The Intersection of Gender, Stigma and Violence: The Intersection of Gender, Stigma and Violence Laura Nyblade


Gender: Gender Gender refers to the widely shared expectations and norms about appropriate male and female behavior Gender is a culture-specific construct Gender roles of women are consistently different from men across cultures


HIV-Stigma : HIV-Stigma Is a ‘process of devaluation’ of people living with, or associated with, HIV and AIDS which includes: Identifying and labeling differences Associating differences with negative attributes Separation of “us” from “them” Status loss & discrimination (enacted stigma)


Violence: Violence Violence against women or gender-based violence is any act “that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivations of liberty, whether occurring in public or private life.” (United Nations, DAW, 1993, Article 1)


Violence: Violence Forms of violence included are: Physical violence (slap to murder) Emotional abuse (e.g. insults, abusive language) Psychological violence (e.g. threats, abandonment, isolation) Sexual violence (e.g. harassment, molestation, coercion, rape)


Why Gender, Stigma and Violence?: Why Gender, Stigma and Violence?


Fuel HIV and Violate Human Rights: Fuel HIV and Violate Human Rights


Stigma and HIV: Stigma and HIV Fear of stigma inhibits testing and disclosure “People fear to take the blood test because if their results became positive, they think that people will isolate and segregate them.” (Man, Ethiopia) Knowledge and disclosure are essential for individuals and their families to access care, support and treatment Knowledge and disclosure key for prevention


Violence and HIV: Violence and HIV Violence can increase risk of HIV infection: Physical trauma of forced sex directly increases risk of transmission Violence, and threats of violence, limit women’s ability to prevent HIV (e.g. practice abstinence, negotiate condom use, adopt PMTCT) Sexual abuse as a child leads to increased risk taking as an adolescent/adult HIV can increase risk of violence Male partners may react violently to disclosure of HIV status People living with HIV may be targets of violence


HIV-Stigma and Violence are Universal and Prevalent: HIV-Stigma and Violence are Universal and Prevalent


Universal and Prevalent: Universal and Prevalent Stigma 56% of a sample of people living with HIV in Tanzania reported experiencing 1 of 17 forms of stigma in the past year (Tanzania Stigma-indicators field test group, 2005) Violence 18-48% (beaten by husband) 21-59% (women ever beaten) (Kishor and Johnson 2004)


Gender and Stigma: Gender and Stigma


Sex Differences in HIV-Related Stigma: Sex Differences in HIV-Related Stigma


Impact of HIV-related stigma on social networks by sex: Impact of HIV-related stigma on social networks by sex


Resources to Cope with and Challenge Stigma: Resources to Cope with and Challenge Stigma “More often I see it’s a woman who’s more likely to be ill-treated because a woman has no voice.” (Tanzania) “The reason why the man blames the woman is because he is the one who has power over the woman.” (Zambia)


Violence and Gender: Violence and Gender


Triggers Violence: Triggers Violence Women often attribute violence to causes like “mistakes” in running the household (ICRW, 2000) Not preparing meals on time (66%) Not cooking meals properly (51%) Not caring for the children properly (48%) Or defending themselves or questioning a spouse “If a wife questions [an] erring husband, he will turn violent because a woman has no right to ask such questions to a husband. [He] will beat up and say behave like a woman and do not interfere in everything.” Trucker’s spouse, India


Justifies Violence: Justifies Violence


‘Normalizes’ Violence: ‘Normalizes’ Violence Violence becomes acceptable, normal and thus invisible “A husband beating his wife is natural” (Trucker’s spouse, India) Men surveyed reported violence against their wives (ICRW, 2002) 72% emotional violence 40% physical violence 50% sexual violence


‘Normalizes’ Violence: ‘Normalizes’ Violence YET 92% of men surveyed said that they had not said or done anything that suggested lack of control, was uncalled for, or that could be considered harsh or severe in interactions with their wives in the last year. (ICRW 2002) 58% of family members and 41% of neighbors know about the violence


Stigma and Violence: Stigma and Violence Violence is a form of enacted stigma HIV used to justify violence Violence often leads to stigma Women and other marginalized groups (e.g. MSM, IDU) are blamed and shamed-’deserve’ violence as ‘misbehaved’, are ‘dirty’, ‘immoral’ Both lead to self-stigma


Severe Forms of Experienced HIV-Related Stigma: Severe Forms of Experienced HIV-Related Stigma


Nexus of Gender, Stigma and Violence: Nexus of Gender, Stigma and Violence


Gender, Stigma and Violence: Gender, Stigma and Violence Communities experience gender, stigma and violence together Communities articulate a need to address them together Gender, stigma and violence fuel HIV Gender norms and inequality Create the ‘enabling’ environment for stigma and violence Make women and marginalized groups (e.g. MSM, CSW) vulnerable to violence and non-HIV related stigma Increasing vulnerability to HIV


The Nexus of Gender, Stigma and Violence: The Nexus of Gender, Stigma and Violence HIV-related stigma is then added to existing stigma Compounding stigma Further ‘justifying’ violence Deepening denial, isolation and increasing ‘invisibility’ Prevention and access to services becomes even more challenging for these most vulnerable individuals and groups Further fueling the epidemic “If I tell him I will be left…therefore she continues as usual in her secrecy. Therefore, you find those viruses continue to be spread because if she tells her husband he will chase her [away].” (Woman, Tanzania)


Next Steps: Next Steps Research to improve understanding of the nexus of gender, stigma and violence How affects vulnerability Access to services and prevention Develop knowledge based joint programming


Next Steps: Next Steps Develop knowledge based joint tools Build on the existing ‘individual’ tools Understanding and Challenging HIV Stigma Stepping Stones Stigma and Violence Reduction Toolkit Ensure rigorously evaluated programs to allow for assessment & scaling up of best practices Advocacy