This factsheet is the result of a collaboration between the International Women's Health Coalition, the World AIDS Campaign, International Aids Women Caucus (IAWC), and Women Won't Wait. Download full text with references as a Word document or a PDF. Also available as PDFs in Portuguese and Spanish.

TOWARDS A JUST AND HEALTHY LIFE FOR ALL: SEVEN THINGS THE WORLD CAN DO TO END VIOLENCE AGAINST WOMEN

The facts

• In every country of the world, women across all classes and cultures experience sexual, physical, and emotional violence. Violence against women is a fundamental violation of women’s human rights.
• One in three women will be beaten, coerced into sex, or otherwise abused in her lifetime.
• Violence aggravates women’s vulnerability to HIV infection, limits women’s access to life-saving sexual and reproductive health services, and increases stigma and discrimination. 
  

The realities
Violence against women is both a cause and a consequence of HIV. Pervasive gender inequalities mean that women face increased vulnerability to HIV infection through being exposed to violence. Young women and girls, moreover, are highly vulnerable to sexual abuse and violence in their homes, neighborhoods, schools, and communities. Early sexual initiation is strongly associated with sexual coercion in many places.

There is a strong correlation between violence against women and increased rates of sexually transmitted infections (STIs) and HIV, since risk of transmission can be attributed to physical trauma. The use of physical force or emotional coercion during a sexual act greatly increases the risk of HIV transmission to the female if the male is infected. The female genital tract is highly susceptible to HIV. Sexual violence can further increase HIV risk by causing abrasions, bleeding, and tearing, especially among young girls whose genital tracts are not yet fully mature.

The lack of action and response to the violence epidemic is caused and perpetrated by social and cultural norms that perpetuateits acceptability and normalcy, and perpetrators of violence are rarely punished for their actions. Women in some studies report that the fear of being beatenor abandoned by their partners is their main reason for not obtaining an HIV test, for not disclosing the results, or for not requesting that their partners behave safely by being tested, using condoms, or being faithful. For women living with HIV, the fear of violence can prevent them from disclosing their status,and seeking treatment and care. Women who are or who are seen to be HIV+ are at particular risks of violence, as well.

Moreover, limited access to comprehensive sexual and reproductive health services is also a major barrier to effectively addressing violence against women in the context of HIV. Some abusivemen control their female partners by forbidding them to leave their home, contact friendsor family members, or attend health clinics or other community services. Young married girls are often particularly isolated, and most adolescent girls who experience sexually abusive relationships or encountershave difficulty accessing services. Female sex workers also often routinely experience violence. They are subject to violence in their work and by their clients; they get tested for HIV without their consent, are beaten, threatened, coerced to have sex, and/or suffer from sexual violence, greatly increasing their risk and vulnerability to HIV. Many sex workers are also migrants or are mobile within countries, lacking basic access to social servicesand legal recourse.
 
Policy responses that address violence against women and HIV

Policies, programmes, and laws that uphold women’s rights and work to end gender inequality are urgently needed at local, provincial and national levels to protect women and girls from all forms of violence, including sexual abuse or coerced sex and its consequences, such as HIV infection. Continuous advocacy, strategic investment, political will, and committed leadership are essentialto addressing violence against women and HIV and AIDS.

1. Establish and implement laws, programmes, and policies for zero-tolerance of abuse and violence. Political, civic, traditional, religious and other leaders should publicly condemn all forms of sexual harassment, abuse, and violence and initiate and implement laws, programmes, and policies that guarantee the fulfillment of the human rights of women.
2. Make health services available. Sexual and reproductive health services that are adequately equipped to screen for and respondto violence against women should be offered to all women, adolescents, and girls and encompass information and services for the prevention, diagnosis, and treatmentof sexual violence, unwanted pregnancy, and STIs, including HIV. To ensure that these services are accessibleto young women, they must be affordable, non-judgmental, confidential, available outside of school hours, and accessible without parental consent requirements. These services should be available to all women outside of normal working hours, providing for a 24 hour service. 
3. Integrate Emergency Health Services in public facilities.  Emergency services such as Post Exposure Prophylaxis, emergency contraception, and referrals to safe abortion services should be available in hospitals, clinics and public facilities such as police stations.T services must ensure confidentiality, and be accompanied by counseling and special/ private rooms for consultation and rest.  
   
4. Guarantee comprehensive sexuality education. Comprehensive sexuality education in schools whichis factual and non judgmental should be available to all students, beginning in the primary levels. Such education gives young people information about their rights, their bodies, their sexual and reproductive health, and their sexuality.It helps them develop the skills to negotiate safe sex, establish gender equality, respect the right to consensual relationships, and end violence and coercion.
5. Conduct awareness and education campaigns. Awareness and prevention messages about violence against women and HIV should be effectively promoted.
6. Create safe spaces for girls inside schools and for women in their communities. Schools, youth programmes, and communities must have clear policies and interventions to preventand punish all forms of violence and abuse, including harassment, in these settings. 
   
7. Train health care providers and provide comprehensive services. Health care providers should be trained to recognize and treat emotional, physical,and sexual abuse among women and youth andto screen for violence among women, including providing referrals and confidential, non-judgmental counseling. Health care providers should routinely offer STI and HIV counseling and testing, emergency contraception, and post-exposure prophylaxis to prevent HIV infection. Women, including young women, should also receive pregnancy counseling and testing, and safe abortion services if desired. 

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