Family Planning for HIV Positive Women is a Human Right


Coming
from a family planning/reproductive justice background, I am very interested
in the integration discussion going on at the International AIDS Conference
regarding sexual and reproductive health and HIV/AIDS. The divide between
the reproductive rights movement and the HIV/AIDS movement is counterproductive
and does not deal with realities on the ground. I have been bothered
by the lack of communication and cooperation between the two communities
and interested in bridging the gap.

So,
when I read the abstract for a session on the sexual and reproductive
health of people living with HIV and AIDS, put on by the Guttmacher
Institute, I was intrigued. The panel included four presenters,
two from the US, one from Nigeria, and one from Zimbabwe. I went
to the session hoping to hear about true integration of reproductive
rights and HIV/AIDS movements. Instead, I was disturbed by the
lack of understanding between the two movements. A theme ran through
the presentations, given by the US-based colleagues, which was both
incredibly problematic and incredibly enlightening.

Both
of these presentations addressed contraception as an HIV prevention
method, rather than contraception as a family planning option for HIV-positive
women. In fact, one of the presentations, "contraception as
a way to prevent HIV," directly followed the presenter from Nigeria,
a woman living with HIV who spoke movingly about the lack of access
to comprehensive support for women living positively, including lack
of adoption options and support for women choosing to have children.
Just seeing the title slide from the subsequent presentation made me
nervous: was this presentation going to be about stopping HIV positive
women from having children?

As
stated by the woman from Nigeria, one of the largest obstacles in the
fight against HIV is the lack of access to information and commodities,
such as contraceptive options, for vulnerable populations. However,
this lack of family planning options should not be treated as a cause
of HIV infections, but as another symptom of the marginalization of
groups such as youth, women, those below the poverty line, injection
drug users, men who have sex with men, and sex workers. A strategy around
providing sexual and reproductive health services, including family
planning, to these vulnerable populations is important to the AIDS movement
because it provides information and access, empowers them to make healthy
sexual choices in their own lives, and can help decrease stigma and
prejudice, all pieces of what makes members of these communities more
at risk for HIV. But most of all, sexual and reproductive health services
should be important to the HIV/AIDS movement because they are a basic
human right.

I’m
sure the US-based presenters would agree with everything I just wrote.
However, the way they framed the connection between family planning
access and HIV/AIDS was much different. One presentation connected access
to family planning and HIV prevention by emphasizing the importance
of contraception in preventing unwanted, HIV-positive children. It was
argued, with scant evidence, that women who are HIV positive are more
likely to have unintended pregnancies and that the focus has been too
much on preventing mother-to-child transmission once a woman is pregnant.
This framing is, first of all, incorrect because it gives the impression
that preventing the unintended pregnancies of HIV-positive women is
more important than preventing the unintended pregnancies of negative
women, simply because these women are HIV positive. Second, it is insensitive
to women living with HIV and AIDS, a population that has more often
than not been told they should not reproduce rather than told they can.

As the moderator and final presenter
had an opportunity to change the framework around sexual and reproductive
health and people living with HIV and AIDS to one about basic human
rights, she only repeated this problematic framework. All in all, I
was disheartened.

This
problem reminds me of one we have been dealing with in the reproductive
justice movement for years; the language around the choice of not having
a child does not resonate for populations who have experienced forced
sterilization, been coerced into having fewer children, or marginalized.
It does not resonate for many women of color in America and it does
not resonate with people living with HIV and AIDS.

I
have been so excited about the change from a "pro-choice" framing
to a reproductive justice framing in the past couple years because I
thought that it represented a shift in the way we talk about family
planning to a way that makes sense for all populations. I was extremely
disappointed that this framing was missing when it came to talking to
the HIV/AIDS community. Reproductive justice is inclusive and when it
comes to HIV-positive people, is something we need to incorporate into
our framing. If we stand for basic human rights, we should stand
for the rights of those living with HIV and AIDS, not because we hope
they will have fewer children, but because they also deserve sexual
and reproductive health and justice.

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  • invalid-0

    good blog. are you saying the HIV/AIDS contraception movement does not see contraception as a family planning tool but only as a way to prevent the spread of HIV/AIDS, and therefore misses the chance to make contraception available to more women who need to do family planning, regardless of whether they are HIV/AID positive or not?