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#16Days of Activism Against Gender-Based Violence

Gender-based violence and HIV infection: Overlapping epidemics in Brazil

Kristin Kay Gundersen's picture

One woman is victimized by violence every 15 seconds in Brazil, with a total of 23% of all Brazilian women experiencing violence in their lifetime. There are many notable consequences affecting victims of gender-based violence, yet many health consequences of violence have not been widely addressed in Brazil. This leads to the question: Are victims of gender-based violence at a higher risk for HIV infection in Brazil?
 
Brazil has 730,000 people living with HIV, the largest number in Latin America and the Caribbean. Brazil is also one of 15 countries that account for 75% of the number of people living with HIV worldwide. Although the HIV epidemic in Brazil is classified as stable at the national level, incidence is increasing in various geographic regions and among sub-groups of women.
 
Rates of violence against women (VAW) are particularly high in the Southeastern and Southern regions of Brazil. These regions also have the highest HIV prevalence, accounting for 56% and 20% of all the people living with HIV in Brazil, respectively. Violence and HIV in Brazil are clearly linked, with 98% of women living with HIV in Brazil reporting a lifetime history of violence and 79% reporting violence prior to an HIV diagnosis.
 
Despite these statistics, there is limited research in Brazil examining VAW in relation to HIV. Accordingly, a bi-national collaboration of researchers from the University of California, San Diego, University of Campinas, São Paulo and the University of Rio Grande do Sul, Porto Alegre developed an innovative study to investigate these intersecting epidemics.
 
The focus of the study is in the regions of Brazil with the highest rates of VAW and highest prevalence of HIV: São Paulo in the Southeastern region and Porto Alegre in the Southern region.
 
The aims of the research were to describe the contextual factors of violence victimization among women in Brazil and to examine the association with HIV infection.
 
The study merged two population-based studies with identical sampling methodologies conducted in the São Paulo and Porto Alegre, Brazil. Women ages 18-49 years were sampled from public health centers, including 2,000 women from São Paulo and 1,326 from Porto Alegre. These women were administered surveys that gathered extensive data on violence victimization and social-ecological factors on access to preventative health services.

Working to address gender-based violence in fragile situations

Diana J. Arango's picture
World Bank Senior Gender-Based Violence and Development Specialist Diana J. Arango shares insights into her work to operationalize gender-based violence prevention and response in fragile settings.

Why is gender important for development in environments affected by fragility, conflict and violence (FCV), in the context of your work?

Even though we know that 35% of women in the world have experienced physical or sexual violence at the hand of an intimate partner or sexual violence at the hand of a non-partner, we have yet to fully understand the complexity and different manifestations of gender-based violence (GBV) experienced by women and girls in conflict. 
 
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We do know that women and girls experience increased violence, because of the breakdown in social fabric that regulates the use of violence, the lack of security and services, and the reality of being forcibly displaced and living in areas where there is no protection. UNHCR estimates that globally, women and girls comprise about half of internally displaced or stateless populations.
 
We are learning that the Syrian crisis has led to increases in early marriage, and has severely limited women’s mobility. Girls are not given access to education because they are not allowed to leave their homes. Women in Iraq who are widowed enter into temporary marriages to collect dowry and provide food and shelter for their families. While in these temporary marriages, they are often sexually and physically assaulted. 
 
The increased vulnerability of women and girls in FCV and the entrenchment of norms and attitudes that contribute to violence and eat away at women’s autonomy are reasons why it is especially important to always bear in mind how FCV affects women and men, girls and boys differently. 
 
Tell us about your experience working in this area.
 

I led the creation of the Violence Against Women and Girls Resource Guide which was developed and launched in partnership with the Global Women’s Institute (GWI) at George Washington University, and the Inter-American Development Bank in 2014. The International Center for Research on Women (ICRW) joined the partnership in June 2015.
 
The guide was created to provide basic information on the characteristics and consequences of violence against women and girls, including operational implications. It offers guidance on how to integrate prevention and the provision of quality services to violence survivors within a range of sectoral projects. The guide highlights potential entry points and partners to engage with, while recommending strategies for integrating violence against women and girls into policies and legislation, sector programs and projects. The guide gathers existing global evidence and emerging promising practices, including those implemented by several teams across the World Bank.
 
In addition, we are partnering with the Sexual Violence Research Initiative out of the Medical Research Council of South Africa to address the dearth of evidence. The Development Marketplace for Innovations to Prevent Gender-Based Violence is funding innovation in GBV prevention and response around the world -- including in FCV countries. Two of the nine projects we funded last year are working with Syrian refugees in Lebanon and Turkey. The funding in Lebanon, for example, will help us better understand the drivers of early marriage and how men, women, boys and girls understand this phenomenon. This information will give us the data we need to design an intervention to address the root causes of early marriage.
 
How can we take this agenda forward?
 
The new World Bank Group Gender Strategy and commitments under the International Development Association (IDA) give us the opportunity to continue our research and improve our understanding of the different ways in which FCV affects women and men. We can also integrate into our operations measures to address GBV and increase economic opportunities as well as access to labor markets for women, while also increasing access to assets and services.
 
I hope to use my experiences of working for almost a decade in humanitarian settings and GBV to provide technical support and share examples of evidence-based interventions that we can use across the World Bank’s programs in FCV to help women and girls in these environments.
 


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