Women, Interpersonal Violence (IPV) & HIV

1. Women, Interpersonal Violence (IPV) & HIV Challenges and Opportunities

2. Interpersonal Partner Violence (IPV) • 31% of American women report being abused by a husband or boyfriend at some point in their lives; • Nearly 25 % of American women report being raped and/or physically assaulted by a current or former spouse, cohabiting partner, or date at some time in their lifetime. • Women are 5 – 8 times more likely to be victimized by a partner. • One in three girls will be sexually assaulted by the age of eighteen. • Approximately 80% of women reporting sexual assaults knew their assailant.

3. HIV/AIDS and Women in CT • 14th in the United States in AIDS cases per capita. • Nationally, ranks third in percentage of AIDS cases among women. • 3,692 women reported to be living with HIV/AIDS. • Among cumulative AIDS cases, Black and Latina women account for 72% of the cases. • In the years 1980 – 1998, women accounted for 25% of AIDS cases. In 2008, they represented 33% of new cases. • 13%of newly reported HIV cases are among 13 – 29 year olds. (most infected as teens)

4. HIV/AIDS and Women in the US • 1.2 million people are estimated to be infected; 24 – 27% are unaware of their status. • Between 2000 and 2004, AIDS increased 10% among women. • Women accounted for 8% of new AIDS cases diagnosed in 1985 and 27% in 2004. • In 2006, women of color account for 66% of new AIDS cases. • In 2005, teen girls represented 43% of HIV cases reported among 13 – 19 year olds. • Young African-American girls represented 66% of AIDS cases reported among 13 – 19 year olds. Latina teens represented 16%.

5. HIV/AIDS and IPV • HIV is a risk factor for IPV and IPV is a risk factor for HIV. • Complex set circumstances: cultural, social, biological. • HIV+ women report more IPV than their counterparts. • Globally, women are the fastest growing population of people becoming infected with HIV. • IPV may increase women’s risk for HIV infection through coerced or forced intercourse, trading sex for money, housing, safety, food. • Depression, low income, substance use, mental health also impact behavioral risks. • Women with a history of IPV and dissociative disorders can impact their ability to negotiate safer sex or manage the information when they’re in an unsafe situation.

6. HIV/AIDS and IPV (PTSD/MH/SA) In one study on women who had experienced childhood sexual abuse: • 24% were HIV+ (versus 16%) • 10% traded sex for drugs/housing (v. 3%) • 39% partner has multiple partners (v. 27%) • 27% with PTSD partner had sex with an HIV+ person (v.16%) • Only 25% always used condoms (v. 32%) • A history of childhood victimization, adult partner violence, or both placed women at a significantly increased likelihood of high HIV-risk practices.

7. IPV, HIV, Substance Use, and Mental Health In a 2001 HIV Cost and Service Utilization Study: • Study, nearly 50% screened for MH disorder. • Nearly 40% reported using an illicit drug other than marijuana. • 12% screened for drug dependence. • More than 1/3 had major depression; 25% had a less severe form. In another study, 40 – 60% of partnered substance using women reported IPV within the last 12 months.

8. HIV/AIDS and IPV (PTSD/MH/SA) • Depression among HIV+ women is associated with HIV progression. • Symptoms of depression is associated with unprotected sex, multiple partners, trading sex for money, drugs or housing, and STIs. • In one study among female crack users, 59% of women interviewed were diagnosed with PTSD due to violent traumas such as assault, rape or witness to murder, and non-violent traumas such as homelessness, loss of children or serious accident.

9. Barriers to Accessing Services For Programs/Organizations/Workers • Lack or resources (funding) limit our ability. • The women who come through our doors, regardless of which door that is, often have many of the same issues/problems/concerns which presents an opportunity to expand our thinking in asking the questions to open the other doors with them. • Lack of information and training opportunities. • Programs rarely address the “other” issues. • Program restrictions on substance use, mental health status. • Programs don’t “speak” to one another, including relevant state departments.

10. Barriers to Accessing Services For women: • Poverty, poor access to services, information and resources across the board. • Typical models of risk reduction involve negotiation - more difficult for women who have or are experiencing IPV and often require a higher dependence on her partner - negotiating safer sex for example. • Unprotected sex may be a safety strategy for managing violence putting HIV prevention at odds with violence risk reduction.

11. Barriers to Accessing Services • Social isolation and restriction of activities can make it difficult for women to attend a multi-session groups of any kind. • Heightened distress/anxiety and substance use may increase their ability to think clearly and act on new knowledge. • Shame, stigma • Partner notification issues regarding C&T. • Lack of affordable housing.

12. Strategies for Change • Roots of the BWM, HR and HIV/AIDS movements are to start where people are, ask questions, create a safe place where women can respond and not feel like there are right or wrong responses or negative consequences. • Invite your local ASO to come in on a regular basis and provide information to staff or support groups. • Think about developing a more integrated service model. • Progressive support groups – Emergency - Education - Empowerment.

13. Resources • CT AIDS Resource Coalition (CARC) www.ctaidscoalition.org 860.761.6699 • www.ctcadv.org 888.774.2900 • www.connsacs.org 888.999.5545

14. Women, IPV, & HIV Shawn M. Lang, Director of Public Policy CT AIDS Resource Coalition 860.761.6699 shawn@ctaidscoalition.org