Addis Ababa University School of Graduate Studies Institute of Gender Studies The Interface between Violence against Women and HIV/AIDS The Experiences of HIV Positive Women Beneficiaries of the Society for Women and AIDS in Africa -Ethiopia in Kebeles 03/09 and 04/05, Arada Sub-city, Addis Ababa By: Hanna Tegegn A Thesis Submitted to the Institute of Gender Studies in Partial Fulfillment of the Requirements for the Degree of Master of Arts in Gender Studies May, 2007 Addis Ababa Addis Ababa University School of Graduate Studies The Interface between Violence against Women and HIV/AIDS The Experiences of HIV Positive Women Beneficiaries of the Society for Women and AIDS in Africa -Ethiopia in Kebeles 03/09 and 04/05, Arada Sub-city, Addis Ababa By: Hanna Tegegn INSTITUTE OF GENDER STUDIES APPROVAL BY BOARD OF EXAMINERS W/o Tizita Mulugeta Chairperson Signature Date Dr. Hirut Terefe __________________ Advisor Signature Date __Dr. Elaine P. Rocha __ ______ _______________ Internal Examiner Signature Date Professor Habtamu Wondimu External Examiner Signature Date Acknowledgements I lack space to list all people who have directly and indirectly contributed to the work of this research. First and foremost, I would like to thank my advisor, Dr Hirut Terefe, who did not hesitate to take me as her advisee despite her overburdened schedule. I am grateful for her valuable advice, support and encouragement. I would also like to thank Dr Elaine Rocha, for reading and commenting on the draft thesis. I am grateful to Professor Habtamu Wondimu for taking his time to read the draft thesis and for his constructive comments. Special thanks to my office colleagues Almaz Assefa, Zewdu Ayene and Kedir Ahmed for stepping up for me during my studies. Thanks to my classmates especially my friends Almaz Zeleke, Yelfigne Abegaz and Etenesh Melese for sharing ideas and valuable comments and materials. I am grateful to my colleagues at Addis Ababa University Libraries, Institute of Development Research Library, Institute of Ethiopian Studies Library and Institute of Gender Studies Library for their assistance and W/o Yerusalem Ashenafi, Director of the Information Resource Center of the US Embassy, who cheerfully provided me with needed materials. I would like to thank the staff of the Society for Women and AIDS in Africa-Ethiopia (SWAA-E), especially W/o Bossena Kassa, W/o Blen Mekonnen and W/o Tsehay Semu whose support and cooperation facilitated my access to research participants. I would like to express my deepest appreciation to the management of Addis Ababa University for sponsoring me. I also acknowledge the financial support of Addis Ababa University for this research. I wish to acknowledge my special indebtedness to the women participants in the study, particularly the five women whose real name is withheld for anonymity, for confiding in me their innermost secrets, feelings and anguished lives. I hope such sacrifices these women paid will contribute for the betterment of oppressed women. THANK YOU ALL!! Last but not least, my special thanks goes to my husband, Girma Makonnen and my beloved children Tsedey and Mikyas for their encouragement, support and being there for me when I needed them most. Above all, I thank God for his kindness. Dedication This thesis is dedicated to my husband, Girma Makonnen, an educator, a librarian and most of all a kind, patient, caring and sensitive person who unfailingly believes in me. TABLE OF CONTENTS Pages Acknowledgements i Dedication ii List of Tables v Glossary vi List of Acronyms vi i Abstract vi ii Chapter I 1.1. Introduction ................................................................................................ 1 1.2. Statement of the Problem ........................................................................... 4 1.3. Objectives of the Research............................................................................. 6 1.3.1. General Objective.................................................................................... 6 1.3.2. Specific Objectives.................................................................................. 6 1.4. Research Design and Methodology................................................................ 6 1.4.1. Data Collection Instruments ………………………………...………… 8 1.4.1.1. In-Depth Interviews………………………………...………….. 8 1.4.1.2. Observation ………………………………….….….……….… 9 1.4.1.3. Focus Group Discussions ………………….……….………… 9 1.4.1.4. Survey ……………………………………….……….……….. 10 1.4.2. Data Analysis .................................................................................... 10 1.4.3. Method of Entry .................................................................................. 11 1.4.4. Ethical Consideration ........................................................................... 