Even When Criminalization Isn't a Threat, Abusers Still Use HIV as a Tool of Control and Coercion

"You have AIDS." That's what the nurse at the New York City Health Department told Maria Nogueira after she took an HIV test in 1994.

"It was kind of tough because I had no education. I was like, 'Where do I go? What do I do?'" Nogueira remembered wondering. But health department staff offered no counseling to help her navigate her newly learned status. "I felt like I was gonna die." Later, Nogueira learned that she had HIV, not AIDS.

At the time, Nogueira was regularly using crack cocaine. To get money, she sometimes engaged in sex work. That's how she met "Voltron," nicknamed after the 1980s cartoon because, Nogueira explained, "That's how big and tall he was." Voltron was never rough or disrespectful when they interacted, so when he offered to help her, Nogueira had no reason to believe that the offer would turn into a nightmare of captivity and violence.

This was after she had received her diagnosis. "I was in the grips of addiction," she remembered. Not knowing much about HIV -- and having been offered no counseling or services -- she went back to getting high. That was when Voltron made his offer. "Originally, it was, 'You can come home with me; you can shower; I'll take care of you,'" she recalled him telling her. She accepted his offer. The two stayed together in a room in the apartment that he shared with his aunt.

"The first day was like, 'Honey, baby, sweetie, what would you like to eat?' or 'Here, try this on, I bought this for you,'" she recalled. But Voltron would not let her leave the room by herself. If she had to use the bathroom, he would accompany her and stand inside until she was finished. Then he would bring her back to the room.

Related: Resources on the Intersection of Women, HIV and Violence

By the third or fourth day, his demeanor changed when Nogueira asked whether they could go outside. He not only refused to let her leave the room but told her, "Don't ask me again."

On the fifth day, Voltron's aunt knocked on the door to the room, insisting that her nephew allow Nogueira to eat. Instead of letting her leave the room, Voltron brought in a plate of food. That was when she realized that she was trapped.

All together, she spent five-and-a-half months trapped in the apartment. During her imprisonment, she was forced to have sex with Voltron. At times, she pretended not to feel well to avoid having sex, but her captor soon caught on. "I can recall having to have sex just so I wouldn't get beat or have to stay locked up in the room," Nogueira recalled.

His aunt, she later realized, knew what was happening; when Voltron left the apartment, she would unlock the door to the room and allow Nogueira to use the bathroom and, very occasionally, to go outside to the front of the building. Then, she would lock her back in so that her nephew would not know.

Eventually, Voltron began allowing her out of the room. "Once he saw that I was listening to everything he had to say, he would allow me to go to the bathroom alone and sit with him in the kitchen while he made some food," Nogueira explained. But, she continued, "the moment he sensed I was trying to be sneaky, I was slapped and dragged into the bedroom. He then would put his big hand over my mouth so his aunt wouldn't hear me scream and commence to hitting me, choking me, and then forcing me to have sex. He would then want to kiss me and start crying, saying he's sorry and if I wouldn't had tried to be sneaky he wouldn't hit me."

During those five-and-a-half months, she left the apartment only three times, usually to walk to the front of the building and return before Voltron came home.

Several times, Nogueira tried to summon the courage to tell Voltron about her HIV status. But fear kept her from doing so. He was already keeping her hostage and controlling her every move; what would he do if she told him?

A combination of fears also kept her from fleeing. She was afraid that if she ventured even around the corner, she would give into the temptation to start using again. She was also afraid that Voltron would find out and then there would be hell to pay.

Those fears came true. The last time that Voltron's aunt allowed her to go outside, Nogueira went around the corner and got high. But he soon found her. "He started beating me up like I was a man, kicking me with his steel-toed boots," she recalled. He began to reach inside his vest -- for what, Nogueira still does not know, though she was sure it was a gun. But at that moment, another person clattered down the stairs, screaming: "What are you doing? Get away from her! Leave her alone!" The shouting and attention scared him away.

