Women, Interpersonal Violence (IPV) & HIV Challenges and Opportunities

Interpersonal Partner Violence (IPV) 31% of American women report being abused by a husband or boyfriend at some point in their lives; Nearly 25 % of American women report being raped and/or physically assaulted by a current or former spouse, cohabiting partner, or date at some time in their lifetime. Women are 5 – 8 times more likely to be victimized by a partner. One in three girls will be sexually assaulted by the age of eighteen. Approximately 80% of women reporting sexual assaults knew their assailant.

HIV/AIDS and Women in CT 14th in the United States in AIDS cases per capita. Nationally, ranks third in percentage of AIDS cases among women. 3,692 women reported to be living with HIV/AIDS. Among cumulative AIDS cases, Black and Latina women account for 72% of the cases. In the years 1980 – 1998, women accounted for 25% of AIDS cases. In 2008, they represented 33% of new cases. 13%of newly reported HIV cases are among 13 – 29 year olds. (most infected as teens)

HIV/AIDS and Women in the US 1.2 million people are estimated to be infected; 24 – 27% are unaware of their status. Between 2000 and 2004, AIDS increased 10% among women. Women accounted for 8% of new AIDS cases diagnosed in 1985 and 27% in In 2006, women of color account for 66% of new AIDS cases. In 2005, teen girls represented 43% of HIV cases reported among 13 – 19 year olds. Young African-American girls represented 66% of AIDS cases reported among 13 – 19 year olds. Latina teens represented 16%.

HIV/AIDS and IPV HIV is a risk factor for IPV and IPV is a risk factor for HIV. Complex set circumstances: cultural, social, biological. HIV+ women report more IPV than their counterparts. Globally, women are the fastest growing population of people becoming infected with HIV. IPV may increase women’s risk for HIV infection through coerced or forced intercourse, trading sex for money, housing, safety, food. Depression, low income, substance use, mental health also impact behavioral risks. Women with a history of IPV and dissociative disorders can impact their ability to negotiate safer sex or manage the information when they’re in an unsafe situation.

HIV/AIDS and IPV (PTSD/MH/SA) In one study on women who had experienced childhood sexual abuse: 24% were HIV+ (versus 16%) 10% traded sex for drugs/housing (v. 3%) 39% partner has multiple partners (v. 27%) 27% with PTSD partner had sex with an HIV+ person (v.16%) Only 25% always used condoms (v. 32%) A history of childhood victimization, adult partner violence, or both placed women at a significantly increased likelihood of high HIV-risk practices.

IPV, HIV, Substance Use, and Mental Health In a 2001 HIV Cost and Service Utilization Study: Study, nearly 50% screened for MH disorder. Nearly 40% reported using an illicit drug other than marijuana. 12% screened for drug dependence. More than 1/3 had major depression; 25% had a less severe form. In another study, 40 – 60% of partnered substance using women reported IPV within the last 12 months.

HIV/AIDS and IPV (PTSD/MH/SA) Depression among HIV+ women is associated with HIV progression. Symptoms of depression is associated with unprotected sex, multiple partners, trading sex for money, drugs or housing, and STIs. In one study among female crack users, 59% of women interviewed were diagnosed with PTSD due to violent traumas such as assault, rape or witness to murder, and non-violent traumas such as homelessness, loss of children or serious accident.

Barriers to Accessing Services For Programs/Organizations/Workers Lack or resources (funding) limit our ability. The women who come through our doors, regardless of which door that is, often have many of the same issues/problems/concerns which presents an opportunity to expand our thinking in asking the questions to open the other doors with them. Lack of information and training opportunities. Programs rarely address the “other” issues. Program restrictions on substance use, mental health status. Programs don’t “speak” to one another, including relevant state departments.

Barriers to Accessing Services For women: Poverty, poor access to services, information and resources across the board. Typical models of risk reduction involve negotiation - more difficult for women who have or are experiencing IPV and often require a higher dependence on her partner - negotiating safer sex for example. Unprotected sex may be a safety strategy for managing violence putting HIV prevention at odds with violence risk reduction.

Barriers to Accessing Services Social isolation and restriction of activities can make it difficult for women to attend a multi-session groups of any kind. Heightened distress/anxiety and substance use may increase their ability to think clearly and act on new knowledge. Shame, stigma Partner notification issues regarding C&T. Lack of affordable housing.

Strategies for Change Roots of the BWM, HR and HIV/AIDS movements are to start where people are, ask questions, create a safe place where women can respond and not feel like there are right or wrong responses or negative consequences. Invite your local ASO to come in on a regular basis and provide information to staff or support groups. Think about developing a more integrated service model. Progressive support groups – Emergency - Education - Empowerment.

Resources CT AIDS Resource Coalition (CARC) www.ctcadv.org www.connsacs.org

Women, IPV, & HIV Shawn M. Lang, Director of Public Policy CT AIDS Resource Coalition