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Reproductive health rights and services for the infected

by Emma Tuahepa Kamapoha
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People Living with HIV (PLHIV) have the right to a pleasurable and enjoyable sexual life; the right to intimacy, to have children, and to love. 

Sexual and reproductive health rights imply that the choices and decisions regarding our sexuality and reproduction should be ours to make – free of coercion and  HYPERLINK "" \o "Read about our work reducing stigma" \t "_self" stigma. PLHIV have freedom of choice regarding consensual and pleasurable sexual expression; reproduction, marriage and planning a family.  

HIV positive people also have the fundamental right to access sexual and reproductive health services without fear of being stigmatised or judged for their sexual and reproductive health choices. 

Seven years ago, I made an informed decision to have my own child, crystal clearly knowing that I am HIV positive practicing my reproductive right. I honestly feared the reaction from the public and the community. It is commonly expected that as an HIV positive person, I protect myself and my partner. It is also believed that addressing sexual reproductive health and human rights is also key to slowing the spread of the epidemic by preventing new infections. I personally opted for an insemination that was done in South Africa and I am a proud mother who gave birth to one of the most beautiful girls in the world.

It is estimated that more than 200 000 people in Namibia are living with HIV. These statistics are clearly derived from the HIV positive tested pregnant women. For too long the sexual and reproductive health rights of people living with HIV received little attention. 

A positive HIV test taken in most cases is sought to be the end of a person’s sex life, chances of child bearing and starting a family. In Namibia we had and are still having a case where a number of Namibian women lose their child bearing capabilities due to the fact that they are HIV positive. 

These women are deprived of their reproductive rights intentionally by health practitioners. At the first pregnancy of an HIV positive person, it is well accepted by our health practitioners and the second, third . . . is extremely condemned. 

Women get these negative harsh reactions; verbally and emotionally get abused by our health service providers simply because they are HIV positive and pregnant. The policymakers and health professionals must learn to understand people living with HIV’s needs in consideration of their reproductive rights.

Addressing the sexual and reproductive health needs of people living with HIV, we need to address the reality on the ground. People living with HIV need to guide this process. I am of the opinion that if people living with HIV are well trained and informed about their rights a lot can be achieved. 

Speaking from a public health perspective, people living with HIV do enter into relationships, have sex and bear children. Our public health sectors, policy makers and health professionals should ensure that people living with HIV do those things safely in order to maintain their own health and that of their partners. In Namibia we do not have various options of making babies without putting the other partner at risk of re-infection or new infection. As far as I am concerned that is the reality on the ground unless someone can advise me otherwise. We are silent on these kinds of issues and yet we strive for prevention. It would be probably cost effective if there is a private health practitioner in Namibia introducing the process of sperm insemination and if considered this could be a breakthrough of our health sector. This in itself would address the aspects of re-infection and new infection and is a prevention method on its own. 

The sexual and reproductive health desires of people living with HIV are as varied as the epidemic itself. 

The issues facing  HYPERLINK "" \o "More on young people and HIV" \t "_self" young people living with HIV as they embark on new relationships (repeated disclosure; potential sexual rejection because of HIV status, etc) are very different to the issues facing an HIV positive couple who may wish to conceive (health care provider attitudes; accessibility of appropriate services). 

So our reproductive health policies to HIV positive people should not be perceived as only for HIV positive couples wishing to conceive but rather holistically for indefinite couples as well. It is time that our health system introduces various ways of reproduction without putting others at risk. Know your reproductive rights, practice them and seek medical advice.



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