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SEX WORK, GENDER VIOLENCE AND THE HIV EPIDEMIC DURING THE WAR IN UKRAINE
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As the horrors of war unfold in Ukraine in the aftermath of the full scale Russian invasion in 2022, experts say the risks of the HIV epidemic and women’s vulnerability to the consequences of violence have risen sharply.
The rise of sexual violence in Ukraine in 2022
A group of UN human rights experts has already highlighted the increased risk for women.
"History has repeatedly shown that outbreaks of conflicts and wars increase the risk of war crimes against women and girls, especially all forms of gender-based violence, arbitrary killings, rape and human trafficking," the experts said.
The Brussels Times reports that, according to the UN, the war in Ukraine exposes women and girls to an increased risk of sexual violence both within the country and when fleeing in search of temporary refuge in other countries.
The current situation in Ukraine, which was partly occupied by Russia on February 24 and resulted in the displacement of millions of Ukrainians, puts all residents of Ukraine at risk, but this threat is greater for women and girls, according to Dagmar Schumacher, director of the UN Women Office in Brussels.
"We are very worried. We want this war to stop. The current situation endangers the safety of all people in Ukraine, but also exposes women and girls to an increased risk of sexual violence…” she told The Brussels Times.
Allegations of rape by soldiers
One example of this heightened risk is the rape of Ukrainian women by Russian soldiers, which Ukrainian Foreign Minister Dmytro Kuleba cited when discussing the country’s ongoing conflict and reports of war crimes and crimes against humanity during an online event hosted by the Chatham think tank House.
In his statement, he referred to "numerous cases" of sexual violence since Russian President Vladimir Putin launched an all-out offensive against Ukraine.
"When bombs fall on your cities, when soldiers rape women in occupied cities - and we have numerous cases, unfortunately, when russian soldiers rape women in Ukrainian cities - it is, of course, difficult to talk about the effectiveness of international law," Kuleba said, commenting on the call for a special tribunal to punish Putin.
"But," he added, "this is the only tool of civilization available to the country to ensure that all those who made the war possible are brought to justice, and the Russian Federation, as a country that committed an act of aggression, will answer for its deeds."
... the level of HIV incidence in Ukraine will undoubtedly increase as a result of the Ukrainian-Russian conflict...
Ukraine has the second largest HIV epidemic in Eastern Europe and Central Asia, with an estimated 250,000 people living with HIV. These rates disproportionately affect women, increasing their vulnerability to HIV infection and subjecting them to stigma, marginalization and violence.
In her article "Ukrainian Time Bomb: Women, War and HIV" for "Ms" magazine, journalist Jessica Henn drew disturbing parallels between the war in Ukraine and past conflicts, highlighting the plight of women, including sex workers, during the war and the threat of a growing HIV epidemic.
Note: "Ms" was the first national magazine in the US (published in 1971) that made women’s voices heard, women’s journalism grounded, and the feminist worldview accessible to the public.
Jessica suggests that the HIV rate in Ukraine will undoubtedly increase, as a result of the ukrainian-russian conflict.
The catastrophic destruction caused by the russian invasion has dramatically increased the risk of HIV infection and related violence for women in Ukraine.
The position of sex workers and the threat of human trafficking
According to 2019 estimates, about 80,000 sex workers lived in Ukraine. Sex work in peacetime was one of the few available ways to earn a living, especially for women who did not have access to education. The war, displacement, destruction and economic decline caused by the war have left many women homeless and without income, which can push them to provide sex services for any kind of reward: food, medicine, shelter. During active hostilities, the majority of sex workers in Ukraine were also left without work, and therefore without access to the necessary resources: water, food, housing, etc. Which creates conditions for more risky sexual behavior: sex workers are forced to agree to sex without a condom, risky sexual practices, drug use, and so on.
At the same time, hostilities and instability increase the risk of exploitation and human trafficking. There are already reports of criminal gangs targeting Ukrainian refugee women fleeing the horrors of the Russian invasion.
Violence and HIV
Studies have shown that seven out of ten women experience gender-based violence during conflict. Sexual violence makes women more vulnerable to HIV infection, given the likelihood that perpetrators will abuse victims without taking measures to protect against STDs.
A UNFPA report on gender-based violence in the regions of eastern Ukraine, which has been at war with Russia since 2014, also confirms that women’s vulnerability to domestic violence has increased during the conflict. Reasons cited include the normalization of a culture of violence in society, the wider availability of guns and the fragmentation of communities and the loss of support networks.
There is a correlation between domestic violence and increased HIV incidence, given that women fleeing domestic violence are often vulnerable, without housing or economic security. Many victims also use harmful coping methods, such as substance abuse, to cope with psychological trauma. These factors make women prone to exploitation and forced prostitution, which increases the risk of HIV infection.
Gender-based violence is not only a cause of HIV, but also a consequence of it, with women and other marginalized groups disproportionately affected by it. After the diagnosis, the probability that HIV-positive Ukrainian women will face violence (domestic and structural) increases by an average of 15.5 percent. Although the data show a decrease in the level of domestic violence after an HIV diagnosis, Ukrainian women living with HIV are still 16.3% more likely to experience domestic violence than HIV-negative women.
Increase of violence is especially common in medical institutions. Fear and mistrust of health professionals can lead women to conceal their diagnosis, denying them access to HIV treatment. Avoiding health care facilities also has life-threatening consequences for non-HIV related medical problems. In an interview, one woman told how her fear of seeking medical help nearly cost her her life.
"The doctor started yelling at me and added some humiliating words... After that, I was afraid to go to the doctors for a long time, even when I felt pain in my stomach. The ambulance took me to the gynecology department, unconscious and covered in blood. As it turned out, I had a tubal pregnancy. They saved my life, but unfortunately I can’t have children now."
Cultural violence against women and marginalized groups with HIV is becoming an increasingly serious problem in Ukraine. In recent years, the government and civil society have implemented antiretroviral treatment programs that have been relatively successful in the past. However, in territory controlled by Russia or pro-Russian separatists, increasingly conservative legislation is being used to block access to HIV information and support services.
This is particularly alarming given that the Donetsk and Luhansk regions have one of the highest rates of HIV infection in Ukraine. The recent Russian invasion raises fears that Ukrainian citizens may lose access to vital medical treatment.
This article uses materials and research results:
The publication was made possible thanks to the support of the Government of Canada within the project "Women’s Voice and Leadership - Ukraine", implemented by the Ukrainian Women’s Foundation. CO "Legalife-Ukraine" is responsible for the content of the information. The information presented in the publication does not always reflect the views of the Government of Canada and the UWF.
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