UNAIDS has called for the provision of HIV services and protection of the rights of adolescent girls and young women to be stepped up.
Violence against women and girls is both a consequence of and cause of HIV. Violence or the fear of violence can stop women and girls from negotiating safer sex, accessing HIV and sexual and reproductive health services and disclosing their HIV status to partners, family members and health providers.
UNAIDS Executive Director Michel Sidibe announced that women and girls who are survivors of violence suffer a range of health consequences, including mental health issues such as depression and anxiety, higher use of alcohol, less control over sexual decision making and poor sexual and reproductive health outcomes.
Studies show that women living with HIV who have experienced intimate partner violence were significantly less likely to start or adhere to antiretroviral therapy and had worse clinical outcomes than other women living with HIV. Women and girls who experience violence are also less likely to adhere to both pre-exposure and post-exposure prophylaxis.
In some regions, women and girls who have suffered intimate partner violence are 1.5 times more likely to acquire HIV than women who have not suffered such violence. More than one in three women and girls worldwide have experienced physical and/or sexual violence, often at the hands of their intimate partners.
A global review found women who have experienced violence are 16% more likely to have a baby with a low birth weight and almost twice as likely to experience depression
7 out of 10 women in conflict setting and in refugee populations are exposed to gender-based and sexual violence.
Women who have experienced violence are 50% more likely to be living with HIV. Women who have been physically or sexually abused by their partners report higher rates of mental health issues, including depression and anxiety, higher use of alcohol and less control over sexual decision-making.
16% of rural currently married adolescent girls and young women who live in sub-Saharan Africa report using a
modern contraceptive 23% of urban currently married adolescent girls and young women who live in sub-Saharan Africa report using a modern contraceptive.
Each year, 12 million girls are married before the age of 18—married too soon, endangering their personal development and well-being.
Adolescent girls are prime targets of gender-based violence, which includes incest, sexual abuse, intimate partner violence, early and forced marriage, marital rape, female genital mutilation, sexual exploitation and trafficking.
Women and adolescent girls belonging to especially marginalized groups face elevated risks of violence, discrimination and stigma, compounding the risks of HIV.
While data and research specific to the experiences of adolescent girls and young women from those groups are lacking, and data are not systematically disaggregated by sex, age and other variables, the information available shows that pregnant women from key populations experience high rates of unintended pregnancies, sexual violence, abortion and unmet need for contraception. Women who inject drugs have reported high rates of sexual violence from law enforcement officials.
Some studies find that survivors of violence are more likely to inject drugs than women who had not experienced assault.
Lesbian, gay, bisexual, transgender and intersex (LGBTI) adolescents are more likely to experience bullying in schools than in their homes or communities, correlating with higher rates of depression, suicide and homelessness.
High rates of gender-based violence against adolescent girls and young women underscore the need to screen for sexual violence history and provide post-violence care as part of HIV prevention programmes.
However, programmes for such services have not been scaled-up sufficiently to provide quality care and access.
Community-based social programmes that include combined livelihood and training programmes have been shown to reduce intimate partner violence. In 16 of 36 countries with recent age-disaggregated data, adolescent girls
aged 15–19 years reported a higher prevalence of intimate partner violence than women aged 15–49 years. 7
A study from Kenya showed that approximately one in five adolescent girls and young women (aged 15–24 years) had been sexually assaulted or abused by an intimate partner in the previous 12 months, and one in four
had suffered sexual violence at the hands of a non-intimate partner. Alarmingly, in 2017 only 41 countries that reported data to UNAIDS indicated they have specific legal provisions prohibiting violence against people living with HIV or people belonging to a key population.
In a study in eight sub-Saharan African countries, 33% of the transgender women surveyed said they had been physically attacked at some point in their lives, 28% had been raped and 27% said they were too afraid to use health-care services.
Seven out of 10 women in conflict settings and in refugee populations report being exposed to gender-based and sexual violence.
