Advancing Gender Equality and Preventing and Responding to Gender-Based Violence

Our Approach and Results

USAID’s approach emphasizes the integration of interventions to prevent and respond to gender-based violence in all HIV prevention and treatment services. USAID uses evidence-based interventions to prevent both HIV and gender-based violence, and the provision of clinical and non-clinical post-violence care integrated in HIV services, such as HIV pre-exposure prophylaxis (PrEP), index testing, and care and treatment services. This is reflected not only in the way HIV services are designed and delivered, but also in how they are measured and monitored. For example, in HIV prevention strategies, USAID monitors the age and sex of participants in GBV prevention to address harmful gender norms that reinforce behaviors that put individuals at risk for HIV to ensure we are reaching the right population for prevention of both HIV and GBV.

For biomedical prevention interventions such as PrEP, healthcare providers identify clients experiencing intimate partner violence and provide appropriate support and referrals to GBV response services, improving survivors’ ability to successfully continue on PrEP.

GBV case identification during HIV testing, initiation on ART, and routine HIV appointments are essential to identify people living with HIV who are survivors of violence and provide them with timely and compassionate care, as well as support their linkage and adherence to and continuation of treatment. Per World Health Organization guidelines, providers should offer post violence care services to those who disclose a fear of or current experience of violence provide escorted or active referrals to gender-based violence response services if none are available at the site where testing and treatment is provided. Such interventions not only help provide survivors of gender-based violence with the care and support they need, but also help to improve their overall HIV outcomes with the goal of achieving viral suppression.

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Caption: Students at a primary school in Uganda participate in a meeting that teaches youth, particularly orphans and vulnerable children (OVC), about their rights and resources and teaches them skills and strategies to protect themselves against exploitation. / Robin Hammond for World Education

USAID provides integrated gender-based violence clinical services in 28 countries. In 2023, healthcare providers reached over 465,000 survivors with post-violence clinical care services through USAID’s programming support, with local partners delivering the majority of care (83 percent). From 2020 to 2023, USAID trained more than 1,200 individuals (including health care providers, case workers, educators, community outreach workers, and counselors) from 30 countries on first-line support using the World Health Organization’s LIVES approach.  

Per the World Health Organization Guidelines and current PEPFAR guidance, the full minimum package includes:

• rapid HIV testing with referral to care and treatment as appropriate, post-exposure prophylaxis (PEP);

• sexually transmitted infections (STI) screening/testing and treatment;

• emergency contraception (EC);

• counseling (other than counseling for testing, PEP, STI and EC); and,

• the treatment of serious or life-threatening medical issues (e.g., lacerations, broken bones).

Since 2016, USAID has continued to reach more individuals with post-violence clinical care services. The majority of these services in 2022 were provided to females for physical and/or emotional violence.

USAID continues to advance key technical priorities, emphasizing program quality and innovation. USAID’s implementing partners have employed strategies to increase the accessibility of integrated HIV and post-violence care services, including mobile services, hotlines, transportation assistance, virtual counseling, and first-line support. In addition, USAID continues to expand its network of local partners providing critical services to prevent and respond to gender-based violence.