11 1.5. Significance of the Study............................................................................. 1 2 1.6. Limitations of the Study............................................................................... 1 3 1.7. Research Setting........................................................................................... 1 3 1.7.1. Society for Women and AIDS in Africa-Ethiopia (SWAA-E) ...... ........13 1.7.2. Arada Sub-City .......... .......... .......... .......... .......... .......... .......... .......... 14 1.8. Fieldwork ............... ............... .......... .......... .......... .......... .......... .......... ....... 17 Chapter II 2.1. Review of Related Literature and Theoretical Background ……………….. 19 2.1.1. Gender Based Violence........................................................................... 19 2.1.2. The Feminization of HIV/AIDS ……………………………………… 25 2.1.3. The Intersection of Violence against Women and HIV/AIDS………… 29 Pages 2.1.4. Poverty, Violence against Women and HIV/AIDS…………………… 31 2.1.5. The Social Construction of Sexuality………………………………… 35 2.2. Theoretical Background................................................................................. 39 2.2.1. Feminist Perspectives on Violence against Women.............................. 40 2.2.2. Feminist Perspectives on HIV/AIDS....................................................... 42 Chapter III 3. Findings and Discussion....................................................................................... 43 3.1. Socio Economic Background of Survey Participants................................... 43 3.1.1. Socio Economic Background of HIV-Positive Participants................... 43 3.1.2. Socio Economic Background of Kebele 03/09 and 04/05 Participants 47 3.2. What Can a Woman Do? Women’s Experiences of Sexual Violence........... .....48 3.3. Life with HIV/AIDS........... ........... ... ........... ........... ................... ........... ...... 54 3.3.1. Coming to the Experience of AIDS........... ........... ........... .................... 54 3.3.2. Reaction to HIV-Positive Diagnosis............ ........................................ 56 3.3.3. Disclosure of HIV-Positive Status ....................................................... 57 3.3.4. Effect of HIV on Daily Lives: HIV/AIDS Related Stigma and Discrimination....................................................... ..................... 59 3.3.5. Women’s Experiences of HIV/AIDS Stigma and Discrimination......... 61 3.3.6. Coping with Life with the Virus.................................................. .......... 62 Chapter IV 4. Lived Experience of Sexual Violence and HIV/AIDS: Cases of Five Women....... 6 4 4.1. Case One........................................................................................................... 6 5 4.2. Case Two......................................... .......... .......... .......... .......... .......... .......... 6 7 4.3. Case Three............... ............... ................................................ .......... .......... 6 9 4.4. Case Four ……................ ............... .......... .......... .......... .......... .......... .......... 7 4 4.5. Case Five............... ............... .......... .......... ..................... .......... .......... ......... 7 9 5. SUMMARY AND CONCLUSION 8 5 6. RECOMMENDATIONS 8 9 7. REFERENCES 9 2 ANNEX Annex 1: Map of Addis Ababa Annex 2: Sample Crime Recording Sheet Format of Arada Sub-City Police LIST OF TABLES Pages Table 3.1: Socio-Economic Background of HIV-Positive Participants 45 Table 3.2: Living Condition of HIV-Positive Participants 46 Table 3.3: Socio-Economic Background of Participants from Kebeles 03/09 and 04/05 47 Table 3.4: Kebele Residents’ Attitudes towards Women Who Encountered Sexual Violence 52 Table 3.5: Kebele Residents’ Opinions on Institutional Responses to Sexual Violence 53 Table 3.6: Reasons Given for Taking the HIV/AIDS Test 56 Table 3.7: Disclosure of HIV Status of HIV-Positive Respondents 58 Glossary Arekie Locally prepared distilled alcoholic drink Chat Leaves of the plant Cathea edulis that are grown locally and chewed. Chat acts as a stimulant/euphoriant when taken (Dawit Abebe et al, 2005). Damakese An indigenous Ethiopian herb used for treatment of several ailments. Debal/ Tigegna Co-resident Edir “Indigenous voluntary associations established primarily to provide mutual aid on burial matters but also to address other community matters” (Pankhurst and Damen, 2000: 36). Injera Staple food of Ethiopians, it is a kind of pancake. Most of the time, it is made from teff (it could also be prepared from other grains such as barley, wheat, maize and sorghum) and eaten with different sauces. Grocery A kind