Ipas > Women with HIV still need broad reproductive health care

Women with HIV still need broad reproductive health care

New position statement from International Community of Women Living with HIV/AIDS

January 28, 2008

Photo courtesy of Gisele Wulfsohn, Panos Pictures.

Around the world, women living with HIV face many challenges in addition to the direct consequences of infection. They are disproportionately likely to be survivors of sexual violence and to lack access to reproductive health services, making them more likely to face an unwanted pregnancy. HIV-positive women are more likely to have concerns about how pregnancy would affect their own health, as well as the health of their future children. HIV-positive women are at greater risk of developing complications during or after pregnancy, and this especially may be the case after an unsafe abortion.

To address and draw attention to these difficulties, the International Community of Women Living with HIV/AIDS (ICW) has adopted a public position on the importance of reproductive rights, including the right to safe abortion care, for HIV-positive women. A two-page briefing paper, made possible with assistance from Ipas, was released this January. It discusses the challenges that HIV-positive women face when seeking reproductive health care, as well as the reasons why safe reproductive health care is especially important for these women.

“Women living with HIV seek abortion care for the same myriad reasons as all other women. Additionally, the same factors that make some women vulnerable to HIV also often increase their need for access to safe abortion services,” says Barbara Crane, Ipas executive vice president for technical leadership and advocacy.

Yet despite this need, many HIV-positive women do not receive proper care. More than 20 years into the epidemic, HIV infection still carries enormous stigma. Women who are also dealing with unwanted pregnancies face an even greater burden. Too many health-care providers treat HIV-positive women with humiliating or judgmental attitudes, do not provide confidential services or deny treatment outright.

As some women living with HIV are being denied access to safe abortion care, others face undue pressure to have abortions, denying women their rights to have children and receive a fair standard of care. Pressure can come from health-care providers who say or demonstrate a belief that HIV-positive women should not have children; provide women with misleading information about the effects of pregnancy on a woman’s health or the likelihood that a developing fetus will acquire HIV; or even require that women undergo sterilization if they are to receive services.

“Yet, HIV-positive women have the right to have children and, given the right care, treatment and support, they generally can have healthy pregnancies and babies,” the ICW paper says. “Positive women should never feel pressured by their partners, families or health workers to have abortions – that is also a violation of our human rights.”

ICW recommends a broad range of reproductive health services for the women who do seek abortion care. Information should be provided in an objective and understandable manner, without attempts to sway patients’ positions one way or the other. Services should include family-planning information, safer-sex counseling, marital and individual counseling and other services. These services are needed both to educate women about how to regulate their fertility and reduce their chances of transmitting HIV to a partner or their child, as well as to help them deal with the emotional difficulties that come with the decision about whether to keep a pregnancy.

The ICW paper also discusses the potential benefits and challenges of HIV testing for women who seek abortion care. Women who seek abortion services may be more likely than the general population to have HIV. With knowledge of their HIV status, women can take steps to improve their own health and to reduce their chances of transmitting HIV to others. At the same time, pressuring women who receive abortion services to be tested for HIV can subject them to emotional turmoil, discrimination and abandonment at a time when they are already emotionally vulnerable. The ICW paper does, however, offer possible alternatives that can find a balancing point between informing women without overwhelming them. Health-care providers can offer HIV testing in a non-authoritative manner, taking care to not sound judgmental and to try to genuinely ascertain the woman’s feelings. They can also offer referrals to HIV testing, so that women can find out their HIV status when and if they want to.

ICW is an international network run by and for HIV-positive women. Formed in 1992, ICW provides women living with HIV with support, information and services from the people best equipped to provide it – their peers. ICW also works to call greater attention to the lives of the 13 million women living with HIV, and advocates for their rights to voice their opinions and receive proper treatment and care.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258