Preventing intimate partner violence and HIV

For women who face physical or sexual violence from a partner, refusing sex, insisting on fidelity or condom-use are not realistic options. Even if women change their own risk behaviour, they are at increased risk of HIV infection.

Intervention with microfinance for AIDS and gender equity (IMAGE) is a collaborative study between the University of the Witwatersrand, the Small Enterprise Foundation in South Africa and the London School of Hygiene and Tropical Medicine. It found that integrating an HIV/AIDS component into existing programmes, such as microfinance can help women facing violence from their partners.

An established microfinance programme combined with participatory education on gender and HIV/AIDS can socially and economically empower women and reduce intimate partner violence.

Through training sessions over six months, women who were microfinance clients explored issues such as gender roles, culture, sexuality, communication, relationships, violence and HIV/AIDS. Women leaders then encouraged their loan centres to mobilise communities and work with men and youth on these issues.

Preliminary results from the project evaluation in rural South Africa were presented at the recent XVI International AIDS Conference in Toronto. The findings suggest:

• Two years after the programme started, participants' risk of physical or sexual intimate partner violence in the past year reduced.
• Household economic well-being and social networks of participants improved.
• Increased self-confidence, ability to communicate with partners about sex and solidarity with women helped women to reject and oppose violence, expect and receive better treatment from partners, leave abusive relationships and raise public awareness about intimate partner violence and HIV through public demonstrations.
• IMAGE households showed greater communication between generations about sex and HIV.

Lessons offered are:

• Violence within an intimate relationship can be reduced within the time period of a programme.
• Reducing violence should be funded as a central component within national HIV/AIDS programmes.
• Addressing basic needs, for example through income generation, can motivate vulnerable groups to sustain their contact with an HIV intervention over long periods: most independent health interventions find it difficult to do so.
• HIV/AIDS funding should be used to develop other inter-sectoral partnerships that integrate intimate partner violence and HIV interventions into existing programmes, for example through job skills retraining, literacy, and water and sanitation programmes.
• Broader macroeconomic policies and gender equity policies should also adopt these empowerment strategies.

Paul Pronyk and Julia Kim
Rural AIDS and Development Action Research Programme (RADAR), Tintswalo Hospital, PO Box 2, Acornhoek 1360, South Africa
T +27 (0)13 795 5076
F +27 (0)13 795 5082
pronyk@soft.co.za and jkim@soft.co.za
http://hermes.wits.ac.za/www/Health/PublicHealth/Radar/Home.htm

See also

Effects of a structural intervention for the prevention of intimate partner violence and HIV in South Africa: a cluster randomized trial, Presented at the XVI International AIDS Conference, Canada, Abstract no. THPE0252, by Paul Pronyk et al, 2006
www.iasociety.org/abstract/show.asp?abstract_id=2184944

Microfinance and HIV prevention - emerging lessons from rural South Africa, Small Enterprise Development 16 (3), pages 26-38, by Paul Pronyk, Julia Kim, James Hargreaves, M Makhubele, L Morison, C Watts and J Porter, 2005

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