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Violence by lovers, families threatens women who test positive for HIV

A pregnant woman turned to her boyfriend for comfort when she tested positive for the virus that causes AIDS. He said he'd kill her if he were infected.

Another woman, a mother of two, told her boyfriend that she was HIV positive. He beat her, then abandoned her. Without his financial support, she and their two children became homeless.

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A third woman announced to her family that she was infected with HIV. She was doused with Lysol and told to leave home.

These and other stories of cruelty flowed yesterday as more than 100 health and legal professionals discussed domestic violence in the lives of women who have the human immunodeficiency virus. The Baltimore workshop was sponsored by the University of Maryland School of Law.

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"Violence against women is the No. 1 cause of injury against women. HIV is growing fastest among women -- this is a look at two major epidemics among women," said Karen Rothenberg, a UM law professor and a workshop organizer.

Preliminary data from two Baltimore studies indicate that some women who test positive for the virus risk physical abuse by doing what Maryland public-health policy urges them to do -- informing their partners.

Under state law, if a person testing positive for HIV refuses to notify partners, a health worker "may inform the local health officer and/or the individual's sexual and needle-sharing partners" of the person's HIV status.

But the possibility of domestic violence forces health care workers continually to weigh the safety of individual women against public health concerns, Ms. Rothenberg said.

And there is an occasional irony: Sometimes the women are first tested for HIV when seeking prenatal care -- and may have been infected by the men who later threaten them.

In a study by the University of Maryland Law and Health Care Program, 167 health professionals from hospitals, drug treatment centers, community-based organizations and clinics were surveyed.

Twenty-four percent of those questioned said they had patients who were physically abused after disclosing their HIV status; 38 percent had patients who were emotionally abused.

And 37 percent of the respondents said they had patients who were abandoned by their partners after the women disclosed their HIV status.

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Furthermore, more than half the health professionals said they worked with women who were reluctant to disclose their medical condition because of fears of abandonment or of emotional abuse; 45 percent said they have patients who fear physical violence if they disclose their HIV status.

One respondent said a woman patient reported being raped, and another health professional reported seeing a man slap a woman after learning she was HIV-positive. Other women had obscenities scrawled on their furniture.

A second, continuing study, by the Johns Hopkins University School of Hygiene and Public Health, also sheds light on the link between domestic violence and HIV.

A total of 78 HIV-positive women were surveyed, and 58 percent said they had experienced physical abuse, said Andrea Gielen, assistant professor in the department of health policy. Twenty percent of the 78 reported being injured severely enough to require medical care.

The understandable reluctance of many women to disclose their infection contributes to the epidemic, said Joanne Tulonen, director of the Maryland Alliance Against Family Violence. "If anyone thinks that violence has nothing to do with the spread of HIV, they are not thinking," she said.


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