Who is right and who is wrong – putting the right back into sexual and reproductive rights

This session, as emphasized by the speakers it was the only one where all speakers, and including the chair are HIV+ - expressing the desire that this should happen more often in International Conferences like that.

All speakers were emphatic when saying that HIV+ men and women have the right to full express their sexuality, and have the right to access SRH services and the need of comprehensive SRH services.

As Deloris Dockrey said: We as people living with HIV reaffirm our rights to fully enjoy sexual and reproductive health. These rights include the enjoyment of sexual pleasure, and the freedom of choice regarding reproduction, marriage and family planning.

Veronica, from ICW, discussed the forced and coerced sterilization of positive women in Namibia and she offered some recommendations, such as:

·        Investigate and take action against hospital staff who have wrongly or coercively sterilized women

·        Offer sterilization reversal procedures for women who have been coercively sterilized where possible

·        Health care staff should be thoroughly educated about the principals of informed consent and the correct way to obtain consent.

·        Ensure that health services staff adequate knowledge about ARV regiments for pregnant women and educate women on options available

·        Provide family planning information in a non coercive manner allowing women to make fully informed and voluntary decisions about family planning

Shaun Mellors challenge the idea that HIV+ people have their sexual rights respected and asked “whose rights?”

• Forced abortions and sterilisation of women living with HIV
  
  Pressure from health care workers discouraging PLHIV from having sex, let alone children
  
  
• Lack of safe abortion services for those who need them

• Misconceptions among health care workers about sexual activity: lack of information, services and supplies
  
  
• Specific legal and political barriers – e.g. criminalisation of HIV transmission

Shaun also mentioned that the donors could do more, such as:

•         Agree on a definition of SRHR

•         Political will and pressure

•         Political dialogue 

•         Facilitate more financial resources

•         Support rights-based programming and policy development

Carlos Garcia, from AVE de Mexico, calls for Universal Action for Our Rights Now!

The only all PLHIV panel at this Conference clearly showed the need for the realisation of sexual and reproductive health and rights of people living with HIV as an important component to the response to HIV. While existing human rights frameworks and international commitments provide important tools to address sexual and reproductive rights, the lack of a clear definition of sexual rights and the resistance to recognising them are major barriers to the realisation. Experiences from around the world show that PLHIV are experiencing violations of their sexual and reproductive rights - coerced abortions, sterilisations and judgemental attitudes from health care providers and others that compromise freedom of choice and access to comprehensive information and services.

Results from a study conducted by the International Community of Women living with HIV and AIDS revealed cases of forced sterilisation in Namibia among women living with HIV. The study also revealed that lack of appropriate information, counselling, “coerced consent”  by health practitioners all compounded by stigma and discrimination were contributing factors. ICW is currently supporting two women to seek redress through the national justice system for this violation of their human rights.

Policies and services still fail to go beyond an individual’s HIV status to recognising people living with HIV as human beings, with the full range of human rights and needs for their wellbeing and a fulfilling life. Following the Amsterdam Statement on the SRHR of PLHIV, the Positive Living 2008 Summit has made an important contribution by developing a definition of sexual and reproductive rights of PLHIV and by making specific recommendations on realising the SRHR of PLHIV.

While the realisation of sexual and reproductive rights in general, and particularly for PLHIV, remains a challenge, speakers drew attention to the way forward. They emphasised the need for increased awareness among PLHIV of their own rights and empowerment to claim them, as well as partnerships with supportive organisations and individuals that support the needs and rights of PLHIV. Furthermore, national planning processes and proposals to the Global Fund were identified as important sources of political and financial commitment to support the realisation of rights. Including indicators for progress on realising SRHR, as well as ensuring that costed activities, such as support for advocacy, law reform and accountability mechanisms, in national plans will support efforts to realise efforts to realise the SRHR of PLHIV.