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When HIV-Prevention Messages and Gender Norms Clash: The Impact of Domestic Violence on Women's HIV Risk in Slums of Chennai, India

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Abstract

This paper examines how marital violence affects women's ability to protect themselves from HIV/AIDS. In-depth interviews (n = 48) and focus groups (n = 84, 3–7 per group) were conducted among men and women in two randomly selected slums of Chennai, India. The study showed that community gender norms tacitly sanction domestic violence that interferes with adopting HIV-preventive behaviors. Given the choice between the immediate threat of violence and the relatively hypothetical specter of HIV, women often resign themselves to sexual demands and indiscretions that may increase their risk of HIV acquisition. In conclusion, AIDS-prevention interventions must incorporate gender-related social contexts in settings where husbands strictly enforce their locus of control. HIV-prevention messages targeting men may effectively reduce women's exposure to HIV/AIDS.

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References

  • Bhatti, R. S. (1990). Socio-cultural dynamics of wife battering. In S. Sood (Ed.), Violence against women (pp. 45–56). Jaipur, India: Arihanti.

    Google Scholar 

  • Campbell, J. C. (1989). Women's responses to sexual abuse in intimate relationships. Health Care for Women International, 10, 335–346.

    Google Scholar 

  • Campbell, J. C., and Alford, P. (1989). The dark consequences of marital rape. American Journal of Nursing 89, 946–949.

    Google Scholar 

  • Celentano, D., Sivaram, S., Mayer, K., Krishnan, A., Murugavel, K., Go, V., Latkin, C., and Solomon, S. (2001). HIV/STD burden in urban slums of South India. Paper presented at the Sixth International Congress on AIDS in Asia and the Pacific, Melbourne, Australia.

  • Choi, K. H., Binson, D., Adelson, M., and Catania, J. (1998). Sexual harassment, sexual coercion and HIV risk among US adults 18–49 years. AIDS and Behavior, 2, 33–40.

    Google Scholar 

  • Cokkinides, V. E., Coker, A. L., Sanderson, M., Addy, C., and Bethea, L. (1999). Physical violence during pregnancy: Maternal complications and birth outcomes. Obstetrics and Gynecology, 93, 661–666.

    Google Scholar 

  • Curry, M. A., Perrin, N., and Wall, E. (1998). Effects of abuse on maternal complications and birth weight in adult and adolescent women. Obstetrics and Gynecology, 92, 530–534.

    Google Scholar 

  • De Zoysa, I., Sweat, M. D., and Denison, J. A. (1996). Faithful but fearful: Reducing HIV transmission in stable relationships. AIDS, 10 (Supplement A), S197-S203.

    Google Scholar 

  • Dixon-Mueller, R., and Wasserheit, J. (1991). The culture of silence: Reproductive tract infections among women in the Third World. Washington, DC: International Women's Health Coalition.

    Google Scholar 

  • Eby, K. K., Campbell, J. C., Sullivan, C. M., and Davidson, W. S. (1995). Health effects of experiences of sexual violence for women with abusive partners. Health Care for Women International, 16, 563–576.

    Google Scholar 

  • Ellsberg, M., Heise, L., Pena, R., Agurto, S., and Winkvist, A. (2001a). Researching domestic violence against women: Methodological and ethical considerations. Studies in Family Planning, 32, 1–16.

    Google Scholar 

  • Ellsberg, M. C., Winkvist, A., Pena, R., and Stenlund, H. (2001b). Women's strategic responses to violence in Nicaragua. Journal of Epidemiology and Community Health, 55, 547–555.

    Google Scholar 

  • European Study Group on Heterosexual Transmission of HIV. (1992). Comparison of female to male and male to female transmission of HIV in 563 stable couples. British Medical Journal, 304, 809–813.

    Google Scholar 

  • Fisher, B., Hovell, M., Hofstetter, C. R., and Hough, R. (1995). Risks associated with long-term homelessness among women: Battery, rape, and HIV infection. International Journal of Health Services, 25, 351–369.

    Google Scholar 

  • Gangakhedkar, R. R., Bentley, M. E., Divekar, A. D., Gadkari, D., Mehendale, S. M., Shepherd, M. E., Bollinger, R. C., and Quinn, T. C. (1997). Spread of HIV infection in married monogamous women in India. Journal of the American Medical Association, 278, 2090–2092.

    Google Scholar 

  • Go, V. F., Sethulakshmi, C., Bentley, M. E., Sivaram, S., Srikrishnan, A., Celentano, D., and Solomon, S. (in press). Crossing the threshold: Engendered definitions of socially acceptable domestic violence in Chennai, India. Culture, Health and Sexuality.

  • Goldstein, D. (1994). AIDS and women in Brazil: The emerging problem. Social Science and Medicine, 39, 919–929.

    Google Scholar 

  • Greenberg, J. B. (2001). Childhood sexual abuse and sexually transmitted diseases in adults: A review of and implications for STD/HIV programmes. International Journal of STD and AIDS, 12, 777–783.

