Concord Times (Freetown)

3 September 2012

Sierra Leone: Violence Against Women and HIV

column

Sexual violence affects a large proportion of the population with the majority of those directly experiencing such violence being women and the majority perpetrating it being men. The harm they cause can last a lifetime and span generations, with serious adverse effects on health, education and employment. The links between violence against women (VAW) and human immunodeficiency virus (HIV) are undeniable. Growing evidence now exists to affirm that directly addressing VAW and gender inequality as key programmatic components of HIV prevention has significant potential to make programmes more effective. Research over the last decade from diverse cultural settings has conclusively established that women who experience VAW or high levels of gender inequality in their sexual relationships are at increased risk of HIV infection through a range of direct and indirect pathways.

Evidence shows that men who perpetrate or use violence are more likely to engage in sexual risk-taking behaviour, and thus are at increased risk of HIV - social norms for men surrounding multiple and concurrent partnerships, as well as sexual risk-taking and substance use, encourage behaviours that endanger men as well as their sexual partners. HIV prevention programmes must therefore address the interrelated problems of gender inequality and VAW in order to be effective not only at preventing heterosexual transmission of HIV, but also at interrupting all interpersonal HIV transmission routes, including injection drug use that are impacted by unequal and inequitable gender relations and VAW.

The UN defines 'violence against women' 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 as coercion or arbitrary deprivation of liberty, whether occurring in public or in private life. There are many forms of VAW. Some of these include sexual, physical, or emotional abuse by an intimate partner; physical or sexual abuse by family members or others; sexual harassment and abuse by authority figures (such as teachers, police officers or employers) and trafficking for forced labour or sex. Systematic sexual abuse in conflict situations is another form of VAW.

In both developed and developing countries, past exposure to sexual and other forms of violence and controlling behaviour from a sexual partner is consistently associated with subsequent high-risk sexual behaviour in women who have survived violence, including multiple and concurrent sexual partnerships, increased numbers of overall partners, lower levels of condom use, increased substance use and sexual intercourse while intoxicated, and increased participation in transactional sexual intercourse as well as commercial sex work. This increased risk is partly due to the psychological impact of violence; this can last many years after the violent acts, and can include post-traumatic stress disorder, other forms of anxiety, depression, dissociative symptoms and substance use - often as a form of self-medication. Thus, the abuse feeds a vicious cycle, enhancing future risk of HIV/AIDS.

Gender inequality and VAW are integrally linked. Violence against women is an important consequence of gender inequality; VAW also serves to reinforce and reproduce gender inequality at both societal and relationship levels. Qualitative research shows that the intersections of HIV, gender inequality and gender-based violence lie in the patriarchal nature of most societies, especially in ideals of masculinity that are predicated on control of women and valorize male strength and toughness. These ideals readily translate into risky sexual behaviours, sexual predation and other acts of VAW. They also help create expectations that men have an unquestionable right to have multiple partners and to control both their sexual encounters and women whom they partner.

While individual women may resist male power, women are largely expected by society to accept men's behaviour. In many settings and situations, women are expected to be acquiescent, sexually ignorant and tolerant of men's sexual risk taking. Violence against women also reduces the likelihood that they will be able to influence the timing and circumstances of sexual intercourse, resulting in more unwanted sexual intercourse, and less condom use. The relationship between VAW and HIV risk is complex, and involves multiple pathways. Violence against women places women at increased risk of HIV both through direct risk of infection and through creating an environment in which women are unable to adequately protect themselves from HIV. Rape is one important potential cause of direct infection with HIV through violence for some women.

It is also factual that most violence against women is perpetrated by intimate partners. Intimate partner violence occurs mainly from adolescence and early adulthood onwards, most often in the context of marriage or cohabitation, and usually includes physical, sexual and emotional abuse as well as controlling behaviours. Sexual violence can occur at any age - including during childhood - and can be perpetrated by parents, caregivers, acquaintances and strangers, as well as intimate partners. Both forms of violence are in the majority perpetrated by men against girls and women; however the sexual abuse of male children is also common. Intimate partner violence may also be perpetrated by women against men and can occur in the context of same-sex relationships. Intimate partner violence is behaviour within an intimate relationship that causes physical, sexual or psychological harm, including acts of physical aggression, sexual coercion, psychological abuse and controlling behaviors. This definition covers violence by both current and former spouses and partners. Sexual violence is any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting including but not limited to home and work. This definition includes rape, defined as the physically forced or otherwise coerced penetration of the vulva or anus with a penis, other body part or object - however the legal definition of rape may vary in different countries.

FDID-SL will at this point like to say kudos to the Director of National AIDS Commission, Dr. Brima Kargbo and his team at the secretariat for their tremendous work in the fight against HIV/AIDS in our country. The same sentiment is extended to the Minister of Social Welfare, Gender and Children's Affairs, Mr. Stephen J. Gaojia, for honesty and dedication to duty on the issues of women and children. Both men have a vital role to play in the above issues discussed, and this is precisely what they are currently doing. To both of you FDID-SL says keep it up.

Violence against women has a far deeper impact than the immediate harm caused. It has devastating consequences for the women who experience it, and a traumatic effect on those who witness it, particularly children. It shames states that fail to prevent it and societies that tolerate it. Violence against women is a violation of basic human rights that must be eliminated through political will, and by legal and civil action in all sectors of society.

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