HIV and Sexual and Gender Based Violence

*Warning: Graphic Content related to Sexual and Gender Based Violence*

Four months have quickly come and gone since I haphazardly landed here in Gulu to start work with HANDLE Uganda. I’ve had some time to integrate myself with my team, learn from my colleagues and participate in field activities carried out as part of the Sexual and Gender Based Violence (SGBV) Project – a cause I am deeply passionate about and elated to be a part of.

I’ve learned a lot about post-conflict settings and the devastating aftermath of war that is almost incomprehensible to think about. More specifically, I’ve broadened my knowledge on the nature of SGBV, and learned much about new contributing factors that come into play when dealing with war-affected communities – factors which further complicate an already difficult issue to tackle.

One is these factors is HIV. There remains a lack of education surrounding the issue of HIV, including knowing one’s status and how the disease is transmitted. The World Health Organization demonstrated the direct linkages between the risk of experiencing GBV and positive HIV status[1]. One study revealed that women’s refusal of sex was a principle reason for domestic violence perpetrated by males against their female partners[2]. Women in the study indicated that they refused sex because they suspected that their partner was infected with the virus. Indeed, women who perceived their partners to be HIV-positive were three times more likely to experience domestic violence than those who believed their partners to be at low risk of HIV. Young women who are HIV-positive are ten times as likely to experience SGBV[3].

Infidelity is also a principal reason cited by perpetrators and survivors for leading to GBV among intimate partners. What’s more, when women refuse sex, their partner come to suspect that the woman has cheated and the violence follows.

A persistent stigmatization of individuals infected with HIV is particularly harmful for women, who tend to experience the brunt of the stigma. After humanitarian and development agencies flocked to the region in the early-2000s, campaigning for HIV risk education, the population’s awareness of the illness increased along with their fear of contracting HIV. Women who are HIV-positive may suffer from social isolation and rejection from their families. The associated fear of stigmatization has led to people fearing being tested to learn of their HIV status, which also puts people at risk of unknowingly transmitting the virus to any sexual partners. Women in particular have experienced discrimination in the form of abuse and denial of land ownership rights if HIV-positive[4]. This compounds their risk of experiencing violence and places them at risk of engaging in sex work to make ends meet[5].

Women also face a harsh double-standard when it comes to infidelity. In a society where polygamy is widely practiced and accepted among males, women are not afforded the same privileges and can suffer violence at the hands of their husbands if suspected of engaging in extra-marital affairs.

Turning to a more personal view of SGBV and its relation to HIV and lack of education and awareness of status, I want to speak about a recent case I heard about in discussion with a local lawyer. She told me of a case of a client who showed up in her office seeking legal advice about the violence she suffered from her husband. A friend had accompanied her to the office but upon the client’s arrival, she got very quiet and was reluctant to talk. There were other survivors of GBV in the office, and the lawyer rightly realized that the client may not be comfortable speaking out in front of others for fear of repercussions. The lawyer escorted the client to another room for privacy, and after some time and gentle encouragement, the woman started telling her story. Her husband, she said, had been abusing her for a painfully long time. She would cook his dinner on a small coal fire, leaving the embers slowly burning away to keep the food warm, as he often arrived home late. He would often turn up late at night, drunk, eat his supper, and then he would proceed to have sex with his wife. Before this, though, he would take the hot coals and burn her genitals, believing that he was “sterilizing” her so that she could not infect him with HIV – a status that was only suspected and never confirmed. Her husband carried out this horrific ritual on a near nightly basis for over 9 years.

This is an especially gruesome and extreme case of Female Genital Mutilation (FGM) and rape that differs from the usual conception we have in our minds of FGM being associated with proof of sexual “purity”. We don’t hear about it because the media doesn’t cover it. It points to several issues related to the proliferation of SGBV in the region – and specifically the paucity of knowledge of HIV and the continued fear of stigmatization.

This is why an important part of the SGBV training that HANDLE provides to women in VSLA groups and the Role Model Men (read about them here) involves building awareness of partners’ roles in promoting sexual health and planned parenthood, as well as real facts about HIV, the importance of testing and the prospects of treatment. Teaching about safe sexual practices is important to teach people that people living with HIV/AIDS can enjoy life. It is also crucial to talk about the realities of HIV so that we can combat stigma and its associated forms of discrimination which contribute to SGBV in the area and beyond.

 

[1] Ahikire J., and Mwiine A. A., (2014) Addressing the links between gender-based violence and HIV in the Great Lakes region, Uganda Country Report, UNESCO 2014.

[2] Koenig, M., Lutalo, T., Zhao, F., Nalugoda, F., Wabwire-Mangen, F., Kiwanuka, N., Wagman, J., Serwadda, D., Wawer, M., Gray, R. (2003). Domestic violence in rural Uganda: evidence from a community-based study. Bulletin of the World Health Organization. 81 (1).

[3] Durick, H. (2013). Post-Conflict Development in Northern Uganda: The Importance of Holistically Addressing Sexual and Gender-based Violence. University of Tennessee Honours Thesis Projects.

[4] UN WOMEN. (2012). Effective Approaches to Addressing the Intersection of Violence Against Women and HIV/AIDS: Findings from Programmes Supported by the UN Trust Fund to End Violence Against Women. Equity/Empowerment Policy Document.

[5] Durick, H. (2013), op. cit.