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The link between sexual violence and HIV is well established. It is in part directly biological as women may be exposed to HIV during rape, and partly mediated through gender power inequalities and the impact of sexual violence on women’s sense of self, and in particular perceptions of control over sexual access to their bodies and their self-esteem.

Sexual Violence and Women’s Vulnerability to HIV
Types of evidence used to establish the link between sexual and gender-based violence and HIV infection include:

• Follow-up studies showing increased risk of HIV among previously HIV negative rape survivors:
• Cohort studies in Africa of HIV-discordant partners showing an increased risk of infection among partners who report violence;
• Studies associating childhood sexual abuse with HIV risk later in life;
• Studies of indirect consequences for HIV risk of coerced first intercourse at any age;
• Increased HIV risk associated with intimate partner violence.
• The link between sexual violence and HIV is well established. It is in part directly biological as women may be exposed to HIV during rape, and partly mediated through gender power inequalities and the impact of sexual violence on women’s sense of self, and in particular perceptions of control over sexual access to their bodies and their self-esteem.

Direct Risks:

• If the perpetrator is infected, HIV transmission may occur during the rape. If the rape results in abrasions and tears these will facilitate the entry of the virus into the bloodstream.
• Those who suffer anal rape are also considerably more susceptible to HIV since anal tissues can be easily damaged, allowing the virus an easier entry into the body.

Indirect Risks:

• Physically violent men are more likely to have HIV and to impose risky sexual practices on their partners. They are more likely to have multiple partners, to have sex more often, to practice transactional sex, to practice anal sex and to report symptoms of sexually transmitted infections (STI).
• HIV-infected women are more likely to have experienced physical or sexual violence; and victims of violence are at higher risk of HIV infection.
• Men who have been victims or perpetrators of violence against males are highly suspectible to HIV.
• Being a victim of sexual violence can make women susceptible to risk behaviours which can lead to HIV infection.
• Forced sex in childhood or adolescence increases the risk of contracting HIV as it adds to  the likelihood of:
• having first consensual sex at a younger age

• engaging in unprotected sex
• having multiple partners
• participating in transactional sex.
• People who experience forced sex in intimate relationships often find it difficult to negotiate condom use; and proposing the use of the condom may increase women’s risk of violence.
• Fear of partner violence and rape impede women’s access to HIV/AIDS information, HIV testing, HIV/AIDS treatment and counselling.
• Sex workers are among those disproportionately affected by HIV, with estimated prevalence ranging from 30% in Yaounde, Cameroon to 75% in Kisumu, Kenya.
• According to research in South Africa, “An estimated 16% of all HIV infections in women could be prevented if women do not experience domestic violence from their partners”.

• Developing an Integrated Model for Post-rape Care and HIV Post-exposure Prophylaxis in Rural South Africa. Population Council, University of Witwatersrand and Tshwaranang Legal Advocacy to End Violence against Women, 2007
• Prevention of HIV/AIDS and Violence Against Women and Girls with Disabilities in Tanzania. Msedi Ngololo M. Barbara Faye Waxman Fiduccia Papers on Women and Girls with Disabilities Center for Women Policy Studies, 2011
• Violence Linked to Substance Use and Mental Health in BC Women with HIV. 1st International Workshop on HIV and Women, January 10-11, 2011, Washington, DC
• It's All One Curriculum: Guidelines and Activities for a Unified Approach to Sexuality, Gender, HIV, and Human Rights Education. Population Council, January 2011
• Preventing Gender-Based Violence and HIV: Lessons from the Field. AIDSTAR-One, Spotlight on Gender. Ellsberg M and Betron M. USAID, 2010
  An Essential Services Package for an Integrated Response to HIV and Violence Against Women, Women Won’t Wait Campaign, 2010
• Youth InfoNet 72, Interagency Youth Working Group, September 2010
  
• Addressing violence against women and HIV/AIDS: What works? Report of a Consultation. World Health Organization and Joint United Nations Programme on HIV/AIDS), 2010  
• ‘Men-streaming’ gender in sexual and reproductive health & HIV/AIDS. International Planned Parenthood Federation and Men Engage, 2010
• A 2010 Delegate’s Guide to Women and AIDS: Women’s Rights Here, Right Now. XVIII International AIDS Conference Vienna 18-23 July 2010
  
• Agenda for Accelerated Country Action for Women, Girls, Gender Equality and HIV. Operational plan for the UNAIDS action framework: addressing women, girls, gender equality and HIV. UNAIDS, 2010
• Towards a Just and Healthy Life for All: Seven Things the World Can do to End Violence Against Women. Women Won’t Wait Campaign, International AIDS Women’s Caucus & International Women’s Health Coalition, 2010   
    

• Agenda for Accelerated Country Action for Women, Girls, Gender Equality and HIV. UNAIDS, 2010
• Respect, Protect and Fulfill: Legislating for Women’s Rights in the Context of HIV/AIDS, Volume 1: Sexual and Domestic Violence. Canadian HIV/AIDS Legal Network, 2009
• Sexual Violence and HIV: Factsheet
• The Right to Survive: Sexual Violence, Women and HIV/AIDS Françoise Nduwimana. International Centre for Human Rights and Democratic Development, December 2004.
• Young Men and HIV Prevention Horizons Program, Population Council, December 2004.
• Women, HIV/AIDS, and Human Rights Amnesty International, November 2004.
• Intimate Partner Violence and HIV/AIDS WHO Information Bulletin Series, 2004. [PDF, 203K]

• Gender and Sexuality: Emerging Perspectives from the Heterosexual Epidemic in South Africa and Implications for HIV Risk and Prevention. Jewkes R, Morrell R. J. Int. AIDS Soc; 13(1): 1-11, 2011
• Confronting Structural Violence in Sex Work: Lessons from a Community-Led HIV Prevention Project in Mysore, India. Argento E, Reza-Paul S, Lorway R, Jain J, Bhagya M, Fathima M, Sreeram SV, Hafeezur RS, O'Neil J. AIDS Care; 23(1):69-74, 2011

• Respect, Protect and Fulfill: Legislating for Women’s Rights in the Context of HIV/AIDS. Canadian HIV/AIDS Legal Network, 2009.
• Antiretroviral Postexposure Prophylaxis After Sexual, Injection-Drug Use, or Other Nonoccupational Exposure to HIV in the United States Centers for Disease Control and Prevention, MMWR 2005;54(No. RR-02):1-20.
• Offering HIV Prophylaxis Following Sexual Assault: Recommendations for the State of California Joan E. Myles, Joshua Bamberger. Housing and Urban Health of the San Francisco Department of Public Health and The California HIV PEP After Sexual Assault Task Force in Conjunction with the California State Office of AIDS, June 2004. [PDF, 218K]

• AfroAIDSinfo
• AIDSPortal
• Canadian HIV/AIDS Legal Network
• HIV Insite- Sexual Violence- Related Resources
• PlusNews
• Responding to HIV and gender based violence: Stories from Southern Africa, Sonkhe Gender Justice, 2008
• Resources for HIV/AIDS and Sexual and Reproductive Health Integration
• SASA: A Film about Women, Violence and HIV/AIDS
• The Center for Health and Gender Equity
  
• UNAIDS
• UNAIDS – Gender
• Unifem Gender and HIV Portal
• What Works for Women and Girls: Evidence for HIV/AIDS Intervention
• WHO and HIV/AIDS
• Women WON'T Wait
• Women Won’t Wait Campaign