In late September, I presented with Connect-to-Protect (C2P)—a coalition aimed at creating structural change to reduce vulnerability to HIV among sexual minority men and trans women—at a training aimed at teaching people from HIV and domestic violence service organizations about the intersections between HIV and intimate partner violence (IPV—a more current and broad term for domestic violence).
Both HIV and IPV are issues that are not discussed together very often in the world of health. Unfortunately, many times when they are discussed, stereotyping of people living with HIV and victims of IPV often occurs. Yet the truth is that both HIV and IPV can occur in anyone’s life. However, what are often overlooked are the social determinants that cause different populations to be disproportionately burdened by these issues.
Related to HIV, social determinants such as one’s educational level, level of income, job security, access to food, health services, and housing all can influence an individual’s risk for HIV. More so, people living with HIV are often highly stigmatized due to their sero-status, and thus face even worse social situations. This can lead to a high level of continual stress that has consequences for poor physical and mental health outcomes.
Unfortunately, less is known about social determinants that worsen the burden of IPV. This is mostly due to the fact that IPV is de-prioritized in policy and its relationship to HIV is very under-researched. What we do know is that while most of our knowledge regarding IPV is about the high prevalence of women of marginalized identities and backgrounds as victims, there are other communities that are potentially being overlooked in the discussion as victims. IPV, like HIV, is a highly stigmatized issue—and the vulnerabilities they both create overlap and interact a great deal.
Valentina Djelaj, the coordinator for C2P, illustrates this intersection, by pointing out that “research suggests a synergistic relationship between these two public health issues. Amongst other linkages, research shows that IPV is both a risk and consequence of HIV infection.”
Yet despite this known link, little has been implemented socially or clinically to work against this intersecting risk. Why is this? As with many complex social issues, there are multiple road-blocks at work here. As Djelaj states:
The intersections of the human immunodeficiency virus (HIV) and intimate partner violence (IPV) are rarely discussed at great length within our communities… Although many service workers may acknowledge that this intersection exists; social action around these issues is not always clearly defined. In addition, there are not many resources readily available to community based organizations regarding either topic, let alone resources on the intersection of HIV and IPV. There is also much stigma around both HIV and IPV; therefore, we (as service providers) are forced to work in siloes, rather than coordinating our efforts as one supportive community.
However, just because there is not much collaborative work between people dealing with HIV and IPV to date, does not mean the interest is not there. At C2P’s training, workers from both camps expressed enthusiasm about addressing the intersection between HIV and IPV, and provide ideas for what we, as the Southeast Michigan community, can do.
One of the specific future directions that were brought up was integrating IPV into the discussion of HIV risk factors. As seen in our presentation, there are many HIV risk factors listed by researchers and demographers—included men having sex with men, intravenous drug use, and heterosexual contact with men or women—yet IPV is not one of them. Including IPV in our framework of risk factors could help raise awareness, and tailor specific interventions to those at risk. Of course, on a larger scale, this requires more research on IPV in general, to find out its prevalence among different populations and learn the nuanced ways in which IPV affects HIV risk and how living with HIV affects one’s risk for IPV.
To catalyze these future directions, Djelaj hopes the next step will be “to assemble a group of community members to begin a dialogue around HIV and IPV that is specific to Southeast Michigan. This work will require support from the many AIDS Service Organizations and Domestic Violence Organizations throughout Southeast Michigan as well as the support from various other community-based organizations and individual community members.”
So what can we do, as individuals in different communities? We can educate ourselves about both IPV and HIV, and their intersections. We can attend to survivors of IPV from different backgrounds, and gain their input for what should be researched, what should be provided, and what should be addressed. We can discuss. We can listen.
The Hollywood Homeless Youth Partnership provides a guide for service providers to work with IPV in runaway and homeless youth.
The Children’s Hospital, Los Angeles, and the Center for Strengthening Youth Prevention Paradigms developed a guide for young gay, bi, and queer men to recognize health relationships versus IPV and abuse.
The Global Coalition on Women and AIDS provides an overview of the evidence and consequences of the intersections between IPV and HIV/AIDS.
The SafeHouse Center works to provide safety, support, advocacy and resources for survivors of sexual assault and IPV and their children, with a focus on Washtenaw County, and a commitment to helping individuals from a diverse range of backgrounds and identities.
Turning Point works to develop and promote programs that address the root causes of violence, with a goal of ending violence as a form of oppression and control, and of enabling people to assume control of their own lives.
The Batterer Intervention Services Coalition of Michigan works to create and maintain community coalitions that act to hold batterers accountable for their behavior, and promote safety and empowerment for victims of IPV.
The Challenging Male Supremacy Project seeks to intervene on activist communities in New York to shift practices of cisgender men and form allies in feminist, queer, and trans justice movements.
Tags: Intimate Partner Violence, HIV, health disparities, stigma, sexual violence, presentations, Michigan