• Women do not access HIV testing for fear of
violence at home and of being accused of
‘bringing the virus into the home’. Women
would also often rather stay uninformed
about their HIV status, increasing their risk
of contracting HIV or becoming re-infected.
• Abused HIV positive women often cannot
disclose to their male partners or family
members due to fear of more violence and
stigma, with negative impacts on their
ability to access relevant treatment, care
and support services.
MOSAIC Programmes
and Services
MOSAIC (Support• Heal• Train) implements the
following programmes and offers the following
services for survivors and perpetrators of
domestic violence:
• Domestic violence court support services.
• Integrated domestic violence and HIV
prevention interventions and services.
• Behaviour change programmes
working with communities and
community leaders to challenge risky
gender norms and promote gender
equality.
• Outreach programmes emphasising
strategies to ensure safe relationships
free from domestic and sexual violence.
• Specialised counselling for survivors
and perpetrators of violence. Counselling also aims to promote
sexual and reproductive health.
• Comprehensive integrated sexual and
reproductive health services, including
HIV testing, cervical health management,
pap smears, pregnancy related problems
(for instance increased violence), safe
abortion, proper nutrition, screening
and treatment of STIs, and screening for
violence against women
• Post-HIV test services for survivors and
HIV positive women.
• Training, including manual
development and training support for
other NGOs and relevant stakeholders,
and skills-training for abused women.
• Partnership building and referrals to
relevant service providers.
Supported by the Global Fund to Fight AIDS, Tuberculosis
& Malaria. The views described herein are the views of this
institution, and do not represent the views or opinions of The
Global Fund to Fight AIDS, Tuberculosis & Malaria, nor is there
any approval or authorization of this material, express or implied,
by The Global Fund to Fight AIDS, Tuberculosis & Malaria.
Contact us to find out more, or to access any of our services.
MOSAIC, 66 Ottery Road, Wynberg 7800 or
P.O. Box 18460, Wynberg 7824, Cape Town, South Africa
Tel: +27 21 761 7585 Fax: + 86 651 8662
Email : [email protected], Website: www.mosaic.org.za
NACOSA National Head Office:
3rd Floor, East Tower Century Boulevard,
Century City 7441, Cape Town, South Africa
Tel: +27 21 552 0804, Fax: +27 552 7742,
Email: [email protected]
SAfAIDS Regional Office - Zimbabwe:
17 Beveridge Road, Avondale, Harare, Zimbabwe.
Tel: +263 4 336193/4 Fax: +263 4 336195
E-mail: [email protected], Website: www.safaids.net
479 Sappers Contour, Lynnwood, Pretoria 0081, South Africa
Tel: +27 12 3610889, Fax: +27 12 3610899
Email: [email protected], Website: www.safaids.net
Making the link:
HIV and Domestic
and Sexual
Violence
What is
domestic violence?
Domestic violence , also known as intimate partner
violence or spousal abuse is defined as a pattern of
abusive behaviour by one partner against another
in an intimate relationship such as marriage,
dating, family or co-habitation.
Domestic violence or the fear of violence
contributes to high HIV incidence in women by
reducing women’s power in sexual relationships
and consequently their ability to protect themselves
from contracting HIV and other sexually transmitted
infections (STIs).
HIV and violence against women affects
women and girls of all ages, religions, races, cultures,
educational level and socio-economic backgrounds.
Male perpetrators are often those who are, or who have
been, in positions of trust, intimacy and power with the
woman – husbands, boyfriends, fathers, fathers-in-law,
stepfathers, brothers, uncles, sons and other relatives.
Although in the majority of cases violence is
perpetrated on women by men in heterosexual
relationships, women in same-sex relationships can
also experience violence.
HIV and violence against women in
intimate partnerships are linked
to, and are a direct result of
gender inequalities.
Ten forms of domestic violence
Domestic violence can take the ten forms below:
1. Physical abuse involves physical or threatened harm
or injury to the body, including through the use of
weapons. Typically the violence is on-going and becomes
progressively worse, at times resulting in death.
2. Emotional, verbal and psychological abuse is
known as the ‘silent killer.’ This abuse includes: a
pattern of behaviour that degrade or humiliates through
repeated insults, name calling, threats, possessiveness or
jealousy, invasion of privacy, integrity and security.
3. Sexual abuse is especially traumatic for the survivors,
and carries an increased risk of HIV transmission. This includes any conduct that abuses, humiliates,
degrades, or otherwise violates the sexual integrity of
the complainant and is at times preceded by physical
violence in domestic settings.
4. Economic abuse occurs when the perpetrator denies
the victim access to or knowledge about family finances
or other resources to limit decision-making power. Physical and Emotional abuse may follow.
5. Intimidation means uttering or conveying a threat, or
causing a complainant to receive a threat, which induces fear.
6. Harassment means engaging in a pattern of conduct
that induces the fear of harm in a complainant, including:
repeatedly watching, or loitering outside or near
where the complainant happens to be; making calls or
inducing another person to make calls to the compliant;
and sending or causing the delivery of objects to the
complainant. 7. Stalking means repeatedly following, pursuing, or
accosting the complainant.
8. Damage to property means the wilful damaging or
destruction of property belonging to the complainant or
which the complainant has a vested interest in.
9. Entry into the complainant’s residence without
consent, where the parties do not share the same
residence; or
10. Any other controlling or abusive behaviour towards
a complainant, harming, causing imminent harm to the
safety, health or wellbeing of the complainant.
Increased HIV and STI
RISK FACTORS for
women who experience
violence include:
• Unequal power relations between
women and men with high levels of male
control and intimate partner violence
are associated with heightened risk to
contracting HIV for women, due to lower
decision-making power to suggest and
insist on condom use.
• Use of force during sexual intercourse
increases the risk of vaginal, anal and oral
cuts and tears, increasing exposure to HIV,
especially for young girls whose vaginal
tracts are still immature and prone to tear
more easily.
• Survivors of abuse may find it difficult to
adapt to and insist on safer sex practices due
to fear of violence or the threat of violence in
new relationships or circumstances.
• Women who have experienced intimate
partner violence are more likely to engage in
transactional sex than women who have not
experienced violence, according to studies.
• An intergenerational or age-disparate
relationship is where a younger woman
becomes sexually involved with an older
man (who usually has had more partners and
power in sexual matters, and is riskier in terms
of HIV transmission). Male partners in these
relationships are sometimes very controlling.
• Some cultural, religious and gender norms
make it difficult for women to exercise their
rights to gender equality, and to negotiate for
safer sex, often resulting in abusive and volatile
relationships and HIV or STI transmission.