Spotlight: HIV in the Lives of Women as Criminals and Women as Victims
A cycle of violence and crime exists in the lives of women who are victims of domestic abuse. A September 2000 report from the 1999 National Institute of Justice (NIJ) Conference on Criminal Justice Research and Evaluation states that "women who are most marginalized by society are vulnerable to both [violence and illegal activity]."(1) Vulnerability to violence and illegal activity often leads to behaviors that put women at risk for HIV infection. According to the Kaiser Family Foundation (KFF), the proportion of women in new AIDS cases has been rising rapidly over the past 15 years. In 1986, 7% of AIDS cases were women, whereas the most recent data shows that proportion has more than tripled: 23% of 1999 AIDS cases were women (see Figure 1).(2) The 2000 NIJ report and the 2001 KFF report provide the numbers that describe an increase in violence, incarceration, and HIV infection among women in the United States.
The proportion of AIDS cases that occur among women is steadily increasing, and has more than tripled since 1986.(2) This table was taken from the Kaiser Family Foundation Report on Women and HIV/AIDS, May 2001.
Violence Against Women Is WidespreadAccording to the NIJ, one million women are victims of violence committed by an intimate each year. Some studies have found the rate to be higher: the National Violence Against Women (NAVW) survey found that 1.5 million women reported being victimized, and 7-22% of all women have experienced domestic assault. Another study found that one in three women report physical attack within her lifetime. Hospital data has revealed that 37% of women who sought emergency hospital care in 1994 were victims of domestic abuse.
Emotional abuse, as well as physical abuse, has a major impact on the health of women. The NIJ report states that "Battered women are four to five times more likely to require psychiatric treatment and five times more likely to attempt suicide than non-battered women." Many rape victims do not seek help from state or private support systems due to fear, stigma, or other emotional or physical obstacles. One study found that 84% of rape victims did not report the rape to the police.(1) Inability to access support systems, lack of trust in law enforcement agencies, fear, stigma, and other emotional or physical obstacles may explain why many women do not report to state or private support systems. These obstacles not only keep women from getting help after a violent incident, they may put women at risk for further exposure to violence.
Incarceration of Women Is Increasing Faster than Incarceration of MenApproximately 138,000 women are in prisons and jails in the US, which is more than triple the 1985 women inmate population.(3) The prison population of women grew more than 10% annually since 1990 in some states, compared to 6.4% for men (see Figure 2).
Figure 2. Women and Men As Percentage of Jail Inmates(3)
HIV/AIDS Among WomenWomen constitute one quarter of Americans living with HIV (200,000-225,000), and one fifth of Americans living with advanced AIDS. While important treatment and prevention advances have been made for HIV/AIDS, women do not appear to have benefited at the same rate as men. According to the KFF report, new AIDS cases among men fell by 60% during the 1990s, while new AIDS cases fell only 36% for women.(2) Furthermore, HIV/AIDS has a higher impact on women of color. The latest data shows that 49 per 100,000 AIDS cases in women are African American, which is more than 21 times greater than the rate among White women (2.3 per 100,000). The case rate among Latinas is more than six times the rate for white women (14.9 per 100,000).
People of color are also more likely to be incarcerated than White people. According to the Bureau of Justice Statistics, 16.2% of Blacks and 9.4% of Hispanics are likely to be incarcerated at some point in their lifetime, versus 2.3% of Whites.(4)
Catch 22: Risking Incarceration and HIV InfectionIncarcerated women typically have a history of unmet social, education, health and economic needs, in addition to a history of victimization. Thus it comes as no surprise that the primary causes of incarceration among women are for nonviolent offenses; violating laws that prohibit the sale and possession of specific drugs. Drug sales and other nonviolent crimes are "'survival crimes' that women commit to earn money, feed a drug-dependent habit, provide for their children, or escape terrifying intimate relationships and brutal social conditions."(1)
Women who have experienced violence are more likely to engage in risk behaviors that can lead to incarceration as well as HIV infection. The NIJ reported on a study that found that women who have been raped are 10 times more likely to use illegal substances or alcohol. Furthermore, women who are involved in illegal activity, who are in a precarious legal status, or who are socially marginalized, may be less likely to call the police or other agencies when they have experienced a violent episode for fear that they might be caught. Thus these women are in a double-bind; for fear of being caught for a legal violation, they cannot report violent episodes. By not reporting violent episodes, they put themselves at greater risk for further abuse and even HIV infection. Proving this point, a 1996 survey found that at least half of all female prisoners have experienced some form of sexual abuse before their imprisonment.
Sex work is another major cause of arrest among women, and also may be linked to a history of abuse. According to the NIJ report, 90% of sexworkers have been abused by a member of the family, and 70% have been sexually abused between the ages of 3 and 14. One study found that of 130 prostitutes, 68% had been repeatedly raped. NIJ report author Judge Kay Senin states that many of these women never received the valuable life-skills training that a healthful family environment provides. ". . .These girls see violence and sexual exploitation as the norm. They have never known responsible, respectful, and caring adults and peers; they have never learned how to form durable relationships based on mutual support and affection."
Note: The authors of the report recommend more research be conducted, and suggest that current research and intervention programs adjust to incorporate the impact and prevalence of violence in the lives of the women with whom they work.
This article was provided by Brown Medical School. It is a part of the publication HEPP News.