Reproductive rights of HIV-positive women ignored - report

Most HIV/AIDS mother-to-child transmission prevention campaigns have focused on the potential danger of HIV infection to the infant and little attention has been given to the mother, according to a new report.

This had diminished the importance of women's health, particularly when so little was known about the effects of pregnancy on the health of women living with HIV/AIDS, a briefing paper by the Centre for Reproductive Law and Policy (CRLP) said.

According to the international NGO, policies aimed at curbing MTCT could also hold women solely accountable for their child's HIV infection, disregarding the role that men played in preventing the transmission of HIV to children.

"Singling out mothers and ignoring fathers poses the added risk of alienating women who, to avoid blame and stigma, may forgo treatment that could improve their health and reduce the risk of transmission," the report said.

While decreasing MTCT was an important goal, campaigns also had to take into account the woman's health, it noted.

Current debates on the use of infant formula or breast milk also ignored the role of HIV-positive women. International guidelines recommend that HIV-positive women "be empowered to make fully informed decisions about infant feeding [through counselling about the risks and advantages of breastfeeding] and that they be suitably supported in carrying them out."

In some countries, however, women were not given a choice. According to the report, Ghana has severely limited access to breast milk substitutes for HIV-positive women by banning the sale, advertising or promotion of infant formula in public health facilities

Research was still needed to assess the impact of breastfeeding on the health of HIV-positive mothers, the report said.

Though little discussed, the high-energy demands and sleep deprivation associated with infant care, including breastfeeding, were factors that undermined the already weakened immune systems of HIV-positive women, it added.

The right to pregnancy and even marriage was also at risk, as some national policies discouraged HIV-positive women from becoming pregnant.

"In Ethiopia, where abortion is severely limited and only 13 percent of women use contraceptives, the country’s HIV/AIDS and Human Rights Policy states that "prevention of pregnancy shall be encouraged among HIV-positive individuals" without specifying how this policy would be implemented, the report said.

Despite evidence that men’s sexual practices played a greater role in the high prevalence of HIV/AIDS, government and traditional leaders around the world had demonised and stigmatised women’s sexuality, identifying it as the key to both prevention and containment.

Efforts to control women’s sexuality relied on discriminatory social and cultural stereotypes and failed to address men’s role in driving the pandemic, the report noted.

"CRLP urges governments to accept their international legal obligations to protect the sexual and reproductive rights of HIV-positive women and girls," the report concluded.

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