Gender-based violence is both a cause and consequence of HIV, impacting HIV clinical outcomes, including treatment adherence and retention, and posing a significant barrier to the achievement of HIV epidemic control.
Gender-based violence is widespread and is a barrier to HIV treatment adherence and retention
1 in 3 women worldwide experience physical or sexual violence in their lifetime
1.5 is the increased likelihood that women who experience intimate partner violence will acquire HIV
1 billion children experience violence every year, about 50% of all children worldwide
Kenya and Uganda: In a 2018 study on PrEP adherence of HIV serodiscordant couples, 23.8% of people reporting IPV reported PrEP interruptions, compared to 6.9% of those not reporting IPV.
Zambia: A 2020 study showed that adolescents and young people experiencing a high frequency of violence showed higher odds of viral load failure.
South Africa: A 2018 study shows that only 25% of adolescents exposed to four types of violence were adherent to treatment in the past week, compared with 75% of nonvictimized adolescents.
Impact of gender-based violence across the HIV clinical cascade
Prevention: Violence is a barrier to PrEP initiation and adherence. Qualitative evidence suggests that violence can also occur as a result of PrEP use.
Testing: Women experiencing IPV may be less likely to access HIV testing services, or disclose a positive HIV diagnosis, due to fear of violence.
Care and treatment: Violence, particularly intimate partner violence, can result in lower CD4 counts, higher viral loads, and lower adherence to treatment for women and girls.
Cabral, A. et al (2018). Intimate Partner Violence and Self-Reported Pre-exposure Prophylaxis Interruptions Among HIV-Negative Partners in HIV Serodiscordant Couples in Kenya and Uganda. JAIDS Journal of Acquired Immune Deficiency Syndromes, 77(2), 154–159. doi: 10.1097/qai.0000000000001574
Cluver, L. et al (2018). Multitype violence exposures and adolescent antiretroviral nonadherence in South Africa. Aids, 32(8), 975-983. doi:10.1097/qad.0000000000001795
Merrill, K. G. et al (2020). Past-Year Violence Victimization is Associated with Viral Load Failure Among HIV-Positive Adolescents and Young Adults. AIDS and Behavior. doi:10.1007/s10461-020-02958-3
WHO Global and Regional Violence against Women Factsheet, 2013
Violence Against Children and Youth Surveys. (2020, September 22). Retrieved November 16, 2020, from https://www.cdc.gov/violenceprevention/childabuseandneglect/vacs/index…