With sponsorship from the Bixby Program in Population and Reproductive Health, I was able to attend the "Gender Based Violence and Health Conference", held on May 7-9th, 2003 in Johannesburg, South Africa. The conference was organized by the South African Gender Based Violence and Health Initiative (SAGBVHI) and was supported by the Ministry of Health of South Africa along with 15 other member organizations working on gender based violence and health issues. The conference provided a forum for the discussion of research results and innovative strategies to deal with the complex issues of child abuse, domestic violence, violence against women in conflict situations, and the significant impact of violence on HIV/AIDS rates among women in Africa.

Each day of the three-day conference began with a plenary session and the presentation of research results from leading international organizations, including the World Health Organization (WHO) and the Canadian Center for Research in Women's Health. Most interesting was the WHO global study of violence against women that will provide, for the first time ever, comparable results about the impact and health consequences of GBV in 13 countries on 6 continents. Due to the relatively recent identification of gender based violence as a major health issue, the preliminary results were supportive of the general notion that violence against women is severely under-reported around the world.

The link between abuse and HIV/AIDS was a major theme of the conference. One study discussed how GBV can increase women's risk of HIV through: 1. direct infection through sexual assault 2. indirect infection because a history of assault predicts riskier behavior such as inconsistent condom use and transactional sex. This supports the findings of other studies showing a significant relationship between rape, major depression, post traumatic stress disorder, and drug dependence, as well as a study showing that women with a history of sexual assault are more likely to fear asking partners to use condoms.

Another unique study "Talking to Men who Have Killed their Intimate Female Partners" showed a disturbing pattern of nonchalance and premeditation among those who had taken gender violence to the extreme.

Perhaps the most important presentation came from the Canadian Center for Research in Women's Health, showing how ineffective rape kits are in gaining convictions, and how better methods for gathering evidence must be found in order to raise the dismal conviction rate of rapists around the world.

My presentation was titled, "Documenting Gender Based Violence: Giving Voice to Liberian Refugee Women" and demonstrated the dramatic rates of rape and sexual abuse among women who have been forced to flee their home in search of safety, only to find violence along the way. The study was conducted in Western Ivory Coast in the summer of 2001, and showed that over 70% of Liberian women interviewed had experienced some form of abuse including rape, gang rape, physical abuse, and psychological abuse during their time as internally displaced persons (IDP) and as refugees.