" (International Conference on Population and Development ICPD) (ibid)
However the meaning of reproductive right extends into other areas. For example, this includes the right to non-discrimination based on sex/gender and the right to privacy as well as the right to information. The issue of the reproductive rights for women becomes problematic and often fraught with controversy when it is applied to those infected with the HIV virus. This dilemma has far-reaching implications for the millions of women with HIV throughout the world.
3.2. Different perspectives
The different views on the subject of reproductive rights range from the more conservative view that all reproductive rights should be denied in Women with HIV to more perceptive views that links the denial of reproductive rights to other human rights issues. For example, one view from a survey conducted by the International Community of Women Living with HIV / AIDS (ICW) states that,
Health staff has tended to hold very judgmental attitudes concerning the rights of HIV positive women to have children or indeed our right to access safer sex methods and contraceptives or to sexual pleasure. Women interviewed in ICW research have felt that health personnel reflect community member's attitude that HIV positive women should not have children or be sexually active.
Linked Services for HIV Positive Women)
However, views such as the above have a narrow perspective and do not take into account aspects that may impact on women's rights as a reproductive being. Many critics point out that women are more at risk from HIV infection due to their physical vulnerability. Furthermore, many women throughout the world do not have access to information about HIV and AIDS, or they are denied this access. A study by UNICEF found that "...up to 50% of young women in high-prevalence countries did not know the basic facts about AIDS." (ibid)
These factors have to be taken into account from a moral and ethical point-of-view when determining whether women have been denied basic reproductive rights. In addition, it is common knowledge that many women are infected with HIV by their partner's high-risk behavior and not their own. (ibid)
These aspects emphasize the central point that women must be informed in order to have the ability to control their own bodies and reproductive processes. The denial of this information and access to knowledge about HIV is a denial of basic reproductive rights.
This aspect can also be related to social and cultural norms where the woman is viewed as being subservient and inferior to the male. "In many societies, men have the power to determine whether sex is safe or unsafe, forced or consensual, pleasurable or painful. Women, on the other hand, are expected to be ignorant about sex and passive in sexual interactions. " (the Feminisation of HIV / AIDS)
The law status of women in many African counties for example has resulted in a denial of reproductive rights, if these are understood as basic human rights to make decisions about one's own body. In this sense there is no question that especially women with HIV should have full reproductive rights. However the issue of reproductive rights is not just an ethical issue and there are many contributing factors that compound the issue of HIV women and human rights.
3.3. Problem areas
One of the central factors that has affected HIV positive women and prevented them from enjoying reproductive rights and the support of society is the fear of HIV contamination. This fear persists in many societies and affects the implementation and acceptance of reproductive rights even though the medical profession has clearly outlined that HIV cannot be contracted through normal contact. In many instances there are cases of pregnant women being sent away from hospitals because of health-care professionals who fear "occupational exposure to the virus." There are also numerous cases of "A failure to offer adequate pre- and post-test counseling, pressure or coercion to undergo sterilization or terminate pregnancies, and denial of care are all clear violations of HIV-positive women's reproductive rights." (Fulfilling reproductive rights for women affected by HIV) view used by those who are against reproductive rights for HIV positive women is the issue of infant transmission. The fact that HIV may be transmitted to the infant through the mother has fueled the view that women should not have full reproductive rights. While this fact is true it has become much less of a danger in recent years, with many drugs to alleviate the problem.
In the U.S., transmission of HIV infection from pregnant women to their infants is now highly preventable. HIV infection is sufficiently common to justify extension of HIV screening to all pregnant women. Once HIV infection is identified, the degree of immunocompromise may be ascertained through evaluation of CD4 cell number and HIV viral load levels. Use of antiretroviral medications can slow progression to AIDS or death, and prevent mother-to-child HIV transmission.
Livingston, H.) complicating factor which possibly goes to the heart of the dilemma is the controversy about privacy and the declaration of HIV.
In countries like South Africa., for example, where the HIV rate is the highest in the world, the right to privacy is an integral part of the constitution of the country. This not only makes it difficult to ascertain the prevalence of the disease but also presents a problem in that many claim that the right to privacy conflicts with the treatment of HIV / AIDS. "There is a moral conflict between the right to privacy on the one hand and the right to health and information on the other hand. The same problem emerges when the issue of obligatory notification is discussed. " (Vorster, 2003)
While the ethical and moral debates rage, some critics point out that these arguments pale into insignificance in the light of the fact that the dilemma of reproductive rights for women is resulting in deaths throughout the world. "Denial of reproductive rights, including free choice with regard to pregnancy and childbearing, causes millions of deaths every year and much more illness and disability. Most of those affected are women in developing countries. ("Women Endangered, Says World," 1998, p. 14)
The right of control over reproduction is essential, many critics state, if HIV is to be fought. Many experts are of the opinion that women should be forced to disclose their HIV status prior to giving birth. On the other hand there are those who state that the very basis of the problem lies in the denial of women's control over reproduction in the larger sense, which has resulted in the high incidence of women and mothers with HIV. A view that tended to dominate in the literature was that women should not be forced to have HIV tests but that these tests should be offered as an option and encouraged by the medical authorities.
Our argument is not that testing should be forced on women who genuinely do not want it, but that it is useful and should be recommended to them-indeed, more strongly, that it should be regarded as routine except where special objections are expressed. Respect for objections need not suggest, however, that "consent" should be given a stronger interpretation for HIV than for other tests administered during pregnancy, or that women should be counseled against giving consent. (Almond & Ulanowsky, 1990) p.16.
Another factor in the debate is poverty and economics. Once again the views on this subject depend on the country and culture which is being referred to. In Africa for example, where there are areas of extreme poverty, this is a much more serious problem than in the United States. Critics of reproductive rights state that the costs to society and to the family of having an HIV positive child are extensive and often create further problems for the HIV positive mother. Furthermore, HIV leads to AIDS and to death and this can add to the suffering. On the other hand those in favor of reproductive right for women point out that this should, in the first instance, be an issue that women should decide on.
They refer to the fact women should have the right to determine the future of their own lives and children. However, the situation is different in more developed countries where the cost of HIV screening and drugs to prevent transmission have been greatly reduced ((Livingston, H.)
Critics of reproductive rights for women with HIV insist however that in the final analysis the problems created by pregnant HIV mothers outweigh the moral and ethical factors.
For the worst thing that could happen to any young woman embarking on childbearing is to reach the later stages of pregnancy and childbirth and then find out what she would so much have preferred to know earlier: that what would have been a single tragedy has been…