In sub-Saharan Africa, an average of three women are infected for every two men. Among young people aged 15-24, that ratio widens substantially to three women for every one man. This disproportionate impact of the AIDS epidemic on women reflects the conditions of social and economic inequality in which they live. Violence is one of the crucial social mechanisms by which women are forced into a subordinate position in which it is difficult, if not impossible, to protect themselves from HIV.
The correlation between gender-based violence and HIV/AIDS involves a combination of biological, social, and cultural conditions. Women are already at least twice as likely as men to contract HIV from unprotected sex, in part because semen carries more HIV than vaginal secretions. Violent sex and rape increase a woman's biological vulnerability to HIV by causing bleeding and tearing of the genital area, creating passageways for HIV to enter the bloodstream. Conversations about safer sex, HIV status, or HIV risk reduction are highly unlikely in rape situations, and condoms are not generally used. Many victims of sexual violence develop alcohol and/or drug dependency, depression, low self-esteem and post-traumatic stress disorder, which can in turn lead to multiple partners, unprotected sex or increased risk taking.
Violence between intimate partners is another consequence of gender inequality. Studies show that up to 50% of all women worldwide report being physically abused by an intimate partner. Physical violence between intimates contributes to HIV transmission by harming the ability of partners to communicate openly with each other. A woman is less likely to discuss HIV status or insist on the use of condoms when she is afraid of violent retaliation by her partner. The constant threat of violence makes women feel vulnerable and allows men to maintain control over the decision of when and how to have sex.
Gender-based violence also occurs as a result of HIV infection. Popular misconceptions about HIV, such as the belief that sex with a virgin can cure infection, lead to acts of rape and sexual violence. Being HIV-positive is a serious risk factor for violence against women. Many women who reveal their HIV status to partners, family members, and communities are in danger of being physically and emotionally abused. Sex workers also experience an increase in violence from clients who blame them for contracting HIV.
As the correlation between HIV and gender-based violence becomes increasingly apparent, urgent efforts are needed to combat the growing rates of infection among women. Laws and policies that protect against sexual violence and gender discrimination of all kinds must be enacted, publicized and enforced. Gender-based discrimination prevents women from making free and autonomous decisions, particularly with regards to sexuality and relationships. So long as women's human rights and dignity are not respected, sexual violence will continue to increase women's vulnerability to HIV and fuel the impact of the AIDS epidemic.