Domestic Violence, HIV/AIDS and Other STIs
last updated August 2013

The WTO reports (2013) that in some regions, female victims of domestic violence are 1.5 times more likely to acquire HIV than women who have not experienced violence at the hands of an intimate partner.[1] Other research indicates that the risk of contracting HIV is at least two times greater for women who experience domestic violence (presented at the 2010 International AIDS Conference in Vienna).[2] Domestic violence contributes to the spread of HIV/AIDS and other sexually transmitted infections (STIs) in various ways. Lack of bargaining power, economic dependence, and fear of ostracism all affect women's ability to protect their sexual health. At the core of the problem are gender-based inequalities that set the stage for various factors that directly and indirectly contribute to the spread of the virus. "The different attributes and roles that societies assign to males and females profoundly affect their ability to protect themselves against HIV/AIDS and cope with its impact. Reversing the spread of HIV therefore demands that women's rights are realized and that women are empowered in all spheres of life.[3]
Social and cultural norms that sanction male violence against intimate partners can preclude a woman from being able to negotiate safe sex with her partner. As Peter Piot, former Executive Director of UNAIDS, explains further:
[Women] often cannot insist on fidelity, demand condom use, or refuse sex to their partner, even when they suspect or know he is already infected himself. And they often lack the economic power to remove themselves from relationships that carry major risks of HIV infection. . . . Women, fearful of getting beaten or thrown out, are unlikely to ask their boyfriends to wear a condom, or question them about fidelity.[4]
Women in abusive relationships who are unable to negotiate contraceptive use may attempt to use contraceptives covertly, thus putting themselves in further danger if their husbands should discover their contraceptive use.
Additionally, a woman who depends on her partner economically cannot afford to jeopardize the relationship even when she suspects he may be HIV positive or has an STI, or that he has multiple partners. "If she refuses him sex or asks him to use condoms, she is breaking the conspiracy of silence that surrounds his extramarital activity—or, even worse, intimating that she was unfaithful. And while some men agree to use condoms, many react with anger, violence, or abandonment."[5]
Fear of ostracism and further violence associated with having HIV/AIDS or another STI can prevent women from seeking diagnosis and treatment for the virus. Women who test positive for HIV may be at increased risk of violence at the hands of their spouse or partner if they disclose the results of the test.[6]
HIV-positive women may also become the targets of violence within their community. They may be shunned, evicted, barred from their children, treated poorly by service providers, and abused by police.[7] Women, rather than men, bear the brunt of blame for the pandemic, and are stigmatized as promiscuous. As Sisonke Msimang explains:
We are beginning to see dangerous patriarchal responses to the epidemic—from virginity tests to decrees about female chastity from leaders. In part this is simply an extension of deeply rooted myths about female sexuality. However, with HIV/AIDS, it can also be attributed to the fact that in many cases women are the first to receive news of their sero-positive status. This is often during pre-natal screening, or when babies are born sick. Bringing home the 'news' that there is HIV in the family often means being identified as the person who caused the infection in the first place. We know that, in the vast majority of cases, this is simply not true.[8]
As a result of the threat of violence and stigmatization, women often fail to seek healthcare or prevention information, and can spread the virus to family members. As Peter Piot, former Executive Director of UNAIDS, has explained, combating violence against women and girls thus involves, among other things, breaking the silence surrounding sexual violence and AIDS.[9]
Measures combating HIV/AIDS and STIs must also address the power imbalances that can exist within intimate relationships and the cultural and social norms that sanction male violence against intimate partners. Approaches that focus on "fidelity, abstinence, and condom use do not address the ways in which domestic violence inhibits women's control over sexual matters in marriage, minimize the complex causal factors of violence, and incorrectly assume that women have equal decision-making power and status within their intimate relationships."[10]
For a list of research and reports on domestic violence and HIV/AIDS and other STIs, click here.

[1] World Health Organization, Global and Regional Estimates of Violence Against Women: Prevalence and Health Effects of Intimate Partner Violence and Non-Partner Sexual Violence 2 (2013), accessed August 2, 2013, http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf.
[2] Fiona Hale and Marijo Vazquez, Violence Against Women Living with HIV/AIDS: A Background Paper, 13 (2011), accessed August 2, 2013, http://www.dvcn.org/uploads/client_70/files/VAPositiveWBkgrdPaper2011.pdf.
[3] UN Special Session on HIV/AIDS, Fact Sheet: Gender and HIV/AIDS (25-27 June 2001), accessed August 6, 2013, http://www.un.org/ga/aids/ungassfactsheets/html/fsgender_en.htm.
[4] Speech, Peter Piot, UNAIDS Executive Director, Commission on the Status of Women, Forty-third Session Panel on Women and Health: HIV/AIDS and Violence Against Women (3 March 1999), accessed August 2, 2013, http://www.thebody.com/content/art690.html.
[5] UNAIDS, Women and AIDS (October 1997), accessed August 6, 2013, http://data.unaids.org/Publications/IRC-pub04/Women-PoV_en.pdf.   
[6] World Health Organization, Violence Against Women and HIV/AIDS: Setting the Research Agenda—Meeting Report (23-25 October 2000), accessed August 2, 2013, http://www.who.int/gender/violence/VAWhiv.pdf.
[7] Fiona Hale and Marijo Vazquez, Violence Against Women Living with HIV/AIDS: A Background Paper, 13 (2011), accessed August 2, 2013, http://www.dvcn.org/uploads/client_70/files/VAPositiveWBkgrdPaper2011.pdf.
[8] Sisonke Msimang, HIV/AIDS, globalisation and the international women's movement, in Gender and Development: Women Reinventing Gobalisation, vol. 11, no. 1 (May 2003).
[9] Speech, Peter Piot, UNAIDS Executive Director, Commission on the Status of Women, Forty-third Session Panel on Women and Health: HIV/AIDS and Violence Against Women (3 March 1999), accessed August 2, 2013, http://www.thebody.com/content/art690.html.
[10] Human Rights Watch, Just Die Quietly: Domestic Violence and Women's Vulnerability to HIV in Uganda, vol. 15, no. 15(A) (August 2003), accessed August 2, 2013, http://www.hrw.org/reports/2003/uganda0803/.