We live in a world where societal norms leave women in subordinate positions, and where women are valued less than men. Men’s power over women increases women’s vulnerability to both violence and HIV.

All over the world, women experience violence at the hands of their intimate partners at staggering rates. The World Health Organization reports that anywhere from 10 to 69 percent of women experience physical abuse at least once in their lives. And all over the world, women are being infected with HIV at higher rates than men. In sub-Saharan Africa, 59 percent of infected people are women. And young girls are three times more likely to get HIV than boys.

Women are at increased risk of HIV exposure because of high levels of violence they experience. Studies from different countries of Africa indicate that women who have experienced violence are up to three times more likely to get HIV than those who have not. And once infected, women are at increased risk of violence from their partners, family or community when they reveal their positive status.

At the heart of women’s vulnerability to violence and HIV/AIDS is the imbalance of power between women and men. There are several reasons as to why men’s power over women increases women’s vulnerability to both violence and HIV as written below.

Inability to negotiate for safe sex

The threat of violence often limits a woman’s ability to negotiate for safe sex. If a man has all the power in a relationship, a woman isn’t able to insist that her partner be faithful, or that he use a condom.

A South African study found that women who experienced violence were six times more likely to use condoms inconsistently than those who did not experience violence. In a Ugandan study, three in four men and women considered it unacceptable for a married woman to ask her partner to use a condom during sex.

It is now known that married women are most at risk from HIV. People are socialized to believe that decisions about sex are the right of men and that it is women’s obligation to be sexually available to men. But when those men have multiple partners and HIV, the risk for women is deadly.

Forced sex

Forced sex is one way in which woman’s subordinate position to men makes then more vulnerable to violence and HIV. Dozen of studies from around Africa show that many women have experienced forced sex by their intimate partners – 30 per cent in Kenya, 24 per cent in Uganda and 25 per cent in Zimbabwe.

Violence in the form of forced sex increases the risk of HIV, as the chance of virginal tearing and transmission of the virus is high. And clearly, with forced sex, there is no option to use safe sex practices.

Coerced and transactional sex

Many young girls are in very vulnerable situations – they may have lost their parents, or their families may not be able to support them. So older men offering girls food, gifts, or money often lure them into a relationship. Young girls in a relationship with older men are at even greater risk due to their lack of knowledge about HIV transmission, their lack of power to negotiate condom use, and the increased likelihood that their more experienced partners have been exposed to HIV. A 2004 study showed that violence is a feature of relationships with older men and age difference between partners increases a woman’s risk of HIV.

Increased risk-taking behavior

Evidence suggests that there is also a link between violence and women’s own risk-taking behaviors. Women who experience violence are more likely to have multiple partners, partners outside marriage or to engage in transactional sex than women who do not. A South African study indicated that women who experience intimate-partner violence were two to three times more likely to engage in transactional sex.

On top of that, feelings of unworthiness, low self-esteem, shame and lack of trust from sexual abuse in early childhood or forced sex during adolescence affect women’s choices in adulthood. One study showed that victims of childhood abuse were 40 per cent more likely to have multiple sexual partners than non-victims. Abuse is also linked to lack of condom use and a history of STI’s, both risk factors for HIV infections.

Economic dependence

Women’s economic dependence on men also increases their risk. Practices such as bride price, the payment of money or gifts to the bride’s family, perpetuate the belief that women are the property of their husbands. Women experiencing violence who try to leave are often counseled to return to partners because of this obligation.

Research has shown that the economic vulnerability of women makes it more likely that they will exchange sex for money or favors, less likely that they will succeed in negotiating protection, and less likely that they will leave a relationship that they perceive to be risky.

Lack of information and fear of seeking help

Violence or fear of violence is a barrier to women seeking HIV testing, disclosing their status, and seeking treatment. A Ugandan study found that women were afraid to ask for money or permission from their husbands to attend HIV/AIDS facilities or to seek information. In some cases, they are forbidden to take an HIV test.

Violence as a consequence of HIV

Women who disclose their status are at increased risk of violence from their partners, families or communities. They are also sometimes beaten or abandoned, their children are taken away and they are kicked out of their homes and shunned by their communities.

Thirteen studies on women in developing countries reported that fear of abandonment and loss of economic support were the major barriers to disclosing HIV status to sexual partners.

A UNAIDS study in seven countries revealed that men with HIV/AIDS were not questioned about how they became infected, while women were often accused of having extramarital sex and received lower levels of support. HIV-positive women are also at increased risk of economic violence, should they reveal their status, risking loss of their means of support, as well as property and children to the partners’ family.

In a nutshell, violence against women and HIV/AIDs are two of most critical issues impacting communities in Africa. There is a need to address the underlying causes for women’s increased vulnerability to both violence and HIV/AIDS. Therefore, we must eliminate violence against women and the imbalance of power between men and women, if we are to stop the spread of AIDS.

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Betty Nassaka is the Founding Chairperson of The Ugandan Humanist Effort to Save Women (UHESWO).