    Google Scholar 

  • Grisso, J. A., Schwarz, D. F., Hirschinger, N., Sammel, M., Brensinger, C., Santanna, J., Lowe, R. A., Anderson, E., Shaw, L. M., Bethel, C. A., and Teeple, L. (1999). Violent injuries among women in an urban area. New England Journal of Medicine, 341, 1899–1905.

    Google Scholar 

  • Gupta, G. R., and Weiss, E. (1993). Women's lives and sex: Implications for AIDS prevention. Culture Medicine and Psychiatry, 17, 399–312.

    Google Scholar 

  • Harvey, B., Stuart, J., and Swan, T. (2000). Evaluation of a drama-in-education programme to increase AIDS awareness in South African high schools: A randomized community intervention trial. International Journal of STD and AIDS 11, 105–111.

    Google Scholar 

  • Heise, L. (1998). Violence against women: An integrated, ecological framework. Violence Against Women, 4, 262–290.

    Google Scholar 

  • Heise, L. L., and Elias, C. (1995). Transforming aids prevention to meet women's needs: A focus on developing countries. Social Science and Medicine, 40, 931–943.

    Google Scholar 

  • Jain, R. (1992). Familial violence in India: The dynamics of victimization. In E. Viano (Ed.), Critical issues in victimology: International perspectives (pp. 80–86). New York: Springer.

    Google Scholar 

  • Jejeebhoy, S. J. (1998). Wife beating in rural India: A husband's right? Evidence from survey data. Economic and Political Weekly, 33, 855–862.

    Google Scholar 

  • Jejeebhoy, S. J., and Cook, R. J. (1997). State accountability for wife-beating: The Indian challenge. Lancet, 349(Supplement 1), sI10-sI12.

    Google Scholar 

  • Jewkes, R. (2002). Preventing sexual violence: A rights-based approach. Lancet, 360, 1092–1093.

    Google Scholar 

  • Kalichman, S. C., Williams, E. A., Cherry, C., Belcher, L., and Nachimson, D. (1998). Sexual coercion, domestic violence, and negotiating condom use among low-income African American women. Journal of Women's Health, 7, 371–378.

    Google Scholar 

  • Karim, Q. A., Karim, S. S., Soldan, K., and Zondi, M. (1995). Reducing the risk of HIV infection among South African sex workers: Socioeconomic and gender barriers. American Journal of Public Health, 85, 1521–1525.

    Google Scholar 

  • Kaushik, S. (1990). Social treatment issues in wife battering: A reconsideration. In S. Sood (Ed.), Violence against women (pp. 23–44). Jaipur, India: Arihanti.

    Google Scholar 

  • Kyriacou, D. N., Anglin, D., Taliaferro, E., Stone, S., Tubb, T., Linden, J. A., Muelleman, R., Barton, E., and Kraus, J. F. (1999). Risk factors for injury to women from domestic violence against women. New England Journal of Medicine, 341, 1892–1898.

    Google Scholar 

  • Mahajan, A. (1990a). Sources of family tensions in ancient India. In S. Sood (Ed.), Violence against women (pp. 119–128). Jaipur, India: Arihant.

    Google Scholar 

  • Mahajan, A. (1990b). Instigators of wife battering. In S. Sood (Ed.), Violence against women (pp. 1–10). Jaipur, India: Arihanti.

    Google Scholar 

  • Maman, S., Campbell, J., Sweat, M. D., and Gielen, A. C. (2000). The intersections of HIV and violence: Directions for future research and interventions. Social Science and Medicine, 50, 459–478.

    Google Scholar 

  • Maman, S., Mbwambo, J. K., Hogan, N. M., Kilonzo, G. P., Campbell, J. C., Weiss, E., and Sweat, M. D. (2002). HIV-positive women report more lifetime partner violence: Findings from a voluntary counseling and testing clinic in Dar es Salaam, Tanzania. American Journal of Public Health, 92, 1331–1337.

    Google Scholar 

  • Martin, S. L., Kilgallen, B., Tsui, A. O., Maitra, K., Singh, K. K., and Kupper, L. L. (1999a). Sexual behaviors and reproductive health outcomes: Associations with wife abuse in India. Journal of the American Medical Association, 282, 1967–1972.

    Google Scholar 

  • Martin, S. L., Matza, L. S., Kupper, L. L., Thomas, J. C., Daly, M., and Cloutier, S. (1999b). Domestic violence and sexually transmitted diseases: The experience of prenatal care patients. Public Health Reports, 114, 262–268.

    Google Scholar 

  • Maticka-Tyndale, E., Haswell-Elkins, M., Kuyyakanond, T., Kiewying, M., and Elkins, D. (1994). A research-based HIV intervention in northeast Thailand. Health Transition Review, 4(Supplement), 349–367.

    Google Scholar 

  • Maydeo, A. (1990). Domestic violence: The perspective and experiences of an activist group. In S. Sood (Ed.), Violence against women (pp. 267–278). Jaipur, India: Arihanti.

    Google Scholar 

  • Miller, B. (1992). Wife beating in India: Variations on a theme. In D. Counts, J. Brown, and J. Campbell (Eds.), Sanctions and sanctuary: Cultural perspectives on the beating of wives (pp. 173–184). Boulder, CO: Westview.

