The presence of HIV/AIDS tends to lead to other fairly specific dynamics.  For example, the presence of HIV or AIDS can act as a potent emotional stressor that precipitates some incidents of abuse.  While the presence of HIV/AIDS in an abusive relationship adds many unique dynamics, there are some issues that those in this situation may have in common with others surviving domestic violence coupled with another chronic or life threatening illness.  In addition, the outcomes of domestic violence can become more serious when they directly or indirectly affect the health of an HIV-positive person (or in some examples the health of someone dealing with another life threatening illness) as in some of the examples below:

• The abuser may threaten to tell others that the partner has HIV/AIDS.  This is, in some ways, not dissimilar from “outing” of sexual orientation or gender identity, as discussed earlier.  However because of additional social stigma attached to HIV regarding drug use and sexuality, as well as the continued bias that people with HIV/AIDS face, this can pose an additional threat even to people who may already be “out” about their sexual orientation and/or gender identity.

• An HIV-positive abuser may suggest that s/he will sicken or die if the partner ends the relationship (or alternatively, that the abused partner’s health will fail).  The threat may have the ring of truth, if the HIV-positive partner is dependent on the other for housing, nutrition, health care or other forms of support.  The additional power that accompanies this threat is that the survivor may fear dying alone and/or their partner, who despite abuse the victim usually loves, dying alone.  The victim may also fear that family, friends and community who do not understand or are not aware of the abuse may fault and turn against the victim for leaving someone who may be sick or perceived as vulnerable.

• An abuser may interfere with the survivor’s health care by withholding, throwing away or hiding medications, canceling medical appointments, or preventing the HIV-positive partner from receiving needed medical care.

• An HIV-positive abuser may even do the same things to him/herself, in an attempt to blackmail the survivor.

• An abuser may take advantage of an HIV-positive partner’s poor health by using it as a rationale to limit contact with other individuals, assume sole power over economic affairs, and foster a partner’s utter dependency.

• The threat of physical violence can become more potent to victims living with illness, who may be too weak to defend themselves or may fear the HIV-related complications (easy bruising, infections, slow or difficult healing) that can result from being subjected to physical harm.  Additionally the emotional stress associated with surviving an abusive relationship can adversely affect a person’s already debilitated immune system, potentially resulting in exacerbated symptoms, and further compromising the health of someone with HIV/AIDS, or another life threatening illness.

• An abuser with HIV/AIDS may infect or threaten to infect a partner, or may use claims that the victim is responsible for the abuser’s sero-conversion and use this as a reason why the victim cannot leave.