AEGiS-13IAC: Gender violence and HIV: addressing the links between dual epidemics through the health sector in South Africa.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Gender violence and HIV: addressing the links between dual epidemics through the health sector in South Africa.

Int Conf AIDS 2000 Jul 9-14; 13:64 (abstract no.. LBPeD7120)

Kim J, Pronyk P
Health Systems Development Unit, Tintswalo Hospital, Acornhoek, South Aftica. Fax: +27 13 797 0082, E-mail: pronyk@soft.co.za.

ISSUES: It is widely recognised that violence against women is a problem of extraordinary magnitude in South Africa. In 1993, the UN Special Rapporteur on Violence Against Women noted that South Africa has the highest rape statistics in the world, and South African women's organisations estimate that as many as one in six women is in an abusive domestic relationship (Human Rights Watch Report, 1995). Yet the relationship between gender violence and HIV/AIDS has only recently been acknowledged at policy levels. It is precisely those young women who, in the context of their relationships, are unable to exert any meaningful control over sexual and other life choices, who are at the highest risk of infection, and who now comprise the majority of all new cases of AIDS in Africa. Conversely, a woman's discovery of her HIV status can have profound repercussions ranging from economic and social abandonment to physical violence and even death.

DESCRIPTION: This paper will describe an innovative, participatory, HIV training curriculum for health workers, which was developed, implemented, and evaluated within a National Department of Health HIV/TB pilot initiative in rural South Africa. It deliberately expands the current emphasis on biomedical understandings and clinical competencies, to incorporate a gendered understanding of the AIDS epidemic, including the links between gender violence and HIV.

CONCLUSIONS: For HIV counselling and prevention to be effective, training approaches must go beyond traditional "safer sex" messages to acknowledge the lived reality of women's lives - a reality often constrained by unequal gender relations and the threat of violence. Drawing on healthcare workers' own experiences as men and women, and raising awareness about the links between gender violence and HIV should be seen as a critical step in generating realistic and compassionate approaches to HIV counselling and care.

Keywords: AEGIS, HIV Infections, Violence, Disease Outbreaks, Acquired Immunodeficiency Syndrome, Sex, Health, HIV Seropositivity, Rape, Women's Health, Sex Offenses, South Africa, Africa, Human, Female, Male, Epidemiology, AIDS
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