    Google Scholar 

  • Mohan, V. (1990). Is there hope for battered wives? In S. Sood (Ed.), Violence against women (pp. 11–22). Jaipur, India: Arihant.

    Google Scholar 

  • Molina, L. D., and Basinait-Smith, C. (1998). Revisiting the intersection between domestic abuse and HIV risk. American Journal of Public Health, 88, 1267–1268.

    Google Scholar 

  • Muhr, T. (1997). Atlas TI, Version 4.1 [Computer software]. Berlin: Scientific Software Development.

    Google Scholar 

  • Nandi, D. N., Banerjee, G., Bera, S., Nandi, S., and Nandi, P. (1985). Contagious hysteria in a West Bengal village. American Journal of Psychotherapy, 39, 247–252.

    Google Scholar 

  • Newmann, S., Sarin, P., Kumarasamy, N., Amalraj, E., Rogers, M., Madhivanan, P., Flanigan, T., Cu-Uvin, S., McGarvey, S., Mayer, K., and Solomon, S. (2000). Marriage, monogamy and HIV: A profile of HIV-infected women in south India. International Journal of STD and AIDS, 11, 250–253.

    Google Scholar 

  • Parker, B., McFarlane, J., and Soeken, K. (1994). Abuse during pregnancy: Effects on maternal complications and birth weight in adult and teenage women. Obstetrics and Gynecology, 84, 323–328.

    Google Scholar 

  • Piot, P. (2001). A gendered epidemic: Women and the risks and burdens of HIV. Journal of the American Medical Womens Association, 56, 90–91.

    Google Scholar 

  • Rao, V. (1997). Wife-beating in rural south India: A qualitative and econometric analysis. Social Science and Mediciner 44, 1169–1180.

    Google Scholar 

  • Romkens, R. (1997). Prevalence of wife abuse in the Netherlands: Combining quantitative and qualitative methods in survey research. Journal of Interpersonal Violence, 12, 99–125.

    Google Scholar 

  • Roth, J., Krishnan, S. P., and Bunch, E. (2001). Barriers to condom use: Results from a study in Mumbai (Bombay), India. AIDS Education and Prevention, 13, 65–77.

    Google Scholar 

  • Schei, B., and Bakketeig, L. S. (1989). Gynaecological impact of sexual and physical abuse by spouse. A study of a random sample of Norwegian women. British Journal of Obstetrics and Gynaecology, 96, 1379–1383.

    Google Scholar 

  • Shields, N., and Hanneke, C. (1983). Battered wives' reactions to marital rape. In D. Finkelhor, R. J. Gelles, G. T. Hotaling, and M. A. Staus (Eds.), The dark side of families: Current family violence research (pp. 132–148). Beverly Hills, CA: Sage.

    Google Scholar 

  • Singh, G. (1986). Violence against wives in India. Response to the victimization of women and children, 9, 16–18.

    Google Scholar 

  • Skinner, D., Metcalf, C. A., Seager, J. R., de Swardt, J. S., and Laubscher, J. A. (1991). An evaluation of an education programme on HIV infection using puppetry and street theatre. AIDS Care, 3, 317–329.

    Google Scholar 

  • The Microbicide Initiative. (2002). Mobilization for microbicides. New York: Rockefeller Foundation.

    Google Scholar 

  • UNAIDS. (2001). Global Summary of the HIV/AIDS epidemic—December 2001. Geneva: WHO.

    Google Scholar 

  • Van Der Straten, A., King, R., Grinstead, O., Vitinghoff, E., Serufilira, A., and Allen, S. (1998). Sexual coercion, physical violence and HIV infection among women in steady relationships in Kigali, Rwanda. AIDS and Behavior, 2, 61–73.

    Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (1997). The effects of an abusive primary partner on the condom use and sexual negotiation practices of African-American women. American journal of Public Health, 87, 1016–1018.

    Google Scholar 

  • Wingood, G. M., and DiClemente, R. J. (1998). Rape among African American women: Sexual, psychological, and social correlates predisposing survivors to risk of STD/HIV. Journal of Womens Health, 7, 77–84.

    Google Scholar 

  • Wood, K., Maforah, F., and Jewkes, R. (1998). “He forced me to love him”: Putting violence on adolescent sexual health agendas. Social Science and Medicine 47, 233–242.

    Google Scholar 

  • Worth, D. (1989). Sexual decision-making and AIDS: Why condom promotion among vulnerable women is likely to fail. Studies in Family Planning, 20, 297–307.

    Google Scholar 

  • Zierler, S., and Krieger, N. (1997). Reframing women's risk: Social inequalities and HIV infection. Annual Review of Public Health, 18, 401–436.

    Google Scholar 

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Correspondence to Vivian F. Go.

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Go, V.F., Sethulakshmi, C.J., Bentley, M.E. et al. When HIV-Prevention Messages and Gender Norms Clash: The Impact of Domestic Violence on Women's HIV Risk in Slums of Chennai, India. AIDS Behav 7, 263–272 (2003). https://doi.org/10.1023/A:1025443719490

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