Cape Town – Zero HIV infection rates will never be achieved unless tackling gender-based violence is part of addressing the epidemic, an expert told HIV specialists, researchers and nurses, meeting at the first Southern African HIV Clinicians Society conference.
Professor Rachel Jewkes of the Medical Research Council, an international expert on gender-based violence, revealed that incidents of intimate partner violence, sexual abuse as children and sexual violence as adults (rape), massively increased the incidence of HIV infection, especially among women.
A study led by Jewkes found that almost 40 percent of adolescents from the rural Eastern Cape had been sexually abused as children.
“Dealing with this type of violence, is a normal feature of clinical case loads,” said Jewkes, who stressed on several occasions that in her opinion the incidence of violence was hugely under represented in South Africa.
Jewkes added that there was a clear correlation between partner violence and an increased incidence of HIV. One of her studies found that around 12 percent of HIV cases among women could be attributed to more than one case of intimate partner violence. Around 14 percent of HIV cases among women could be attributed to very low power in the relationship as it meant the woman was unable to negotiate condom use or confront her partner if she suspected he was unfaithful.
“A very high percentage of HIV can be attributed to gender based violence,” said Jewkes, expressing dismay over the fact that UNAIDS had relegated it to a “situational factor” in the epidemic.
“It flies in the face of everything we know,” she added.
Jewkes said it was also time to talk about so-called “love seeking behavior” as she believed many children who experience emotional abuse are at higher risk later.
“We need to talk about the dangers they are willing to undertake as part of love seeking or the willingness to hold onto someone who is bad for them, as part of this love seeking behavior,” she said.
Jewkes added that a high number of HIV cases could also be attributed to people who show signs of being psychologically distressed. This includes people suffering from chronic anxiety, depression, post-traumatic stress disorder and substance abuse problems.
In closing, Jewkes said the evidence showed that when thinking about the role of men it was time to work out how to change their masculinities as opposed to their behavior.
The conference continues until Wednesday.