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Women, HIV and Rights

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Geneva, December 1, 2009: The latest research on women's health indicates that lack of contraception and unsafe sex are the crucial risk factors for death and disability in women of reproductive age (15 - 49 years old). Unsafe sex can result in unintended pregnancy, unsafe abortions, reproductive complications and sexually transmitted infections (STIs) including HIV

Complications during pregnancy and childbirth are the leading cause of death and disability among 15 - 19 years old young women living in developing countries [1]. Globally, for women of reproductive age, AIDS related illnesses are the leading cause of death and disease. Women's health, especially their sexual and reproductive health, is therefore an important issue for the wellbeing and development of future generations and the communities they live in.

Several international instruments, including the Convention on the Elimination of Discrimination against Women (CEDAW) and the International Conference on Population and Development (ICPD) Programme of Action, mandate governments to ensure safe motherhood for all women. However, the sexual and reproductive health and rights (SRHR) of women living with HIV are often ignored. Many pregnant HIV-positive women experience human rights violations at various stages of their reproductive years.

Globally an estimated 17.5 million women are currently living with HIV. The number of new HIV infections continues to outstrip the numbers on treatment-for every two people starting treatment, a further five become infected with the virus [2] . Although treatment has increased and the percentage of HIV-positive pregnant women who received treatment to prevent vertical transmission increased from 33 percent in 2007 to 45 percent in 2008, HIV-positive women are often encouraged not to have children. In some countries, access to HIV treatment is tied to women agreeing to use contraceptives [3]. In one study [4], 45 percent of women diagnosed HIV-positive were told not to have any more children-only 18 percent of positive men were given the same advice, suggesting that health-care workers place responsibility for contraception on women.

In addition, there are an increasing number of documented cases of pregnant HIV positive women being coerced into sterilization or denied care because of their HIV status. Many HIV-positive women face stigma and discrimination when planning a pregnancy or seeking pre-natal care. D'addy, a 21-year-old member of the YWCA of Congo Brazzaville, experienced discrimination after an HIV test at a pre-natal clinic revealed that she was HIV-positive. When her labour begun, she returned to the clinic. The nurses recognised her from her earlier visit, remembered her HIV status and refused to assist her. She gave birth alone. D'addy survived, but her baby died.

D'addy shared her story at the YWCA Regional Training Institute (RTI) held in June 2009 in Lagos, Nigeria where participants committed to promote the reproductive rights of HIV positive women. This commitment was also made at the RTI held in the Caribbean in May. The RTIs explored strategies to strengthen YWCA's response to SRHR, HIV and AIDS and violence against women.

But there is hope for women living with HIV. Sophia, a 30-year old volunteer with the YWCA of Mozambique also shared her story with the participants at the African RTI. Sophia is planning on having a family. Although she is HIV-positive and her partner is HIV-negative, she has received the support and guidance from the YWCA and health-care professionals in her hometown. The government provides her with free treatment and her doctor closely monitors her health as she prepares to conceive a child. Sophia is full of hope for the future.

As civil society continues to push for Universal Access to HIV prevention, treatment, care and support by the end of 2010, it is essential that governments and world leaders understand that for universal access to be truly universal, the human rights of young women and women living with HIV must also be upheld.
Below are four actions that governments, international organisations and civil society can take to ensure the sexual and reproductive health and rights of HIV positive women:

  1. Empower women living with HIV by providing access to information on their sexual and reproductive health and rights
  2. Invest in HIV comprehensive prevention strategies that are grounded in sexual and reproductive health and rights and that ensure access to comprehensive services to meet the needs of all women - especially women living with HIV
  3. Support laws and policies that create a safe and secure world that protect the rights of HIV positive women to make free and responsible choices for their sexual and reproductive health
  4. Provide safe spaces without stigma and discrimination, especially for women living with HIV
[1] Women and Health, Today's Evidence, Tomorrow's Agenda [2] UNAIDS AIDS Epidemic Update 2009 [3] ICW. 2006. Mapping of experiences of access to care, treatment and support - Namibia. [4] Asia Pacific Network of People living with HIV. 2004. AIDS discrimination in Asia.
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