This article was exclusively written for The European Sting by Ms. Isabella Marques de Almeida Freitas, a 4rd-year medical student at Universidade Estadual de Montes Claros, UNIMONTES, at Montes Claros, Brazil. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.
Sexual and reproductive health and rights services (SRHR services) are services whose goals are to promote a positive and respectful approach to sexuality and sexual relationships, to enable a pleasureable and safe sexual experiences, to support individuals and couples to make informed decisions on if, when and how often they want to reproduce, and to facilitate a wide range of safe and effective family planning methods, including prevention and management of sexually transmitted infections (STIs) and other essential forms of care such as preventive screening.
HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) services aim to identify HIV infection, prevent new cases and provide care to enhance the quality of life and prevent premature death.
HIV and SRHR services are complementary and overlapping services that would best be delivered in an integrated approach, aligned with other services such as maternal and child health, adolescent health, men’s health and Gender-Based Violence (GBV) services.
In that sense, it’s important to address the inter-connections between SRHR, GBV and HIV/AIDS.
GBV can be defined as any harmful act that is perpetrated against a person’s will and that is based on socially determined gender differences between males and females. GBV manifests in form of Sexual violence (rape or sexual assault, sexual harassment), Physical violence (hitting or beating), Economic violence (denial of resources), Emotional violence (psychological abuse) and Harmful “traditional practices” (forced marriages, female genital mutilation).
GBV is not only a human rights violation but also a barrier to HIV prevention, treatment and care. Intimate partner violence (IPV), for example, lessens one’s ability to negotiate condom use with their partners, thus increasing their risk of HIV infection. For example, forced sex further increases the risk of HIV transmission to women due to tears and lacerations, especially in adolescent girls.
For women, testing positive for HIV or STIs may constitute a risk factor for experiencing GBV, with studies finding an increase in violence following disclosure of HIV status or even following disclosure that HIV testing has been sought.
GBV may also interfere with the ability to access HIV treatment and potentially the ability to maintain adherence to anti-retroviral (ARV) treatment.
Likewise, it also includes the reduced access to information, condoms, HIV testing, treatment and care for the LGBT community.
Because of these linkages, in HIV and SRHR programmes, addressing GBV effectively will reduce SRHR and HIV risks.
Combined prevention efforts must include interventions to prevent and address gender-based violence if we are to achieve the goal of eliminating AIDS as a public health threat.
Services related to GBV, SRHR and HIV all need to address underlying social issues. GBV risk must be monitored, identified and addressed in order to improve the quality of care and treatment outcomes, especially for women, particularly those belonging to marginalized groups, such as sex workers and injecting drug users, who face additional discrimination. A comprehensive SRHR service, with a “life-skills” package that addresses issues related to gender, HIV, communication, and relationships in a community would be the best course of action.
About the author
Isabella Marques de Almeida Freitas is a 4rd-year medical student at Universidade Estadual de Montes Claros, UNIMONTES, at Montes Claros, Brazil. She is very passioned about the research area, always trying to improve herself. Isabella is a member of IFMSA Brazil and a fervorous feminist who loves to advocate for women’s rights and gender respect and equallity whenever possible. Her goal is to make the whole world a better and safer place to live in for everyone.
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