Women living with HIV in Ukraine Face Increased Risk of Gender-based Violence and Stigma

25 February 2018

Ukraine has one of the fastest growing HIV epidemics in Eastern Europe and Central Asia, with approximately 240,000 people living with the virus and a prevalence of 0.9 percent in the general adult population. In Ukraine, 35 percent of women living with HIV have experienced violence from a partner or husband since the age of 15, compared to 19 percent of women who do not have HIV, according to a November 2016 survey by Positive Women, a Ukrainian NGO.

Approximately half of the 1,000 HIV-positive women surveyed across the country had no support after they suffered violence. "There is an epidemic of gender-based violence in many regions of the world, disproportionately affecting women and girls, making them more vulnerable to becoming infected with HIV," Vinay P. Saldanha, UNAIDS regional director for Eastern Europe and Central Asia, tells Al Jazeera.

According to UN Women, women living with HIV are more likely to experience violence, including violations of their sexual and reproductive rights. "Involuntary and coerced sterilisation and forced abortion among women living with HIV has been reported in at least 14 countries worldwide," UN Women reports.

Women are also often the first in a couple to learn of HIV in the family as the coverage of HIV testing and treatment in Ukraine is higher among women. Most women are tested for HIV at least once at gynaecology and obstetrics clinics. "It can tragically unfold that her husband or sexual partner points the finger of blame at her, even if her male partner was the one to infect her with HIV. In such a situation, she is at potential risk of domestic and sexual violence."

The consequences can be life-threatening. "As a result, a woman's de-facto response can be to refrain from telling her family or partner that she has HIV, and she might even be too afraid to seek out the life-saving health services available," says Saldanha. And even if a woman does want treatment, it is not always guaranteed. In some cases, women are unable to access medical support because their partners refuse to pay for travel to the hospital. In small towns and the provinces, the situation is particularly difficult. It can be impossible for a HIV-positive woman to find a gynaecologist who will voluntarily examine or simply look at her.

"'You can get treatment, just not with my money,' is what they say. But when a woman is financially dependent, what can she do?," says Sofia, an HIV-positive officer working for the All-Ukrainian Network of People Living with HIV/AIDS, the country's largest patient organisation. The situation became so precarious that in May 2017, the Positive Women NGO filed a joint report to the United Nations on the violations of women's rights, along with other civil society organisations representing drug-users, sex workers and members of the LGBT community.

"In small towns and the provinces, the situation is particularly difficult. It can be impossible for an HIV-positive woman to find a gynaecologist who will voluntarily examine or simply look at her," says a member of Positive Women, who wished to remain anonymous. "It's only on the orders of high authorities that doctors will agree to an examination. And these are cases involving 'safe' women." If a woman is considered "unsafe" - an alcoholic, drug-user or sex worker - she cannot even enter a doctor's office. A community's attitude to HIV can be so unsupportive that patients are often harassed or forced out."Doctor's attitudes are not much better," says the Positive Women member.

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