Women victims of domestic violence are three times more likely to contract the human immunodeficiency virus (HIV), finds a study conducted by a research team from McGill University.
The article published in The Lancet HIV reveals that there is a strong link between gender-based violence and HIV epidemics in some of the most affected countries. Among women living with the virus, those who have experienced domestic violence in the last year are 10% less likely to have an undetectable viral load, the final stage of treatment.
“About one in four women will experience physical or sexual violence during her lifetime,” says Mathieu Maheu-Giroux, professor at McGill University and holder of the Canada Research Chair in Population Health Modeling. In some countries, more than 40% of women have suffered this kind of abuse in the last year”.
Data shows that the most affected areas are often struggling with a combined epidemic of domestic violence and HIV. In sub-Saharan Africa, the proportion of people living with HIV in the general population is high. Several countries in the South African cone are also affected, such as South Africa, Lesotho and Eswatini.
“Some parts of southern Africa can have virus prevalences of 20% to 30%. It is therefore almost one in five adults, or even one in three, who is living with HIV”, specifies the researcher. In Canada, this proportion is less than 1%.
If the impacts of conjugal violence on HIV have been explored for twenty years, access to new data has made it possible to deepen the causality between the two phenomena.
“Studies conducted since the early 2000s were only able to identify who was living with HIV. Today, new biomarkers allow us to know if the infection was recently acquired or not. We can then determine which comes first: HIV infection or violence,” explains Mr. Maheu-Giroux.
Despite studies, the causal structure between violence and HIV remains unclear. In cases of sexual violence, the risk of injury or abrasion of the mucous membranes is increased, which has a direct impact on the acquisition of HIV.
On the other hand, physical violence does not act directly on the risk of contracting the virus, but can have major repercussions on mental health.
“Where we see a difference is really on the viral load. It is thought that the mental health consequences could have a negative effect on adherence to treatment. If you don’t take your pills, for example, the viral load can rebound,” says the professor.
UNAIDS 95% targets
In order to reduce the risk of transmission to their partners and to increase their life expectancy, people living with HIV must follow a retro antiviral treatment, which makes their viral load undetectable.
“There is no cure for HIV, but it will be so low in the blood that laboratory methods will not detect it. Studies have shown that if HIV is not detected in the samples, the probability of it being transmitted to sexual partners is nil,” maintains Mathieu Maheu-Giroux.
The Joint United Nations Program on HIV/AIDS, also known as UNAIDS, is currently coordinating global action against the virus with the goal of ending the AIDS epidemic by 2030.
The organization’s goals are for 95% of people living with HIV to be diagnosed, 95% of them on treatment and 95% of people on treatment to have a suppressed viral load.
“By multiplying, we arrive at approximately 85% of all people living with HIV who can no longer spread the virus. Several mathematical studies say that if we reduce the number of infectious people to 15%, we will succeed in controlling the epidemic and eliminating HIV as a threat to public health”, specifies the researcher.
He adds that the existence of an intersection between the two epidemics thus calls for the establishment of “more integrated” interventions, rather than having two distinct vertical programs.
“As gender-based violence is so prevalent around the world, including in Canada, there is an urgent need to stem domestic violence and HIV, two mutually reinforcing threats to women’s health and well-being” , summarized Salome Kuchukhidze, doctoral student in epidemiology at McGill University and lead author of the article, in a press release.
This article has been produced with the financial support of the Meta Scholarships and The Canadian Press for the news.