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BREAKING THE SILENCE ON VIOLENCE AND HIV
In breaking the silence
about AIDS at the XIII International AIDS Conference in Durban, South
Africa, this week, the World Health Organization (WHO) is also breaking
the silence about how violence contributes to the AIDS epidemic.
"Violence against
women is an important contributor to HIV’s spread," said Dr Gro
Harlem Brundtland, Director-General of WHO, speaking at a symposium on
Tuesday, 11 July. "We will not achieve progress against HIV until
women gain control of their sexuality."
For the first time, these
issues are on the agenda of the International AIDS Conference. Violence
within intimate relationships is now being recognized as a barrier to
effective HIV prevention and care. Violence not only fuels the AIDS
epidemic but can also be a consequence of it.
In studies from the United
States and Kenya, for example, around one-fifth of women with HIV reported
having experienced violence as a result of their HIV status. Husbands,
partners, family members, and communities count among the perpetrators of
such violence.
"Some women do not
want to reveal their HIV status because of fear of violence, emotional
abuse, or abandonment," explained Dr Pamela Hartigan, acting Director
of WHO’s recently formed Department of Violence and Injury Prevention in
Geneva.
"First, women are at
particular risk for AIDS because of cultural norms that reinforce
inequality between the sexes and put women in subservient positions,"
Dr Hartigan said. "Then others are at risk because women who become
infected with HIV feel powerless to discuss their test results with their
partner."
The fear of violence or the
experience of it may interfere with women’s seeking voluntary testing
and counselling and asking their partner to use condoms. Women with HIV
may also not want to avoid breastfeeding, which can reduce mother-to-child
transmission of the virus, because they fear that the people around them
will be suspicious of their HIV status. Fear of disclosure also may
prevent pregnant women with HIV from receiving drug therapy at childbirth,
which can reduce the risk of their infants becoming infected with HIV.
The first step, according
to Dr Brundtland, is to speak out against all forms of violence against
women, which include domestic violence, rape, and sexual abuse.
"Women must know and feel that society supports them when they say no
to unwanted or unprotected sex," Dr Brundtland continued.
In Durban, WHO is
conducting workshops on the relation between violence and HIV/AIDS.
"In community workshops, skills-building workshops, a satellite
meeting, and programmed sessions, the urgency of increasing awareness
about and study of this issue is being stressed," said Ms Nadine
France, Technical Officer in WHO’s Department of Violence and Injury
Prevention. Conference participants are exploring how violence prevention
can be incorporated into HIV prevention and care programs.
WHO is calling for further
research about the worldwide incidence of partner violence and its affect
on the HIV/AIDS epidemic.
For further information, please contact Gregory Hartl, WHO
Spokesperson, on Tel 09 41 79 203 6715, or Ms Nadine France, Technical
Officer, on Tel 083 6242777.
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