Sexual and Reproductive Rights
People living with HIV/AIDS
People of HIV/AIDS
Worldwide an estimated 34 million people are living with HIV/AIDS, the vast majority of them live in low and middle-income countries. Though AIDS-related deaths are declining, the number is still high (1.7 million according to the UNAIDS World AIDS Day Report 2012.
Meeting sexual and reproductive needs
The reproductive needs of people live with HIV/AIDS are similar to those of the rest of the population. People living with HIV/AIDS, however, face difficult choices in the realization of parenthood and are hindered by social and cultural issues. There is also increasing awareness that existing public health policies and programs often fail to respond to the sexual and reproductive health rights, needs and aspirations of people living with HIV/AIDS (as shown in an overview of human rights, policy and health system issues for people living with HIV by the Harvard School of Public Health).
A University of Cape Town study lists the following reproductive health care needs of people living with HIV: health services for HIV positive men and discordant couples, guaranteed confidentiality, awareness of reproductive health-related complications for HIV-positive women, awareness of the increased risk of contracting human papilloma virus (HPV) and other sexually transmitted infections, access to family planning services in addition to condoms and help with unwanted pregnancies among HIV positive women.
Negative health effects of HIV/ADIS stigma
Discrimination of people living with HIV/AIDS is rampant, particularly in developing nations. HIV is often regarded as incurable and associated with sexual promiscuity, family malfunctioning and drug use.
Stigma or anticipated stigma has been found to be a powerful barrier to testing uptake, as shown for example in programs designed to eliminate new HIV infections among children (see a study on stigma and HIV testing by the UC San Francisco). The use of prevention and care services is also influenced by cultural perceptions that diminish parenthood and reproduction to merely women’s issues, as is argued in a University of São Paulo article on parenthood of HIV positive people.
Human rights of people living with HIV/AIDS and policy implications
National governments have a legal obligation to promote and protect the human rights of people living with HIV, including their sexual and reproductive rights. A human rights approach to HIV also creates opportunities: to include affected communities and principles of non-discrimination in the development of policies and programs. Policies should address the continuum of care from pregnancy to infant and childcare, provide means of integrating reproductive health interventions with HIV/AIDS care and mitigate AIDS-related stigma and discrimination. It’s vital to combine strategies including biomedical e.g. male medical circumcision, behavioral and structural approaches in order to reduce HIV risks and reducing morbidity and mortality.
The 1994 International Conference on Population and Development adopted a plan of action to achieve sexual and reproductive health. The strategies were confirmed by a special session of the United Nations General Assembly (ICPD + 5) in 1999. As a result, there has been increasing advocacy for respect of reproductive rights of people living with HIV/AIDS according to a University of São Paulo article on parenthood of HIV positive people. This article lists the most important principles regarding the reproductive rights of people living with HIV/AIDS:
- HIV positive people must be able to make non-coerced and autonomous decisions regarding sexuality and fertility.
- Through the health system HIV positive adults and young people must have access to relevant information, counseling and services tailored to their sexual and reproductive health related needs.
- HIV positive people are entitled to confidentiality and in all and service provision their fully informed consent must be sought.
- Whenever possible, HIV positive people should be given the opportunity to involve their partners in decision-making and action regarding sexuality, reproductive health and childcare. This principle refers to the involvement of male partners in the upbringing of children from HIV positive women, who often fear disclosure of their HIV test result will result in stigmatization, abuse, divorce and withdrawal of their livelihood by their male partner.
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