That was not the last time she encountered him and feared for her life. Voltron showed up at her parents' house. When they called the police, they were told that, if the police responded, they would need to arrest both parties. Only when Nogueira's brother physically confronted him did Voltron stop coming to her parents' house.

But she wasn't free of him altogether. That winter, her parents and brother went to Puerto Rico. Nogueira was hospitalized with bacterial pneumonia, the flu, and a kidney infection. She had planned to go to her sister's house when she got out of the hospital. Instead, even though a snowstorm was starting, she went to Harlem and bought drugs. Then she ran into Voltron.

"I don't know how he found me," she said. At first, she didn't even recognize him through the snow that was beating down on them. He, however, recognized her.

"I told you, if I can't have you, nobody can have you," she recalled him saying. His next words were chilling: "What the fuck is the use? I should just kill you."

The actions that followed confirmed his intentions. "He lifted me above his head -- keep in mind that he's six foot six -- and dropped me on the concrete." He began beating her until the sound of police sirens scared him away. Nogueira managed to get up and call her sister. Afraid that Voltron was still nearby and not wanting him to learn where her sister lived, she staggered to the emergency room.

While Nogueira's story might seem like an extreme example, women living with HIV are nearly twice as likely to experience intimate partner violence than women living without HIV. One reason? The continuing shame and stigma of being HIV positive, a stigma that is often exploited by abusive partners seeking to maintain control.

That was the case for Teresa Sullivan, who spent 12 years in a relationship that was abusive. During that time, she faced the triple stigma of being a woman of color, being HIV positive, and being in an abusive relationship. It was a combined stigma that her partner took full advantage of, often telling her: "No one's going to love you. You're HIV positive."

"I started believing those things," she said. She internalized these stigmas so much that, when her doctor asked why her partner always accompanied her on medical visits, she simply made excuses.

Finally, Sullivan had enough. "The biggest mistake I ever made was to tell him I was leaving," she recalled. "I just blurted it out."

Leaving is often the most dangerous time in an abusive relationship. Fearing a loss of power and control, an abusive partner may increase the violence to ensure that their partner cannot leave. Nearly 75% of women killed by abusive partners or ex-partners were killed after trying to end -- or ending -- the relationship.

In Sullivan's case, when her partner grabbed a knife, it wasn't to kill her. Instead, he slashed his own arm, then picked up the phone and called 911. He told the dispatcher that Sullivan had cut him with a knife. When the police arrived, he told them that she had tried to kill him. Sullivan was arrested and spent five months in jail. While she was in jail, she received a visit -- and an offer -- from him. He said that, if she came home, he would drop the charges. She refused, choosing to stay in jail instead.

Sullivan now knows that isolation is a common tactic used by abusive partners. "They isolate you from family, friends, any possible support," she pointed out in a recent webinar about HIV and domestic violence. Ironically, it was in jail that she broke through that isolation, joining a support group of other domestic violence survivors. Having that support enabled her to make that decision and take her chances in court. "That [support group] had helped me grow strong in my conviction I would never go back with him," she reflected years later. "I received support, and for the first time in years, I felt alive, despite being in jail."

Her advice to others in abusive relationships? "Don't tell him you're leaving. Make a plan with others."

She also has tried-and-true words of advice for people whose loved ones are embroiled in abusive relationships. Acknowledging that it can be painful to watch a loved one be controlled, coerced, and abused, she cautioned: "We can't make the decision for them. We can give them the tools for when they're ready to leave."

Furthermore, she noted that "abusers isolate people from family, friends, any possible support." Breaking through that isolation and reminding the survivor that others care about them is important. "If you haven't seen me in a while, come check up on me," she recommended. "Come by and say, 'Hi.' Make sure I'm OK."

With everything that she's been through, Nogueira is grateful that she lives in New York, which has no HIV-specific criminalization statutes. Had she been trapped and coerced into sex in another state, she could have been facing jail time for HIV non-disclosure. It could also have been another weapon used by Voltron to control and coerce her.