Gender-Based Violence As A Barrier To Hiv Epidemic Control - Text Version

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.

Sources:

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…