One in three women worldwide has been beaten, coerced into sex, or otherwise abused at least once in her lifetime. And women who have experienced gender-based violence (GBV) can face up to three times greater risk for HIV compared to those who have not, according to UNAIDS. GBV is common, affecting both women and men. Children and key populations are also at high risk, and often don’t have access to the resources they need.
To address GBV as an underlying factor in the global HIV epidemic, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Gender and Adolescent Girls Technical Working Group launched the three-year, $55 million Gender-Based Violence Initiative (GBVI) in 2011 in three countries with high prevalence of both GBV and HIV: Democratic Republic of Congo (DRC), Mozambique, and Tanzania. The GBVI’s purpose was to demonstrate the feasibility of integrating GBV prevention and response into the existing PEPFAR platform and to understand the best approaches for achieving this integration in clinical and community settings.
On May 10, 2016, over 100 participants from PEPFAR, the three GBVI countries, and partner organizations convened at the Center for Strategic and International Studies to share lessons learned from the initiative. The meeting was organized by the Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project.
Jennifer Adams of the U.S. Agency for International Development emphasized the direct links between GBV and HIV and discussed how this linkage also affects men and boys: social expectations can encourage risky sexual behavior and violence against women. “I think we all know people who fall into the categories that we’re talking about today… Today is an opportunity to take that concern and commitment and use that with the information to think forward.”
Jen Casto of EnCompass LLC/AIDSFree, discussed the overall findings of the GBVI, which are summarized in AIDSFree’s collection, Lessons from the Gender-Based Violence Initiative. The GBVI reached over 1.3 million individuals with GBV services and interventions over the three-year initiative. The GBVI also created GBV and HIV service entry points across communities where no such access existed and demonstrated the need to engage a broad range of community stakeholders.
While the GBVI was implemented through different approaches in each country, its overall effect was to identify practical ways to address the issue through relevant tools, training packages, and guidelines and by defining roles among stakeholders. In DRC, the GBV catalyzed change in at least three ways, according to Elizabeth Rowley of PATH/AIDSFree. It demystified critical GBV and HIV linkages in practice and integrated GBV into HIV programs; institutionalized changes in service delivery; and leveraged the reach of other PEPFAR partners to expand the GBVI’s impact. As one implementing partner said, “One of the biggest contributions of the GBVI was to show that this work is possible—something can be done about GBV.”