Talking Points – National Day of Action to End Violence Against WLHIV

National Day of Action to End Violence Against Women Living with HIV
Breaking our Chains – Ending the Culture of Violence
#pwnspeaks   #DVAM   #EndVAWHIV
October 23 2015

TALKING POINTS

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Overview:

Women living with and at risk for HIV are disproportionately vulnerable to violence and are more likely than the general population to have histories of violence and abuse, resulting in high levels of trauma and post-traumatic stress disorder. Women living with HIV (WLHIV) who are living with trauma and coercion or abuse in relationships are likely to face challenges engaging in care and tend to have worse health outcomes. Currently, many HIV clinical and community-based care settings are not consistently screening for intimate partner violence, history of abuse, and current risk for coercion and control. Prioritizing trauma-informed care environments has the opportunity to radically transform care for WLHIV beyond medical treatment to promoting healing.

Talking Points and Statistics:

  • Violence and HIV together can result in health outcomes worse than either condition by itself
  • According to one study, 58% of transgender women reported experiencing violence at home
  • Women with a history of intimate partner violence (IPV) are more likely to report HIV risk factors
  • Over half of WLHIV have experienced IPV, almost twice the rate in the general population of women.
  • 30% of WLHIV are currently diagnosed with post-traumatic stress disorder (PTSD), more than 5 times the national rate, according to a meta-analysis.
  • WLHIV who reported experiencing recent abuse were 4 times more likely than those who didn’t to face challenges with their HIV treatment
  • Women with HIV reporting recent abuse were 42% more likely to die than those who did not.

HIV diagnosis can also exacerbate the risk for violence and abuse:

  • WLHIV may face violence, or the threat of violence, as a result of disclosing their HIV status
  • Laws criminalizing HIV exposure and non-disclosure increase the potential for threats, abuse, coercion and control in relationships, and may make it harder for women with HIV to leave abusive relationships
  • Policies that force women with HIV to remain poor in order to access lifesaving treatment, care, and other services may also create a barrier to leaving abusive relationships.

 Recommendations:

WLHIV with lived experiences of trauma must be involved in development, implementation, and evaluation of care and service delivery programs for WLHIV.

Planning, program design, and care and service delivery

  • Create and implement quality assurance measures in HIV clinical settings and state and local HIV planning that expand screening and intervention for symptoms of trauma, intimate partner violence, and which incentivize improving mental health for WLHIV
  • Prioritize implementation of trauma informed care for WLHIV in clinical and community-based settings:
    • Train all HIV staff and providers on trauma-informed care practices
    • Ensure that WLHIV are regularly screened for trauma, risk for violence, and PTSD symptoms
    • Provide interventions and referrals to ensure safety, reduce the effects of lifetime trauma, promote healing, and increase social support for WLHIV
  • Require providers and public health officials to assess safety when encouraging disclosure
  • Require providers to uphold the full sexual and reproductive rights of WLHIV

Laws and Policies

  • Repeal HIV criminalization laws that place WLHIV at risk for violence
  • Expand access to safe and affordable housing for WLHIV with and without children
  • Expand employment opportunities and vocational rehabilitation services for WLHIV

Soundbites (Share, Post, Tweet)

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  • Violence against women living with HIV is part of a larger context where violence against women, especially trans women and women of color, has been normalized and tolerated.
  • Women who face HIV stigma and other forms of discrimination (eg due to race, class, gender identity) are especially vulnerable to violence.
  • For women living with HIV, violence is more deadly than the virus. A large study of women with HIV showed that those reporting recent abuse were 42% more likely to die than those who did not.
  • Intimate partner violence is about power; HIV status can compound these power imbalances. Oppose violence against women with HIV by fighting laws that criminalize HIV status and leave women even more vulnerable to abuse of power; support programs like Common Threads that promote economic justice and healing for women with HIV.
  • From intimate partners to social institutions: Stop the brutality against women living with HIV! Violence faced by women living with HIV is experienced at the individual, community and institutional level. Screen for IPV, stand up to HIV stigma and repeal HIV criminalization laws that render people living with HIV a “viral underclass.”
  • Criminalization of HIV and attempts to control the sexuality and reproduction of women living with HIV (eg. by shaming WLHIV about sexuality or parenthood desires) are forms of structural violence against WLHIV and may lead to increased intimate partner violence.
  • A third of US WLHIV have diagnosable post-traumatic stress disorder (PTSD). This is what veterans live with when returning from war!
  • We must heal trauma in order to treat HIV. An analysis of studies in transgender and cisgender WLHIV showed that those reporting recent abuse were four times less likely to succeed on treatment.
  • There’s a crater in the HIV care continuum for US women between linkage to care (70%) and staying in care (41%). Evidence is growing that healing the effects of trauma is key to filling that gap. Screening for and responding to intimate partner violence and trauma, must become the norm in women’s HIV care to improve health outcomes for WLHIV.
  • Women with HIV who have experienced IPV could fill an entire city the size of [insert city here]. There are roughly 300,000 women living with HIV in the US and more than half have experienced IPV. That’s more than the population of
    • Kansas City, Kansas
    • Paterson, New Jersey
    • Waco, Texas
    • Green Bay, Wisconsin
    • Berkeley, California
    • Peoria, Illinois
    • New Haven, Connecticut
    • Columbia, South Carolina