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HIV risks rise for Haiti’s abused women

Gender inequality and discrimination can make provision for women effected by HIV and AIDs more challenging / Jacob Silberberg - Jacob Silberberg

Sexual violence against women in Haiti is widespread, and is contributing to the number of women being infected with HIV.

Tania 26, lives in a State Rehabilitation Centre of the Haitian capital, Port-au-Prince.  Every part of her body shows signs of assault and battering: her arms, breasts, back and right eye.  These are but the tip of the iceberg. The psychological devastation is much deeper. The psychologist at the rehabilitation centre says that the consequences of this abuse can be the withdrawal into one’s shell, loss of confidence, and trepidation about the outside world.

“I have sustained violence in all shapes and forms during the six years of my life with him [her partner],” Tania explains in a quiet tone. “It began with humiliation and devaluation of everything in me. In discussions with him, for example, when I voiced an opinion on anything, he rejected it straightaway, saying that I was an idiot.  On the other hand, at work, I was praised as intelligent and creative. I was torn between the two conflicting judgments.”

“The most painful part of all this for me was forced sexual relations,” she says with a sob. “At times I was tired or upset with him, but he imposed himself upon me. When I turned my back to him, he shook my shoulder. He blamed my lack of affection and even imagined that I was having an affair with another man. Finally, I had to let him do it.”

“In fact, I accepted everything from him during those six years, the way he humiliated me, his insults.  [Finally] I wanted to leave, to find myself and to find my dignity.  He found out that I was planning on leaving and gave me another beating.”

Surviving sexual violence

Reports issued by women’s organisations in Haiti show that sexual violence against women in Haiti is widespread. In the month of January 2009 alone, Kay Fanm, the ‘House of Women’, a women’s organisation, recorded 79 cases of rape. In general, 30 per cent of women in Haiti suffer physical, emotional or sexual violence from their partners, according to a study by the Ministry of Women Affairs and Women’s Rights in Haiti.

“One very common practice is that of women being beaten for having demanded the use of condoms from their male partner,” explains Yolette André Gentil, who serves as Kay Fanm’s coordinator in an assistance programme for women and girls victimised by sexual violence.

“Men consider it an insult that their regular partner demands the use of a condom. They not only see it as an insult but also as proof that their female partner has other sexual partners.  This is one of the factors causing higher HIV prevalence among women in Haiti.”

The UNAIDS 2008 Report on the global AIDS epidemic indicates that an estimated 110,000 persons are living with HIV in Haiti, with a prevalence rate of 2.2 per cent. By the end of 2007, 53 per cent of all reported cases of HIV in the country were among women aged 15 to 49 years old.

Women protecting themselves from HIV

Kay Fanm is currently conducting an awareness campaign focusing on the need for women to protect themselves.

“We are promoting the use of the female condom. Although a bit uncomfortable with its size and the way it has to be used, to date, it is the tool available to women, which guarantees sexual health,” says André Gentil. “We encourage women to voluntarily test for HIV because we all know that violence against women is one of the factors promoting the spread of HIV and AIDS among women.  As I said, the biggest problem is that of marital relationships in which men categorically refuse the use of condoms.”

Because they are afraid

A recent UNAIDS report titled Addressing the Vulnerability of Young Women and Girls to Stop the HIV Epidemic in Southern Africa points to evidence of higher HIV risks among people with a history of gender-based violence, and to higher rates of gender-based violence among those who are HIV positive.

HIV prevalence rates are very high among women in Haiti and a driving factor is believed to be gender-based violence. For every 110 infected men, there are 115 infected women, according to the last survey (EMMUS VI) done by the Haitian Institute for Statistics (IHSI) in 2008.  At the beginning of the pandemic there were more infected men than women.

“Factors promoting the increase in HIV prevalence in women are numerous and of multiple forms,” notes André Gentil. “One can cite poverty and/or lack of information. However, sexual violence, psychological violence, and particularly economic violence, are determining factors in the rise of new HIV infections in women.”

“Many women to whom I provide services were infected in the framework of a stable relationship. In this kind of situation, the use of a condom is generally seen as out of place. It is not demanded by most women both because they are in a relationship of trust and because they are afraid.”

A commitment to protect

Article 61 of the UNGASS Declaration of Commitments on HIV/AIDS notes that, by 2005, countries should, “ensure development and accelerated implementation of national strategies for women’s empowerment, the promotion and protection of women’s full enjoyment of all human rights, and reduction of their vulnerability to HIV/AIDS through the elimination of all forms of discrimination, as well as all forms of violence against women and girls, including harmful traditional and customary practices, abuse, rape and other forms of sexual violence, battering and trafficking in women and girls.”

Gender-based violence continues to plague Haiti and contributes greatly to the number of women infected with the virus. Women continue to have less control than their male partners on the use of condoms, making it more difficult and dangerous for them to refuse unsafe sex.

“Many women do not demand the use of a condom to avoid being accused of infidelity,” says Millord Dexai, Coordinator of the Collectif des Féministes Universitaires. “They are afraid of the reaction of their male partner. They are also afraid of jeopardising a relationship in the building of which they have invested energy, emotion and many years of their life.”

“We need to create the conditions to break this reluctance [in the use of condoms] in women.  A number of international conventions, such as the Declaration of Commitment on HIV-AIDS adopted in 2001 by Member States of WHO, have committed to guarantee reproductive and sexual health of populations and of women in particular. These conventions may be used as a guide by the Haitian State to provide an effective response to problems faced by Haitian women.”

Some people’s names have been changed to protect their identity.

This feature was originally published by the Panos Global AIDS Programme as one of its 2010 features.

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07/27/2009