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South Africa: Reproductive Rights of HIV Positive People Under Discussion

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Few services are available for people living with HIV who want to conceive safely.

HIV-positive Phindile Madonsela always used a condom with her partner, but one day it broke. When it had happened before, she had gone to the local clinic and obtained emergency contraception, also known as the morning-after pill, but this time she did not go because she feared the disapproving attitude of the nurses. Later she discovered she was pregnant.
HIV阳性患者Phindile Madonsela长期使用避孕套,但有一次避孕套破了。以前如果出现这种情况,她会去当地诊所进行紧急避孕,即服用晨起型避孕药,但这一次她没有这样做,因为她害怕护士们责难的眼光。后来,她发现自己怀孕了。

Madonsela, a volunteer HIV/AIDS educator for AIDS lobby group, the Treatment Action Campaign (TAC), had mixed feelings. "I promote condoms, so I felt very bad about being pregnant," she told PlusNews. "But I said to people, 'I'm positive, and I still have the right to have a baby.'"
Madonsela是艾滋病院外团体“治疗行动活动”(TAC)的志愿教育工作者,她对此有复杂的感觉。 她告诉PlusNews,她支持使用避孕套,不想怀孕,但她会告诉其他人:“我HIV阳性,但我有生育权。”

She received no advice from counsellors or health workers but consulted her church elders and her mother. "My mother was very angry with me that I was pregnant - she didn't realise I could have a negative baby."

From her work with the TAC, Madonsela knew that if she took Nevirapine, an antiretroviral (ARV) drug available from the public health sector, during labour and also gave it to her baby soon after birth, she could significantly reduce the chances of infecting her child with HIV, and formula feeding instead of breastfeeding would further reduce the risk. Her little girl, now 2 years old, is healthy.

According to the Guttmacher Institute, a sexual and reproductive health nongovernmental organisation (NGO), research in both the developed and developing world suggests that HIV status does not significantly dampen people's desire to have children. As more and more HIV-infected South Africans access life-prolonging antiretroviral (ARV) treatment, the question of whether or not to have a child, and how to do so as safely as possible, is bound to become more common.

There is no official framework to guide health workers on advising HIV-positive people about their reproductive rights and options. Dr Anna Amos, head of women's health in the health department, said guidelines were being developed and a policy document was likely to be released some time in 2007.

"I think there's a realisation that there's a need, but at the moment it's very haphazard," said Dr Vivienne Black of the Reproductive Health and HIV Research Unit (RHRU) at the University of the Witwatersrand.

The disapproval of friends and family, and even some health workers, may deter those less well-informed than Madonsela from learning more about their options. "Most people think if you're positive you don't have the right to be in a relationship, or to have a baby," she said.




作者:admin@医学,生命科学    2011-04-02 05:14