“AIDS has a woman’s face” -In Sub-Saharan Africa, nearly 60% of people living with HIV/AIDS are women -Teenage girls in parts of Africa and the Caribbean are five times more likely to have HIV than their male peers -AIDS is the leading cause of death among African- American women aged Over half (54.%) of all women between are HIV positive in Botswana -Without “drastically expanded” prevention efforts, 45 million more people will become HIV infected by 2010

How women are at risk: Biology: –Semen=more HIV than vaginal secretions –Larger mucosal surface exposed –Young bodies are not fully matured Economics: –Financial dependence. Many women cannot afford to leave risky partners. Cultural: –infidelity accepted for men, not women –violence, ignorance about sex and gender inequality make condom negotiation difficult -- if not impossible

Domestic violence raises the level of HIV risk: Rape likely to cause genital bleeding, condom use unlikely Abuse limits negotiation of any kind of safety – including safer sex Childhood abuse may lead to riskier sexual behavior in adulthood Disclosing HIV status can trigger domestic violence

The link is there…. HIV+ women up to 3 times more likely to have a violent partner currently than HIV- women HIV+ women under 30 ten times more likely to be living with violence than HIV- peers (Tanzania, Maman, 2001) Abusive men more likely to have sex outside relationship and contract STD (India, Martin et al, 1999) Women with violent partners have 50% higher odds of being HIV positive (South Africa, Jewkes et al, 2004)

What do we do? Make sure domestic violence services address sexual abuse and HIV needs Make sure HIV-related services address violence issues (current and history) Help women protect themselves by assuring Education, economic opportunity, support and targeted social services for themselves and their children Gender equality and legal protection of their civil rights to safety, jobs and health care HIV/STD prevention methods they control, such as Microbicides…