Gender-based Violence Compromises HIV Prevention. 4/5/11

HIV and sexual and gender-based violence have a reciprocal relationship as women who are victims of violence are at high risk of infection while those living with HIV are more vulnerable to violence

HIV and sexual and gender-based violence have a reciprocal relationship as women who are victims of violence are at high risk of infection while those living with HIV are more vulnerable to violence, an official with the Namibia Planned Parenthood Association has said.

Ingrid Elvevag, the NAPPA technical advisor, said it was important to address SGBV [sexual and gender-based violence] in any strategy that aims to reduce HIV prevalence. 'Despite the existence of numerous policies designed to protect women and girls from SGBV, the phenomenon remains highly prevalent in Namibia and is fueling the continued spread of HIV,' Elvevag told Parliamentarians, representatives of civil society organizations, sex workers and sexual minorities at a recent workshop to discuss HIV prevention in the context of human rights. She attributed policy failures to lack of community awareness regarding fundamental human rights and the provisions of the law relating to SGBV, as well as poor response skills among officials dealing with survivors of abuse.

'Rectifying this situation requires measures that ensure that existing legislation is effectively communicated at all levels, and that financial and logistical support is provided to ensure that SGBV-related policies are in fact implemented,' she said. She explained that SGBV included a wide-range of human rights violations such as: physical and sexual violence, emotional abuse, harassment and intimidation, human trafficking, harmful traditional practices, and economic abuse. 'Economic abuse is often overlooked as a form of SGBV. Economic vulnerability makes women especially vulnerable to other forms of abuse. 'Male control over household finances may force women to exchange sexual favours for money or gifts to meet basic needs.'

Elvevag said physical or emotional abuse reinforces male dominance in a relationship and prevents women from negotiating safe sex or leaving unfaithful partners. '(It) can limit a women's ability to access health services, maintain adherence to ARV treatment, or limit a woman's choice on how to feed her baby.' With respect to sexual violence, Elvevag said it exposes the victim to the perpetrator's sexual networks.

Sexual violence includes coercion, molestation and rape. Turning to culture, Elvevag said some people still maintained practices that were harmful to women or increased their vulnerability to infection. 'Preferences for dry or wet sex encourage vaginal use of herbs which lead to increased risk of HIV transmission due to vaginal tearing,' she said, adding that virginity testing in some cultures encourage young girls to engage in unsafe alternative sex such as anal sex. Elvevag said there were reciprocal linkages between SGBV and HIV.

'Evidence exists that living with HIV can constitute a risk factor for SGBV, with many people reporting experiences of violence following disclosure of HIV status, or even following admission that HIV testing has been sought. 'Thus a vicious cycle of increasing vulnerabilities to both SGBV and HIV can be established,' she said. She added that many women were still trapped in subordinate positions across cultural groups and were economically dependent on men. Gender stereotyping is another challenge, with agents of socialization such as the family, school and church narrowly defining gender roles.

'Women are supposed to be obedient, please their husbands, tolerate extra-marital affairs and violence,' she said, adding that alcohol and drug abuse were also problematic factors.

Over the years there have been calls to empower women with knowledge about their rights, leading to the production of reams of documents and holding of numerous workshops at which women are taught their rights.

According to Elvevag, it is clear that knowledge alone offers little protection against SGBV.

'Even where knowledge exists women – especially young women – often feel unable to demand their rights.

'Knowing about your rights is not the same as being able to demand your rights.'

The latest Demographic Health Survey for Namibia shows that 95 percent of girls between the ages of 15 and 19 have knowledge about modern contraceptive methods.

That notwithstanding, youth pregnancy rates in the country remain extremely high, with data showing that 20 percent of 17-year-olds, 35 percent of 19-year-olds and 57 percent of 20-year-olds have already given birth.

In April 2008, staff at Gammams Water (Treatment) works in Windhoek estimated that they discovered an average of 13 bodies of newborn babies each month in human waste flushed down toilets.

Contraceptives are not difficult to access in Windhoek; they are available for free at all government and NAPPA clinics and so the incidence of illegal abortions may indicate that there is a large number of girls and women who still cannot negotiate safe sex.

Elvevag bemoaned poor response skills among officials dealing with victims of abuse and the lack of male involvement in issues related to sexual and reproductive health.

She said civil society organizations should play a key role in addressing SGBV through counseling, assistance with legal and/or health referrals, providing shelter and community education to raise awareness, advocacy and playing watchdog.

She warned that empowerment strategies targeting only women would not change male behaviour.