This page offers topic-specific guidance on the use of the Human Rights and Reproductive Health Matrix, created by United States Agency for International Development (USAID)-supported POLICY Project Human Rights Working Group. To view other aspects of the Matrix, including guidance on other topics, please click on the Matix icon above.

HIV-Positive Women

Definition

HIV-positive women are entitled, as any person, to enjoy the highest attainable standard of sexual and reproductive health, and to have access to the information, means and services necessary for them to make decisions concerning reproduction and the prevention of mother-to-child transmission of HIV.

While international law does not explicitly address the situation of HIV-positive women, a number of principles come into play to protect them against the various forms of discrimination they suffer, and to promote and ensure their access to adequate and timely care, treatment and counseling.

Links to Reproductive Health

HIV-positive status is in and of itself a serious sexual and reproductive health issue, but risks to health may increase in a setting that does not provide adequate information, means and services for HIV-positive women to take measures to maintain good health as much as possible, and to prevent mother-to-child transmission of HIV.

Women's legal, financial and social inequality creates further barriers to their access to reproductive and maternal health care, thus augmenting the risks to health.

Finally, AIDS-related stigma and discrimination adds another burden to women's access to health care, which may drive them not to seek care, thereby increasing the risks to health.

Human Rights Implicated

Right to health and the right to sexual and reproductive health entitle HIV-positive women to the treatment, care and services necessary for them to maintain a status where they can pursue their daily activities, and to prevent mother-to-child transmission when they are pregnant.

When women encounter barriers to access to health care, resulting from gender inequalities in relation to their financial and legal autonomy, they suffer a violation of their right to non-discrimination and right to the equal protection of the laws. Their HIV status may add on another form of discrimination if they are refused reproductive and maternal health care because of it.

HIV positive women may decide to have children in spite of their HIV status, or they may decide to terminate pregnancy or not to have children at all. Denial of reproductive and maternal health care may impede on their right to decide the number, timing and spacing of their children, if such denial deprives them of the necessary means and services to implement their decisions, such as contraception and family planning, or maternal health care and PMTCT drugs and services.

The right to education and the right to receive and impart information support HIV- positive women's access to all the necessary information for them to make decisions regarding starting a family, and the prevention of mother-to-child transmission of HIV.

Stigmatization of HIV-positive women violates their right to freedom from degrading treatment because of the humiliation they suffer as a result of the stigmatization.

Ensuring privacy and confidentiality of services is essential to render women more likely to seek family planning or maternal health care, and eventually to improve health.

Countries sometimes allow a woman to terminate a pregnancy because of her HIV status, and sometimes authorize women to be sterilized for contraceptive purposes. However, HIV-positive women face the risk of being subject to forced abortions or sterilizations as a result of AIDS-related stigma and discrimination. Such measures, performed without the women's full and informed consent, violate their right to liberty and security, because women coercively receive treatment in a way that deprives them of the possibility to decide what will be done to their bodies and by whom.

Relevant Human Rights Documents

The International Covenant on Economic, Social and Cultural Rights and the ">Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) oblige governments to establish programs and services providing all sexual and reproductive health care women need. In particular, CEDAW commits governments to provide appropriate services in connection with pregnancy and childbirth.

Those documents also condemn discrimination on grounds of gender, and discrimination on grounds of "other status" which supports the contention that AIDS-related discrimination is prohibited under international law and governments should take necessary measures to reduce it.

The Declaration of Commitment on HIV/AIDS urges governments to provide HIV prevention information and counseling to pregnant women, as well as treatment and care for HIV-positive women.

The consensus documents adopted at the International Conference on Population and Development and at the Fourth World Conference on Women extensively stress individuals' freedom in deciding the number, timing and spacing of their children, and urge governments to provide all the information, means and services necessary to support each woman's decision. This applies to HIV-positive women as well.

Key Human Rights Arguments You Could Use

Because countries commit to international law by ratifying treaties, and because of the highly persuasive force of consensus documents, the rights of HIV-positive women should inform the contents and purpose of policies adopted in relation to reproductive health, family planning, and HIV/AIDS services.

A rights perspective empowers HIV-positive women in making appropriate decisions for their health and that of their family and in their ability to carry those decisions out. Conversely, it calls on countries not only to empower women in their social status against gender and AIDS-related stigma and discrimination, but also to initiate and adopt measures for the reduction of health care provider bias, stigma and discrimination; the establishment of voluntary counseling and testing services that do not violate women's rights; and access to information concerning safe contraceptive methods and the prevention of mother-to-child transmission.

Questions and comments should be directed to policyinfo@futuresgroup.com.