HIV This Week

Fawole OI. Economic Violence to Women and Girls: Is It Receiving the Necessary Attention? Trauma Violence Abuse. 2008;9(3):167-77

Most studies on gender-based violence (GBV) have focused on its physical, sexual, and psychological manifestations. This paper seeks to draw attention to the types of economic violence experienced by women, and describes its consequences on health and development. Economic violence experienced included limited access to funds and credit; controlling access to health care, employment, education, including agricultural resources; excluding from financial decision making; and discriminatory traditional laws on inheritance, property rights, and use of communal land. At work women experienced receiving unequal remuneration for work done equal in value to the men’s, were overworked and underpaid, and used for unpaid work outside the contractual agreement. Some experienced fraud and theft from some men, illegal confiscation of goods for sale, and unlawful closing down of worksites. At home, some were barred from working by partners, while other men totally abandoned family maintenance to the women. Unfortunately, economic violence results in deepening poverty and compromises educational attainment and developmental opportunities for women. It leads to physical violence, promotes sexual exploitation and the risk of contracting HIV infection, maternal morbidity and mortality, and trafficking of women and girls. Economic abuse may continue even after the woman has left the abusive relationship. There is need for further large-scale studies on economic violence to women. Multi-strategy interventions that promote equity between women and men, provide economic opportunities for women, inform them of their rights, reach out to men and change societal beliefs and attitudes that permit exploitative behaviour are urgently required.

Editors’ note: Fighting economic violence is in everyone’s best interest. Nothing less than societal transformation is required. Strategies include undertaking diplomatic and political actions, mounting boycotts, initiating lawsuits, raising public awareness, educating boys and girls that economic violence is unacceptable, attracting media attention, enacting laws that prohibit economic violence against women, and monitoring national plans of action on equality for women. Economic violence increases the risk of HIV acquisition and transmission. Economic violence is predictable and, with political commitment and societal change, it is preventable.

Despite sensitising and prevention messages, women still remain concerned about HIV in developing countries. How do they perceive the illness and methods of prevention? The objective of this study was to assess the social diagnosis of HIV infection and AIDS illness, and endogenous strategies developed by women from Gaoua. A qualitative approach was adopted, involving four focus group discussions with women from the Lobi, Birifor, Dioula and Dagara ethnic groups. An interview guide was developed for the discussions, which were carried out in local languages, tape recorded, transcribed verbatim and analysed in detail. Specific descriptions of signs/symptoms of HIV infection and HIV-related illness were given. These were: Kpéré tchi (lose weight and die) gbè yirè (twig feet) sii dan (end of life) gbè milè (thin feet), respectively for Lobi, Birifor, Dioula and Dagara. The major signs of AIDS mentioned were weight loss, appetite for meat, good meals, curly hair, large spots on the body, high fever, diarrhoea, and redness of lips. In relation to these signs, some endogenous strategies were developed by women to protect themselves against the illness, including « observation » and hot spiced meals for a few days for a partner who was absent for a long time, as well as early marriage for young girls. The social diagnosis of HIV infection and AIDS illness by a specific group like women demonstrates the gap between perceptions of the illness and prevention messages. This could help to understand that it is important to take account of communities’ perceptions of illness in elaboration of prevention messages.

Editors’ note: In this culture, signs of immune system compromise such as wasting, Kaposi sarcoma, and oral candidiasis may be correctly perceived as indicating possible HIV infection, but curly hair and enjoying good meals, particularly those with meat, may lead women to falsely believe you are living with HIV. Unable to propose condom use, pejoratively called a ‘penis sack’, when their husbands return from voyages these married women rely on a home-grown HIV prevention technique of avoiding sex while feeding their husbands highly spiced food for several days to see if it provokes diarrhoea. The first strategy likely will not work for long and the second may produce lots of false positive results. Community HIV prevention conversations have to start with beliefs and involve men if they are to lead to exploration of real options for change.