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DOMINICAN REPUBLIC:
Lethal Link Between Gender Violence and AIDS
By Valeria Vilardo
SANTO DOMINGO (IPS) - When she went to
the doctor, 25-year-old Francisca Barros
received two pieces of earthbreaking news.
The welcome news was that she was pregnant.
The terrifying news: that she was
HIV-positive.
"I didn’t want to say anything to my husband
because I was afraid of his violent
reaction, and because he had never told me
he was living with HIV," the young Dominican
woman told IPS, saying she is treated by her
family "as the one who is guilty of bringing
HIV into our home."
In Caribbean island nations like the
Dominican Republic, where the main route of
HIV transmission is heterosexual sex, the
proportion of women infected with the AIDS
virus is growing in an alarming fashion,
when at a global level, the percentage of
women in the HIV-positive population is
leveling off.
The Joint United Nations Programme on
HIV/AIDS (UNAIDS) reported that women now
make up half of the population living with
HIV in the Caribbean, compared to just 30
percent of the total in 1999. But among the
15-24 age group, women represent 62 percent
of those living with HIV.
In the HIV/AIDS epidemic, the Caribbean is
the second-most affected region in the
world, after sub-Saharan Africa.
Although in a number of Caribbean nations,
the HIV case detection and reporting systems
leave much to be desired, the available
statistics show that the virus is now
spreading fastest in urban areas, although
there are still more HIV-positive people in
rural areas.
That phenomenon is particularly clear in the
Dominican Republic and Haiti, which share
the island of Hispaniola, and have the
highest HIV/AIDS rates in the region,
according to UNAIDS.
In the Dominican Republic, an estimated 1.2
percent of the urban population and 1.3
percent of the rural population are
HIV-positive. And in Haiti, the poorest
country in the hemisphere, the rates are two
percent in towns and cities and three
percent in the countryside.
Sixty percent of the 120,000 people living
with HIV in Haiti – a country of 10 million
people – are women.
Across the border, 51 percent of the 60,000
HIV-positive people in the Dominican
Republic – total population 9.5 million –
are women.
"There are physiological factors that put
women and girls at greater risk of infection
in unprotected sexual relations, but the
feminisation of AIDS is due above all to
social discrimination, gender inequality and
lack of empowerment for women," Myrna Flores
Chian with Profamilia, the Dominican NGO
most active in defending the sexual and
reproductive rights of women, told IPS.
The spread of HIV/AIDS is directly linked to
gender violence through sexual violence, and
indirectly through women’s incapacity to
negotiate the use of condoms or the
conditions under which they engage in sexual
relations, said Flores Chian, the head of
the NGO’s gender and rights programme.
Profamilia’s five centres, located in areas
with the biggest problems of violence
against women and the spread of HIV,
provided assistance to 95,000 people in
2007.
In the study "Vidas Vividas en Riesgo"
(Lives Lived at Risk), published in Spanish
by Development Connections (DVCN) – a U.S.
NGO - the United Nations Development Fund
for Women (UNIFEM) and the World Health
Organisation (WHO), 25 percent of the women
surveyed in the Dominican Republic in 2007
said they became sexually active before the
age of 15 and 75 percent before the age of
19.
"A number of respondents began to have
sexual relations as adolescents, and because
of family neglect or violence in their
homes, they decided to leave home and seek
other opportunities," Wendy Alba, one of the
researchers involved in the study, told IPS.
"Because they came from a background of
poverty, discrimination and violence, these
women are more vulnerable to continued
violence in their adult relationships," said
Alba.
She pointed out that studies carried out in
the Dominican Republic by the DVCN found
that victims of gender violence were nearly
four times more likely to have a sexually
transmitted infection than women who had not
been abused.
The latest data from the public health
secretariat indicate that 82 percent of HIV
infections occur during heterosexual sexual
relations, and nearly 20 percent in stable
couples.
"When I was a little girl, I saw my parents
constantly fighting," says a young
HIV-positive woman interviewed in the study
Vidas Vividas en Riesgo. "He would come home
and accuse my mom of cheating on him, and he
would hit her, right on top of me, so I ran
away and got together with a guy who didn’t
want me to talk to anybody and slept with a
knife under his pillow.
"He would make me get drunk to have sex. I
couldn’t stand it anymore and I got together
with another guy, but things turned out even
worse…He was sweet, but he had other
relationships; he has already died of AIDS,"
she said.
When the women reveal that they are
HIV-positive, they risk abuse or abandonment
by their partners, families or friends, and
face hurdles to obtain the treatment they
need, as in the case of Barros, who told IPS
her story at one of Profamilia’s centres in
Santo Domingo.
The young woman explained that it was
impossible for her to persuade her husband
to use a condom, and that he infected her
with HIV.
The case of Haitian women
But Haitian or Haitian-Dominican women are
even more vulnerable and face greater stigma
and discrimination in the Dominican
Republic.
The highest poverty levels in the country
are found in border areas, which receive the
heaviest influx of Haitian migrants, and
where HIV/AIDS rates are as high as 3.2
percent.
In these areas, 40 percent of Haitian women
suffer different kinds of violence, compared
to an average of 20 percent among Dominican
women, according to 2007 figures.
Haitian women often engage in "high-risk
sexual behaviour linked to their status as
illegals, their poverty, and the
discrimination and linguistic and cultural
barriers they face," said Sara Iglesias,
head of the HIV and violence against women
project carried out by Colectiva Mujer y
Salud (Women and Health Collective), a local
NGO.
The NGO’s project, which has UNIFEM
financing, is active in five border
provinces, Iglesias told IPS.
The goal is to train sex workers, the
police, prosecutors and health ministry
workers about the link between HIV and
violence against women, so that the two
problems are tackled simultaneously, said
the activist.
More than 30 NGOs, civil society and
government bodies and U.N. agencies have set
up a committee to design and implement a
strategic plan aimed at reducing levels of
violence against women and curbing the
spread of HIV in the Dominican Republic.
"This five-year strategic plan will be
launched at the end of the year and will
take into account the needs of Dominican and
Haitian women in the areas affected the most
by HIV and violence against women in the
country," said Alba.
Despite the strides made in the country,
only 9,000 of the 20,000 HIV-positive people
between the ages of 15 and 45 who need
antiretroviral treatment actually receive
it.
But in Haiti, things are even worse: only
10,000 of the 120,000 people living with HIV
receive antiretroviral therapy.
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