50 Million Women in Asia at risk of Contracting HIV from Intimate Partners

Bali — An estimated 50 million women in Asia, who are either married or in long-term relationships with men who engage in high-risk sexual behaviours, are at risk of becoming infected with HIV from their partners, according to a report published by UNAIDS in partnership with UNIFEM and other agencies. The report, entitled “HIV Transmission in Intimate Partner Relationships in Asia”, was released in Bali on 11 August at the 9th International Congress on AIDS in Asia and the Pacific.

According to the report, men who buy sex constitute the largest infected population group in Asia – and most of them are either married or will get married. “This puts a significant number of women, often perceived as ‘low-risk’ because they o­nly have sex with their husbands or long-term partners, at risk of HIV infection,” UNAIDS stated in a news release.

The agency estimates that more than 90 percent of the 1.7 million women living with HIV in Asia became infected from their husbands or partners while in long-term relationships. By 2008, women constituted 35% of all adult HIV infections in Asia, up from 17% in 1990. In Cambodia, India and Thailand, the largest number of new HIV infections occur among married women.

“HIV prevention programmes focused o­n the female partners of men with high-risk behaviours still have not found a place in national HIV plans and priorities in Asian countries” said Dr. Prasada Rao, Director, UNAIDS Regional Support Team Asia and the Pacific, speaking at the launch of the report.

The report points out that the strong patriarchal culture in Asian countries severely limits a woman’s ability to negotiate sex in intimate partner relationships. While society tolerates extramarital sex and multiple partners for men, women are generally expected to refrain from sex until marriage and remain monogamous afterwards.

“Discrimination and violence against women and girls, endemic to our social fabric, are both the cause and consequence of AIDS,” said Dr. Jean D’Cunha, UNIFEM Regional Programme Director for East and South-East Asia. “Striking at the root of gender inequalities and striving to transform male behaviors are key to effectively addressing the pandemic.”

Research from several Asian countries indicates that between 15% and 65% of women experience physical and/or sexual violence in intimate partner relationships, placing them at increased risk of HIV infection. According to studies in Bangladesh, India and Nepal, women exposed to intimate partner violence from husbands infected with HIV through unprotected sex with multiple partners were seven times more likely to acquire HIV compared to women not exposed to violence and whose husband did not have sex with multiple partners.

The report also indicates that the female partners of migrant workers have been shown to be at increased risk of HIV infection when the latter return from working in countries with high HIV prevalence. A study in Viet Nam showed that married migrant workers reported having commercial sex partners and low condom use.

To prevent HIV transmission among intimate partner relationships, the report outlines four key recommendations:

  • HIV prevention interventions must be scaled-up for men who have sex with men, injecting drug users, and clients of female sex workers and should emphasize the importance of protecting their regular female partners.
  • Structural interventions should be initiated to address the needs of vulnerable women and their male sexual partners. This includes expanding reproductive health programmes to include services for male sexual health.
  • HIV prevention interventions among mobile populations and migrants must be scaled-up and include components to protect intimate partners.
  • Operational research must be conducted to obtain a better understanding of the dynamics of HIV transmission among intimate partners.

“The work that has been started around prevention of HIV transmission in intimate partner relationships is incredibly important because it means a new way of doing our work,” said Vince Crisostomo, Regional Coordinator for the Coalition of Asia Pacific Regional Networks o­n HIV/AIDS. “The ultimate goal is the empowerment of women and it shows that the responsibility is o­n both sides.”