A guide for women in abusive relationships:

How do I reduce the risk of HIV/AIDS?

    What is abuse?
    What is HIV/AIDS?
    How could I contract HIV/AIDS
    How do I reduce the risk of HIV?
    HIV/AIDS FACTS
    How could an abusive partner increase my chances of HIV?
    What are my sexual rights?
    How can I talk about using condoms with my partner?
    Who should consider being tested?
    Why should I get tested?
    How is the test done?
    When should I be tested?
    What if I am raped?
    Is there a treatment for AIDS?
    Where can I get help?


FACT:    5 million South Africans are HIV positive – the highest number of HIV infections of any country in the world
FACT:    There are more than 5 000 AIDS-related deaths a week in South Africa every month
FACT:    30% of married women in South Africa are HIV positive
FACT:    1 in 4 pregnant women in South Africa are HIV positive
FACT:    more than 5 000 HIV positive babies are born in South Africa every month
FACT:    9 out of 10 HIV infections in South Africa are caused by unprotected sex.
FACT:    Abused women are more at risk of HIV infection than any other group

Sources: SA Government, Business day, Treatment Action Campaign


What is abuse?

Physical abuse includes slapping, punching, kicking, choking, biting, burning, stabbing, shooting
Emotional Abuse includes blaming, humiliating, intimidation and manipulating the children
Sexual abuse includes forced sex with a woman against her will, making unwanted and humiliating
sexual comments, exposing her to pornography
Financial abuse includes withholding or stealing money to exert power and control
Verbal Abuse includes unfair criticism, shouting, lying, insults, swearing


What is HIV and AIDS?

HIV stands for human immuno-deficiency virus. HIV attacks the body’s immune system, over time the immune system is weakened and an HIV-infected person can become sick with different illnesses. The HIV-positive person is then diagnosed with AIDS - acquired  immune-deficiency syndrome.


How could I contract HIV?

the greatest risk is from having unprotected sex.
HIV infection is passed through semen, vaginal fluids, blood, and breast milk.

You can get infected if you:
•     have vaginal or anal intercourse without a condom – this is a very high risk.
•     have oral sex without protection during which semen or vaginal fluid or menstrual blood enters open cuts or sores in your mouth – a lower risk.
•     You can also get infected if you share needles or any equipment for injecting drugs, unsterilised needles for tattooing, skin piercing or acupuncture, sex toys, razors. Even if HIV-infected blood touches your skin, it won’t cause infection. For you to become infected, enough HIV-infected blood has to get into your bloodstream through an entry point like an open sore or cut.


How do I reduce the risk of HIV?

•     Inform yourself, your partner, your friends, your children. The more you know about Hiv/Aids the more you can do to prevent it from infecting you and your loved ones.
•     Carry a condom with you, especially if you will be drinking or doing drugs. Men also need to take responsibility for having safer sex – it’s the only way to protect themselves and their partners.
•     Talk about safer sex with your partner – before you have sex. This can be difficult if your partner refuses but remember that unprotected sex is dangerous. Many women are not aware that they can refuse to have sex if  their husbands refuse to wear a condom, and that the law must protect them.
•     Remember: If you don’t consent to sex, your partner can be charged with rape. If you ask your partner
to practice safe sex and he forces you to have unprotected sex, then he can be charged with rape. Even though there are laws to protect women from violence and abuse, many women do not use them because they experience discrimination from the police and the courts. There are laws to protect women from such discrimination.


HIV/AIDS FACTS

•     There is no cure for AIDS, nor is there any vaccine.
•     HIV is not a death sentence. With the correct medication and a healthy lifestyle, one can still live for many years.
•     Having sex with a virgin does not cure AIDS.
•     Handshaking, hugging, kissing, dirty silverware, food sharing, insect bites, sheets, public phones, transportation, movie theatres, gymnasiums, schools, work environments, hospital visits, swimming pools, showers and public restrooms do not represent any risk.


How could an abusive partner increase my chances of HIV?

•     Abusers who rape or sexually assault their victims are unlikely to use a condom. Some abusers may intentionally infect their partners with HIV in an attempt to keep them from leaving.
•     Abusers who engage in sexual activity outside the relationship, potentially expose their partners to sexually transmitted diseases, including HIV.
•     Abusers may prevent victims from receiving medical care, testing and counselling.

Abusers may also:
•     Threaten to reveal HIV+ status to children, family, friends, and employer.
•     Threaten to use the victim’s HIV+ status as grounds for paternal custody.
•     Reinforce a victim’s guilt about the HIV+ status of children.
•     Sexually humiliate or degrade the victim for having HIV. Tell the victim she is “dirty” or undesirable.
•     Isolate the victim on the basis that she poses a threat of infection to others.
•     Refuse to assist the victim when she is sick.

