Reproductive Rights

• Pages: 141-143

Contenidos

• The Issue.
• Legal and Policy Considerations.
• Practice Examples.
• References.

Page 141

The Issue

Reproductive rights encompass individuals' freedom to determine the number, spacing, and timing of their children; the right to access the information necessary to make such determinations; and the right to the highest available standard of sexual and reproductive health. HIV-positive women face numerous barriers to the realization of these rights, including both laws and informal practices that restrict reproductive freedom. Many of these restrictions-such as forced or coerced sterilization, recommended abstinence from sex and childbearing, and compulsory HIV testing-are designed to prevent the birth of HIV-positive children. However, with access to appropriate reproductive health care, counseling and treatment, HIV-positive women are able to engage in sex and childbearing with minimal risk of transmission to their partners or infants.

Legal and Policy Considerations

Reproductive rights require governments to minimize restrictions on reproductive liberty and maximize access to resources that enhance autonomous reproductive decision-making. Many governments, with assistance from NGOs, have integrated HIV prevention into existing family planning and reproductive health services. Others have adopted the opposite approach, linking family planning counseling with existing HIV services. Few nations have reproductive policies that actively discriminate against women with HIV, though ostensibly neutral laws often produce discriminatory results. For example, in many African and Latin American countries, abortion is illegal. Although this applies to all women in those jurisdictions, it disproportionately affects HIV-positive women who (i) may be more likely to seek an abortion, or (ii) may experience greater physical risk if they opt to have an abortion illegally. Similarly, contraception access and education is inadequate in many countries, leaving HIV-positive women to choose between abstinence and the risk of transmitting the HIV virus.

Medical advances-particularly the ability to reduce dramatically mother-to-child transmission of HIV-have also raised new legal concerns in the area of reproductive rights (see Topic 1.2). Some countries with high HIV prevalence include routine ("opt-out") HIV testing as an element of prenatal care (see Topic 1.1). While this allows governments to pursue the valid public health goals of reducing...