HIV Risk & Violence Against API Women

Quick Facts

• 86% of API women living with HIV got it through unprotected sex with a male partner.

W. Adih, M. Campsmith, C. Williams, F. Hardnett, D. Hughes, Epidemiology of HIV among Asians and Pacific Islanders in the United States, 2001-2008. Journal of the International Association of Physicians in AIDS Care, April 20, 2011.

• API women were found to have the lowest proportion (17%) of HIV testing compared to women of other races/ethnicities. Of API women who believe they are at risk, only 5% have gone for testing.

H. Hahm, I. Song, A. Ozonoff and J. Sassani, “HIV Testing Among Sexually Experienced Asian and Pacific Islander Young Women: Association With Routine Gynecological Care.” Women’s Health Issues, 2009, 19: 279-288.

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HIV and Domestic Violence

The Intersection of HIV/AIDS and Domestic Violence in Asian American, Native Hawaiian, and Pacific Islander Women provides a brief introduction to the intersection of HIV/AIDS and domestic violence in the AA and NHPI community through a reproductive justice framework by examining the societal and structural barriers women face, the effect the social constructs of gender, patriarchy and culture have on women’s health and the effect of violence on women’s reproductive health.

• The Intersection between HIV/AIDS and Domestic Violence in Asian American, Native Hawaiian and Pacific Islander Women

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HIV, Trauma, and Abuse Among Women

Trauma and post-traumatic stress syndrome are closely tied both to increased risk of becoming infected with HIV and lower rates of successful treatment. Women with HIV are exposed to trauma and suffer from posttraumatic stress disorder (PTSD) at rates far higher than those occurring in women in general - mostly between two and six times higher rates of various types of child and adult sexual and physical abuse and PTSD in HIV-positive women.

• HIV-positive women are 2 to 6 times more likely to have suffered trauma or post-traumatic stress than women without HIV.
• Roughly 30% of women with HIV have PTSD; this is 6 times the rate of PTSD in the general population of women.
• More than 60% of HIV-positive women have experienced sexual abuse in their lives, compared with 12%of women overall.
• 55% of women with HIV have been a victim of domestic violence, compared with 25% of women overall.
• Women with HIV are twice as likely to have been the victim of intimate partner violence compared to national samples of American women.

Experiences of recent trauma or an abusive relationship was strongly associated with treatment failure. Traumatized women fare worse in treatment for HIV/AIDS than women who have not suffered traumatic stress.

• Women with HIV who had suffered a recent trauma were 4 times more likely than women who hadn't suffered a trauma to experience virologic failure, a situation where the HIV virus becomes detectable in the blood despite being on antiretroviral mediations - meaning that their drug treatment wasn't working. This situation can lead to HIV-related illnesses and to the virus developing resistance to the antiretroviral medications.

Trauma also puts women in situations where they are more likely to spread the virus to others.

• Those women were also nearly 4 times more likely than their peers to engage in risky sexual behavior, such as having sex with someone without the virus or whose HIV status was unknown to them, and to not always use condoms with these partners.

Physical violence, sexual abuse and other forms of childhood and adult trauma are major factors fueling the epidemic of HIV/AIDS among women. In order to be successful, programs working with HIV-positive women must include screening and responding to trauma as a core component of health care in addition to traditional medical treatment.

"Recent Trauma is Associated with Antiretroviral Failure and HIV Transmission Risk Behavior Among HIV-Positive Women and Female-Identified Transgenders" by E. L. Machtinger, J. E. Haberer, T. C. Wilson and D. S. Weiss. http://www.springerlink.com/content/n164716853x285h7/ "Psychological Trauma and PTSD in HIV-Positive Women: A Meta-Analysis" by E. L. Machtinger, T. C. Wilson, J. E. Haberer and D. S. Weiss. http://www.springerlink.com/content/65735j14q7r70640/

"Women who report experiencing trauma often do not have the power or self-confidence to protect themselves from acquiring HIV," said Edward Machtinger, MD, director of the Women's HIV Program at UCSF. "Once infected, women who experience ongoing abuse are often not in positions of power to effectively care for themselves or to insist that their partners protect themselves. Effectively addressing trauma has the potential to both improve the health of HIV-positive women and that of the community."