Background

The global population is ageing rapidly, which is associated with declining physical and cognitive abilities. Differing survival rates between men and women mean more women survive to old age, increasing their vulnerability to age-related challenges such as social norms condoning violence against women, including domestic violence, spousal abuse, and rape which may increase older women`s vulnerability to HIV infection. Using data from a qualitative study we explore the perspectives and experiences of older women with regard to domestic violence and their risk for HIV infection.

Objectives

The study objectives are to:

1) Explore the nature of domestic violence experienced by older adults, particularly women, in long-term relationships.

2) Understand the coping and agency of older women in abusive relationships.

3) Examine the relationship between domestic abuse of older women and HIV risk

4) Inform interventions by identifying needs for support systems or policies that address intimate partner violence (IPV) and HIV prevention in older populations.

Methods

The study was conducted in Durban, KwaZulu-Natal, South Africa using a qualitative approach. Twenty-four in-depth interviews with older adults from the age of 50 and older were conducted and stratified by gender and research site.

 

Results

Three major themes emerged:

1) Perceptions of sexual relationships in elderly people: Sexual relationships were acceptable in old people, mostly within the context of marriage.

IDI012W53BHN: if they are not married, I don’t accept it, I don’t like it because it just shows the children something that is not right, because children are looking up to us and so we shouldn’t do bad things that they will see

2) Effect of extramarital affairs on marital relations: Participants highlighted how men’s extramarital affairs with other partners. These partners tended to be much younger or intergenerational and were euphemistically referred to as ‘girls’ by older adults. These activities contributed to perceptions of abuse and marital disruption.

IDI431M56RKP: Now this woman is upset because she doesn’t know what he gets up to as he is leaving, especially if he drinks, maybe he has sex with other girls there, and maybe he doesn’t use protection. Then the wife says, “I will not stand for this”, then she files for divorce.

3) Violence and abuse in elderly relationships: Participants felt obligated to comply with their husband`s sexual needs fearing that refusal could lead to infidelity or pursuit of younger women, some even experiencing sexual violence from their partners.

IDI243W59RKN: He grabbed me, which means that if he grabbed me, he would know that he had really hurt me, he grabbed me badly, I was… maybe he would have been arrested if I had gone to court because I had said that I didn’t like him.

 

Conclusion

The study highlights the critical link in gender inequity, domestic violence and HIV risk in elderly women, highlighting how deeply ingrained social and cultural norms perpetuate power imbalances. Further research is required to better understand the violence and abuse older people may suffer for improved health outcomes through suitable multi-sectoral interventions.