, an estimated 1.2 percent of the urban population and 1.3 percent of the rural population are HIV-positive. And in Haiti, the poorest country in the hemisphere, the rates are two percent in towns and cities and three percent in the countryside.

Sixty percent of the 120,000 people living with HIV in Haiti – a country of 10 million people – are women.

Across the border, 51 percent of the 60,000 HIV-positive people in the Dominican Republic – total population 9.5 million – are women.

"There are physiological factors that put women and girls at greater risk of infection in unprotected sexual relations, but the feminisation of AIDS is due above all to social discrimination, gender inequality and lack of empowerment for women," Myrna Flores Chian with Profamilia, the Dominican NGO most active in defending the sexual and reproductive rights of women, told IPS.

The spread of HIV/AIDS is directly linked to gender violence through sexual violence, and indirectly through women’s incapacity to negotiate the use of condoms or the conditions under which they engage in sexual relations, said Flores Chian, the head of the NGO’s gender and rights programme.

Profamilia’s five centres, located in areas with the biggest problems of violence against women and the spread of HIV, provided assistance to 95,000 people in 2007.

In the study "Vidas Vividas en Riesgo" (Lives Lived at Risk), published in Spanish by Development Connections (DVCN) – a U.S. NGO - the United Nations Development Fund for Women (UNIFEM) and the World Health Organisation (WHO), 25 percent of the women surveyed in the Dominican Republic in 2007 said they became sexually active before the age of 15 and 75 percent before the age of 19.

"A number of respondents began to have sexual relations as adolescents, and because of family neglect or violence in their homes, they decided to leave home and seek other opportunities," Wendy Alba, one of the researchers involved in the study, told IPS.

"Because they came from a background of poverty, discrimination and violence, these women are more vulnerable to continued violence in their adult relationships," said Alba.

She pointed out that studies carried out in the Dominican Republic by the DVCN found that victims of gender violence were nearly four times more likely to have a sexually transmitted infection than women who had not been abused.

The latest data from the public health secretariat indicate that 82 percent of HIV infections occur during heterosexual sexual relations, and nearly 20 percent in stable couples.

"When I was a little girl, I saw my parents constantly fighting," says a young HIV-positive woman interviewed in the study Vidas Vividas en Riesgo. "He would come home and accuse my mom of cheating on him, and he would hit her, right on top of me, so I ran away and got together with a guy who didn’t want me to talk to anybody and slept with a knife under his pillow.

"He would make me get drunk to have sex. I couldn’t stand it anymore and I got together with another guy, but things turned out even worse…He was sweet, but he had other relationships; he has already died of AIDS," she said.

When the women reveal that they are HIV-positive, they risk abuse or abandonment by their partners, families or friends, and face hurdles to obtain the treatment they need, as in the case of Barros, who told IPS her story at one of Profamilia’s centres in Santo Domingo.

The young woman explained that it was impossible for her to persuade her husband to use a condom, and that he infected her with HIV.

The case of Haitian women

But Haitian or Haitian-Dominican women are even more vulnerable and face greater stigma and discrimination in the Dominican Republic.

The highest poverty levels in the country are found in border areas, which receive the heaviest influx of Haitian migrants, and where HIV/AIDS rates are as high as 3.2 percent.

In these areas, 40 percent of Haitian women suffer different kinds of violence, compared to an average of 20 percent among Dominican women, according to 2007 figures.

Haitian women often engage in "high-risk sexual behaviour linked to their status as illegals, their poverty, and the discrimination and linguistic and cultural barriers they face," said Sara Iglesias, head of the HIV and violence against women project carried out by Colectiva Mujer y Salud (Women and Health Collective), a local NGO.

The NGO’s project, which has UNIFEM financing, is active in five border provinces, Iglesias told IPS.

The goal is to train sex workers, the police, prosecutors and health ministry workers about the link between HIV and violence against women, so that the two problems are tackled simultaneously, said the activist.

More than 30 NGOs, civil society and government bodies and U.N. agencies have set up a committee to design and implement a strategic plan aimed at reducing levels of violence against women and curbing the spread of HIV in the Dominican Republic.

"This five-year strategic plan will be launched at the end of the year and will take into account the needs of Dominican and Haitian women in the areas affected the most by HIV and violence against women in the country," said Alba.

Despite the strides made in the country, only 9,000 of the 20,000 HIV-positive people between the ages of 15 and 45 who need antiretroviral treatment actually receive it.

But in Haiti, things are even worse: only 10,000 of the 120,000 people living with HIV receive antiretroviral therapy. (END/2009)