Important: Some ignorant people believe that by having sex with a virgin, one is cured from AIDS. This is UNTRUE, because  there is no cure for AIDS.


What are my sexual rights?

If you have control over your body, you can protect yourself from HIV by deciding: Who you have sex with; When you have sex; and How you have sex.
It is the responsibility of everyone who is sexually active, whether they have HIV or not, to have safer sex (using a condom). For most women, it is difficult to insist on safer sex. Many of us have to rely on our partners being faithful, which is something we have no control over. Being faithful to your partner is no protection against HIV if your partner is not faithful too.


How can I talk about using condoms with my partner?

It can be difficult to talk about condoms and safer sex, especially if you are in abusive relationship, but it is very important. Try to talk about safer sex before you have sex.

To raise the subject with your partner you can say:
•     “Don’t you think that people these days need to always practice safer sex.”
•     “If our relationship is going to become sexual, we should use condoms.”
•     “This feels really good but I want to talk about how we have safer sex before we go any further.”

If your partner doesn’t want to use condoms try saying:
•     “I find putting on condoms very exciting.”
•     “Using condoms lets me relax and enjoy sex rather than worrying about AIDS.”
•     “I’ve heard that condoms help a man last longer.”
•     “Using condoms shows that we respect ourselves and each other.”


You could say ...

Man:  “Don’t you trust me?”
You could say:  “I do trust you, but either of us could have a virus and not know it”.

Man:  “We’ve been using condoms forever, now I want skin-to-skin. aren’t I special enough for you?”
You could say:  “You are special... that’s why I want to make sure that we are both protected.”

Man:  “Condoms don’t feel good”.
You could say:  “Let’s try it a few times. It’ll be more fun if we can both relax.” Then try putting a drop of lubricant (KY jelly) inside the condom. You could also try using a female condom.

Man:  “Aren’t you on the pill?”
You could say:  “Yes, but that doesn’t stop STDs”

Man:  “We both look healthy. We can’t be infected!”
You could say:  “The only way to know for sure is to be tested. Perhaps we should get tested - it’s
better safe, than sorry.”


Who should consider being tested?

•     those who have had unprotected sex.
•     those who have had more than one sexual partner • those who have been raped or molested
•     anyone who is planning to get involved in a sexual relationship with a new partner


Why should i get tested?

It is important to know your status, because:
If you test HIV negative you can:
•     Experience less stress and anxiety because you will know your status

If you test HIV positive you can:
•     Get early treatment to stay healthy
•     Get treatment to reduce the chances of your baby getting HIV if you are pregnant
•     Take precautions to not infect others with HIV.


How is the test done?

The doctor or nurse should inform you about the procedure, the implications of a negative or positive result and the support available. Your consent will be required to perform the test. The result is confidential and cannot be disclosed to anyone by the doctor or nurse.

A negative test result means either that you have not been exposed to the virus, or that it is too early to tell. It takes from two weeks to six months for antibodies to develop after a person is exposed to HIV.  A negative result does not protect you against future infection.

A positive test result means that you have been exposed to HIV; it does not mean you have developed the AIDS syndrome. If you test positive, you should plan to see a doctor familiar with HIV and consider other tests for HIV, as well as treatment options to prevent the onset of AIDS-related diseases.

Counselling is an important aspect of having an HIV test. A trained counsellor can address your fears and help you prepare to receive the results. You will need support. If you test positive, there are many resources available to help you cope with the daily challenge of living with HIV.


When should I be tested?

HIV antibodies do not appear in your blood until 3 to 6 months after infection. Get tested at least 3 months after the last risky incident.


What if I am raped?

There are PEP medicines that can help your body prevent HIV infection if you have been recently exposed to the virus. At the moment these are not available to all women who have been raped. The government policy is that they should be available at public and private hospitals, but you have to ask for them. You must start the treatment within three days of being raped and take the medicine for 28 days. This treatment is most effective if started as soon as possible after the rape. Although it reduces the chances of infection, it does not always stop it.


Is there a treatment for AIDS?

No. There is no cure for AIDS. However treatments are available that can improve the quality of life of those with HIV infection or suffering AIDS-related illnesses. If your HIV test is positive, the most important thing to do is to decide how you want to live from now on. If you decide to have a positive approach, looking after your body and mind well, the chances are that you can still live a healthy life for quite some time. On the other hand, if you decide to stop caring about anything and become negative, this will almost certainly shorten your life. A healthy diet can help in important ways to keep your immune system strong. Food is not a magical cure for HIV/AIDS.  It does not stop people from dying in the end from AIDS-related illnesses, but it can help people to live longer, more comfortable and more productive lives.


Where can i get help?

AIDS Help line:  0800 012 322



© Nisaa 2006