An Argentinian study of recently diagnosed HIV positive women has found that 73% contracted the virus from their long term male partners, discrediting one of the beliefs that infections occur in casual relationships.

Furthermore, it found nearly half of participants to be victims of gender-based violence. The vulnerability of many of the women was accentuated further by a lack of economic resources.

In terms of the women’s experiences within the health system, the study found two key failings, the first being the absence of pre and post test counseling, the second was a the lack of confidentiality surrounding someone’s HIV status.

Leticia, an HIV positive women who took part in the survey, had been married for 11 years and had never been unfaithful to her husband. She, like many of the 465 women surveyed, received the positive diagnosis out of the blue. “To this very day, I sit down and think about it and I still can’t believe it, I was always a very careful woman. I’ve never been with anyone else”, she says.

That just under half of the women in the study (47%) had been victims of violence by a partner at one time or another confirm the hypothesis of the Buenos Aires Network of People Living with HIV-AIDS and the Argentinian Network of Women living with HIV-AIDS – which form part of the research team – that domestic violence is a central aspect of vulnerability to HIV. The study found this vulnerability does not manifest itself in “any one sexual encounter” nor at any given moment in the marriage, but rather in a series of particularly violent moments.

A key conclusion of the study was that the link between violence, sexuality and drug and alcohol use become a theme for future research.

The  study was conducted by Mario Pecheny, working with a team of researchers from Centre for Population Studies (CENEP), National Council of Scientific and Technical Studies (CONICET), the Gino Germani Institute (University of Buenos Aires) and the aforementioned networks of people living with HIV, which carried out all the fieldwork. The National Program for Sexual Health and Family Planning, the Ministry of Health Department of Aids and STDs, UNAIDS, UNFPA, PAHO/WHO, UN Women and UNICEF also took part in the initiative.

The socially vulnerable and economically precarious situation that most women living with HIV have to deal with is evident in the frequency with which their households lack basic foodstuffs. A total of 28% of participants stated that lacking money to buy food was a permanent worry in their household, while 49% said that it was frequently a concern although not all the time. In contrast, only one in four women with HIV live in households which have the resources necessary to cover the family’s food expenses.

The diagnosis

Around one third of the women were tested following a routine medical check-up or after going to the doctor for other health problems unrelated to HIV, while 13% had the test prior to having surgery or because they were being treated in a hospital or health centre. A total of 27% took the test because they knew their partner or someone else with whom they had had sexual relations was HIV positive, while 25% took it out of concern for their own health after having had unprotected sexual relations. A total of 27% of the women interviewed tested positive for HIV during a prenatal check-up and/or at the birth.

It emerged from the study that 57% of the women did not receive any pre-test counseling or advice, while 37.4% received no counseling post-test either. Many interviewees did not receive the diagnosis directly, instead it was given first to family members (mothers, sisters) or to their partners, violating their right to confidentiality: “It hurt me more because they told my mum first, as if that was different from telling me to my face”, said Vanesa, 23, who lives in greater Buenos Aires.

According to the National Ministry of Health Department of AIDS and STDs and UNAIDS, 130,000 people are living with HIV in Argentina today of which 30% are women.

The women interviewed under the study were diagnosed with HIV after the 1 January 2009. They are residents of medium and large sized cities in Argentina and rely on the public health system to attend to their medical needs. A total of 12 male partners of the female interviewees were also interviewed. The fieldwork was carried out between the months of May and July 2011

This research allows us to see in more detail who the women are that are becoming infected today and to think about appropriate policies for treatment and assistance, as well as for prevention.