Women from key populations are especially vulnerable to intimate partner violence and the increased risk of HIV associated with it.
This is more likely to expose young women to unsafe sexual behaviours, low condom use and an increased risk of sexually transmitted infections.47 The risk of trafficking and sexual exploitation is also higher for young women and adolescent girls living in poverty.48 Poverty also increases the risk of child marriage.
Worldwide, girls belonging to the poorest 25% are 2.5 times more likely to be married as children compared with girls in the richest 25%.49 Women and girls also experience heightened vulnerability to HIV in conflicts, emergencies and post-conflict periods. In other cases, adolescent girls are abducted and used for sexual purposes by armed groups.50 For example, a survey of internally-displaced families living in three camps in Sierra Leone found that 9% of female respondents reported having been victims and survivors of sexual violence related to the war.51 There are a number of international commitments which recognise that tackling gender inequality is vital to ending the global HIV epidemic and achieving wider development outcomes.
For example, more than 80% of married 15 to 19 year-old women in Senegal, Niger, Burkina Faso, Côte d'Ivoire and Cameroon do not have the final say on their own healthcare.7 These inequalities are more severe for marginalised women, including female sex workers, transgender women, women who inject drugs, migrant women and women with disabilities who are also at a heightened risk of discrimination and violence.8 HIV disproportionately affects women and adolescent girls because of their unequal cultural, social and economic status in society.
This means that gender inequality must be tackled in order to end the global HIV epidemic, and achieve other, broader development outcomes.9 Intimate partner violence, inequitable laws and harmful traditional practices reinforce unequal power dynamics between men and women.
The third section of the publication contains essays from key thinkers who have championed the `social harm' perspective as a preferable alternative to traditional notions of `crime'.
Section four examines questions of policing communities while the essays in section five considers the ways in which the actions of young people are currently regulated.
The second section, `Violence against women' explores issues of male violence and attitudes to prostitution.
For her essay in this section, Maddy Coy of London Metropolitan University interviewed men who had paid for sex with women.
These dynamics limit women’s choices, opportunities and access to information, health and social services, education and employment.
For example, in 29 countries women require the consent of a spouse/partner to access sexual and reproductive health (SRH) services.10 and 75% of women aged 15 to19 do not have a final say in decisions about their own health.11 Gender assessments of national HIV epidemics and responses carried out in Burundi, Burkina Faso, Cameroon, Chad, DRC, Gabon, Nigeria and Senegal in 2016 found women and girls were vulnerable to HIV — in part due to laws and policies that maintain traditional gender roles — and that women in key populations had limited access to services.12 In many places, discriminatory social and cultural norms are translated into laws which repress the autonomy of young women as demonstrated by the fact that 75% of women aged 15 to 19 do not have a final say in decisions about their own health.13In 146 countries, laws allow girls under 18 to marry with the consent of their parents, while in 52 countries, the same applies to girls under 15.14 Stigma and discrimination further exacerbate women’s vulnerability to HIV and undermine the response to the epidemic.15 In particular, women in key populations face numerous and specific challenges and barriers, including violence and violations of their human rights, in health care settings and from uniformed personnel.16 Although the prevalence of intimate partner violence among married or partnered women decreased between 20 17, it remains high across the world – affecting one in three woman globally18 – and is particularly common in certain regions.19 The fear of intimate partner violence has been shown to be an important barrier to the uptake of HIV testing and counselling, to the disclosure of HIV-positive status, and to treatment uptake and adherence, including among pregnant women who are receiving antiretroviral treatment (ART) as part of services to prevent mother-to-child transmission (PMTCT).20 In places with high HIV prevalence, women who experience intimate partner violence are 50% more likely to acquire HIV than women who do not.21 It can also disrupt HIV prevention services.