I am a woman living with HIV, but I am a woman first. As a woman, I have similar hopes, dreams and desires as women who are not HIV positive, including having a family. Twenty years ago when I was first diagnosed, people living with HIV were discouraged from having children due to lack of methods to prevent our children from becoming infected with HIV. Families who chose to have children during the early days of the epidemic were highly stigmatized by the medical community, family and friends leading many people, including myself to forgo or delay starting or increasing our families due to lack of support.
Today, highly effective methods are available which, when taken correctly, can reduce the risk of HIV transmission to an infant to almost zero. Yet, despite volumes of medical evidence and thousands of children born HIV free globally, people living with HIV face judgement and condemnation when we choose to have children.
According to the World Health Organization, all couples and individuals have the right to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence. "These rights have long been denied to people living with HIV.
Reproductive justice is a concept linking reproductive health with social justice. It is the realization of economic, social and political power and resources to make healthy decisions about our bodies, sexuality and reproduction for ourselves, our families, and our communities in all areas of our lives. What are the reproductive justice issues for people living with HIV in Canada? There are many.
Some actions are obviously unjust and infringe on the human rights of people living with HIV such as coerced termination of pregnancy, coerced sterilization, denial of medical services and differential treatment during hospital stays. Instead of the gloriously joyful experience of birth that every parent has the right to experience, m any people with HIV face isolation, unnecessary and inappropriate disclosure of their HIV status to friends and family by health care providers, extraordinary, over-the-top precautions such as double gloving to take a blood pressure.
Other injustices are not so obvious. These include the public condemnation of people living with HIV who have children. All you have to do is read the comments by pitchfork wielding readers on a story about people with HIV having babies to know that there is little support in the general public for our desires and intentions to have children. Comments such as, "those people are selfish to want to be parents", " why don't they just adopt", and that we should be charged with "murder" for exposing our children to HIV are uninformed and based on prejudice not fact. People with HIV not only face stigma and judgement related to their HIV status, there are also other stigmas faced by our communities including drug use, sexual behaviour and racism.
Sadly these prejudices and attitudes are not only common among the general population but also exist within the medical community. These types of comments and actions, especially by healthcare providers, can traumatize people with HIV and may even prevent some of us from seeking the pregnancy planning, prenatal and antenatal services required to create healthy families. The truth is that no matter how much research we do and how much we evidence and support we provide within the HIV community to those of us who want to have children, stigma from the public remains the greatest barrier to achieving reproductive justice for people living with HIV in Canada.