Drugs, sex, gender-based violence, and the intersection of the HIV/AIDS epidemic with vulnerable women in South Africa

Abstract

Recent innovative research has identified key factors that put vulnerable South African women at risk of HIV/AIDS and gender-based violence, including high-risk patterns of alcohol abuse and sexual partnering, gender norms that place men in control in sexual relationships, low educational levels and limited access to employment, poor health care, inadequate housing, and sex work. These studies suggest that targeted HIV-prevention interventions can effect improvement for this vulnerable population when programs remain sensitive to gender and cultural differences and expectations and address the social and economic inequalities that make women vulnerable. Solving these problems on a larger economic scale will require institutional participation and political support for women’s equity, HIV-prevention literacy, and a broader HIV-prevention agenda. This can be accomplished with a multilevel, collaborative response from government, community, and international partners using multiple prevention strategies and fostering sustainability.

The intersecting risks of substance use and HIV risk among substance-using South African men and women

“…Addressing substance use and sexual risk requires a multilevel approach [32, 33]. While interventions are currently in various stages of development to address both cultural and gender complexities across communities [34], HIV interventions in South Africa must address the intersecting risks of substance use, violence, and HIV risk.…”

Female sex workers in Africa: Epidemiology overview, data gaps, ways forward

“…While recognizing that globally male clients ‘are hard to count’ (Lowndes, Alary, Gnintoungbé, Bédard, Mukenge, Geraldo, et al . 2000; Okal, Chersich, Tsui, Sutherland, Temmerman & Luchters 2011; Rekart 2005; Wechsberg, Parry & Jewkes 2008; Weir, Pailman, Mahlalela. Coetzee, Meidany & Boerma 2003; Wojcicki 2002a, 2002b), the inherent difficulties in identifying, let alone counting, male clients has resulted in highly innovative approaches including intercept surveys.…”

HIV Prevention Among Women Who Use Substances And Report Sex Work: Risk Groups Identified Among South African Women

“…Estimates suggest that 20%–55.5% [14, 15] of women in South Africa have experienced some form of physical or sexual violence. The percentages are even higher among women who engage in sex work [10, 11] and/or use AODs [12, 16]. Experiencing physical or sexual violence or the fear of such violence increases HIV risk by undermining women’s ability to negotiate safer sex practices such as condom use [17].…”

“…Experiencing physical or sexual violence or the fear of such violence increases HIV risk by undermining women’s ability to negotiate safer sex practices such as condom use [17]. Given that sex workers and women who engage in AOD use are more likely to experience physical and sexual violence than women in the general population of South Africa, violence is intricately tied to sexual risk among these vulnerable women [18]. …”