As world leaders gather for a special UN session[i] on 22 September to assess progress made to achieve universal access to sexual and reproductive health and rights, a new report highlights ongoing discrimination faced by women living with HIV in accessing family planning programmes. The report, Quality of Family Planning Services and Integration in the Prevention of Vertical Transmission Context,[ii] published by the Global Network of People Living with HIV (GNP+) and the International Community of Women Living with HIV (ICW), documented experiences of women living with HIV in Cameroon, Nigeria and Zambia.
"I didn't make any preparations, like buying baby clothing, because I was sure I would die on or before the ninth month... Because of the fear and high stigma, I didn't register for antenatal care in any hospital," said a woman living with HIV who participated in a focus group discussion in Abuja, Nigeria.
The study highlights specific challenges women living with HIV face, as advocates for reproductive rights rally to ensure that sexual and reproductive health and rights remain central in the new set of Sustainable Development Goals currently being discussed at UN.
Suzette Moses-Burton, Executive Director of GNP+, said: "The birth of a child is meant to be a happy time, but this report shows that for many women living with HIV it can be a time of intense stigmatization and isolation. Given the unprecedented scale-up of comprehensive prevention of vertical transmission programmes under the Global Plan Towards the Elimination of New Infections Among Children by 2015 and Keeping Their Mothers Alive, Ministries of Health must urgently address stigma around HIV and pregnancy as an important step towards fulfilling human rights, and improving access to quality sexual and reproductive health services."
Rebecca Matheson, Global Director of ICW, said: "We are concerned that many service providers deny dignity, human rights, and good health to women living with HIV by engaging with them differently, failing to provide correct or full information, or discriminating against them. As shown by the study, this is even more pronounced for young women. However, the study also shows that where service providers respected the human rights of women living with HIV, their clients' experiences were also positive. We need to ensure that access to correct information and a range of family planning methods are available for everyone, not just the few."
In Zambia, one woman living with HIV who chose to use injectable hormonal contraceptives was accused of avoiding condoms so as to infect others. Women living with HIV in Nigeria felt discriminated against when services were provided separately from the general client population. Women from Cameroon reported that certain healthcare practices, such as the use of extra gloves and bleach, made them feel stigmatized and discriminated against.
However, women living with HIV in Cameroon and Zambia felt that programmes have improved over the years, potentially due to interventions to integrate HIV and sexual and reproductive health services, and to address stigma, such as involving people living with HIV in service provision. The report also showed that good support, such as the recognition of the right to have a child and receiving positive messages about pregnancy following an HIV diagnosis, was critical for women living with HIV.
ICW and GNP+ call on Ministries of Health to provide discrimination-free sexual and reproductive health care to women living with HIV by improving access to and increasing the quality of counseling, as well as ARVs and family planning commodities. ICW and GNP+ also ask that global leaders prioritise the sexual reproductive health and rights of women living with HIV in the global dialogue and Post-2015 Sustainable Development Goals-setting processes.