Patriarchy, Poverty and Cultural Norms: The Intersecting Drivers of HIV and Gender-Based Violence a Narrative Review with Particular Attention to Sub-Saharan Africa
HIV and gender-based violence (GBV) are deeply interconnected public-health and human-rights challenges shaped by patriarchy, poverty, and harmful cultural norms. Patriarchal systems often give men greater control over money, mobility, sexuality, and household decisions, reducing the ability of women and gender-diverse people to refuse sex, negotiate condom use, disclose HIV status safely, or leave abusive relationships. Poverty increases dependence, homelessness, food insecurity, migration, and transactional sex, while limiting access to healthcare, justice, and safe shelter. Harmful cultural beliefs may normalize male dominance, victim-blaming, child marriage, sexual entitlement, and silence surrounding sexuality, while expectations of masculinity can promote risky behaviour and discourage HIV testing or treatment. GBV heightens HIV exposure through forced sex, trauma, and reduced preventive power, whereas HIV stigma may trigger violence, abandonment, and economic exclusion. Effective interventions must therefore integrate HIV services, survivor-centred care, economic empowerment, legal protection, gender-transformative education, and institutional accountability to achieve lasting social change.