The intersectionality of sexual violence and HIV

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Described by The World Health Organization as a “major public and clinical health problem,” violence against women and girls is one of the world's most pervasive and pressing human rights issue today, with 1 in 3 women experiencing physical and/or sexual violence in their lifetime. Sexual violence can result in a range of devastating consequences, including physical, mental, and emotional trauma for survivors. On top of this, women and girls face the heightened risk of HIV transmission – adding an additional layer of complexity and potential long-term consequences to their experiences.

As we observed International Day for the Elimination of Violence Against Women on the 25th November and the current annual activist-led international campaign of “16 Days of Activism against Gender-Based Violence” happening until the 10th December, we look to the intersectionality between HIV, sexual violence against women and girls and what public private partnerships can do to address sexual violence, and in turn, combat the HIV epidemic.

How are HIV and sexual violence linked?

While HIV incidence is decreasing overall across the globe, rates among women and girls are increasing, which UN Women attributes to sexual violence:

Sexual violence amplifies the spread of HIV through forced unprotected sex, injuries leading to blood exposure, and the limited ability to negotiate safe practices. Moreover, HIV is amplified when women experience sexual violence during conflict or during intimate partner violence, as there is a higher chance of limited access to HIV prevention resources and delayed or limited medical services. HIV and sexual violence are both shrouded in stigma, which further hinders prevention and necessary interventions. Even after women have been subject to sexual violence, psychological trauma stemming from the violence may contribute to future unsafe behaviours, further elevating the risk of HIV transmission.

Going further to support women

Because sexual violence and HIV are so interconnected, it is essential to adopt a multisectoral, public and private partnership approach to the issue, that addresses the interconnected challenges of sexual violence and HIV transmission. A multisectoral approach, utilising the expertise from healthcare professionals, policymakers and the pharmaceutical industry will enable a more effective, well-rounded response.

For example, a public-private partnership could look to provide comprehensive sex education programs in regions where violence against women and girls is high. For example, in South Africa – a country with one of the highest global rates of rape and HIV rates, where 80% of surveyed young men believe women are responsible for sexual violence – funding initiatives following HIV infection is not enough. Education is needed to reverse harmful views on sexual violence and women. Combining the knowledge, data and authority of international organisations with the financial resources and HIV healthcare specific knowledge of pharmaceutical companies, public-private partnerships could create robust, effective sex education programs, which could be implemented in regions where sexual violence is widespread.

Such an approach could likewise be deployed in spreading awareness of Pre-exposure prophylaxis (PrEP) for women. PrEP, especially women specific methods such as vaginal rings, are a crucial tool in the prevention of HIV transmission, but its awareness and utilization among women, particularly in Europe, remains low. Despite being at an increased risk due to factors such as intimate partner violence and sexual violence, studies show that women frequently lack awareness of their susceptibility to HIV. For example, a national study in the UK, Invisible No Longer, revealed that although 74% of surveyed women concerned about HIV were aware of PrEP, none had used it.

Addressing sexual violence against women and girls requires immediate and effective action. Implementing and funding comprehensive sex education programs, increasing awareness of PrEP for women, leveraging the expertise of international organizations, and utilizing the financial and medical resources of pharmaceutical companies, can contribute to further progress, moving us closer to eliminating sexual violence and ensuring that all women and girls live a life free from the fear of violence.