What Works for Women and Girls

Gap noted, for example, in Lao People’s Democratic Republic (Songbandith et al., 2008);South Africa (Kelvin et al., 2008, Ngema et al., 2008, Harrison, 2008); India (Seth etal., 2008); Chile (Cianelli et al., 2008); Papua New Guinea (Dover and Levy, 2008);China (Zhou, 2008); Latin America (Parodi and Lyra, 2008); and Zimbabwe (Feldmanand Masophere, 2003).2. Programs to transform gender norms should address homophobia as part of the definitionof masculinity. [See Chapter 3B. Prevention for Women: Partner Reduction]11B. Strengthening the Enabling Environment:Addressing Violence Against WomenViolence, in addition to being a human rights violation, has been clearly demonstrated as arisk factor for HIV (Stephenson, 2007; Jewkes et al., 2006a; Manfrin-Ledet and Porche, 2003;Dunkle et al., 2004; Quigley et al., 2000b; Silverman et al., 2008). Analysis of DHS data inRwanda showed that women with few, if any, sexual riskfactors for HIV but who have experienced sexual, physical“Men never allow usto use condoms. If we suggestthey beat us.”—Ugandan woman(Karamagi et al., 2006: 7)or emotional abuse within their marriages were between1.61 and 3.46 times more likely to test HIV-positive (Dude,2009).Acts that would be punished if directed at an employer,a neighbor, or an acquaintance often go unchallenged whenmen direct them at women, especially within the family(Heise et al., 2002: S5). Violence against women (VAW),is a more specific form of the category of Gender-BasedViolence (GBV), and is considered acceptable behavior inmany countries (Andersson et al., 2008). Women are “blamed” for bringing HIV into thefamily; women are kicked out of their homes and denied property, leading to further vulnerabilityto infection.Violence Against Women Is WidespreadA report that analyzed DHS Surveys in Bangladesh, Bolivia, the Dominican Republic, Haiti,Kenya, Malawi, Moldova, Rwanda, Zambia and Zimbabwe found that women experienced awide variation across countries in the prevalence of physical or sexual violence by their currenthusband or partner, from 16% in the Dominican Republic to 75% in Bangladesh (USAID,2008a). Inequitable gender norms may be related to increased violence: in five of the 10 countriesstudied (listed above), women who believe that wife beating is justified were more likelyto report experiencing physical or sexual violence (USAID, 2008a). A study between 2000 and2003 with 24,097 women ages 15 to 49 in Bangladesh, Brazil, Ethiopia, Japan, Namibia, Peru,298 CHAPTER 11 STRENGTHENING THE ENABLING ENVIRONMENT