UNAIDS estimates that there were 240,000 people living with HIV in Central Africa in 2005. The standard prevalence of HIV, according to the MICS III survey of 2006, was 6.2%, 5.7% of which were women.
Like in other African countries, HIV-positive women are stigmatized, and discriminated against, because of their serological status. The stigmatization begins at home, and is often conveyed through piercing words and hurtful glances.
In a workshop concerning the sexual and reproductive rights of HIV-positive women, which was organized in December 2009 by the Association of Men Living with HIV (AVVH+)—an affiliate of the Africa Aids Network—participants criticized the behavior of health services personnel.
Medical personnel often believe that HIV-positive women should no longer become pregnant, which results in hospital discrimination.
Indeed, Gabriel Maliyere, the head of the AHVV program, emphasizes how “the behavior of medical personnel is deplorable. After their prenatal exams, HIV-positive women are condemned for the fact that they’re pregnant.”
HIV-positive women are expected to cease having sex and conceiving. In this sense, women are blamed for their sexuality. Yafouta-Kaïe, a member of the National Congress of Young Women Living with HIV/AIDS (CNJFV+), claims: “Above all, it is the hurtful words and the coldness of certain midwives, during childbirth, towards women living with HIV.”
“We begin with the observation that health care professionals sometimes mistreat patients. Certain women are reprimanded because they are expecting a child, and because they are sexually active” Gabriel explains. This may cause healthcare workers to deny [such women] access to contraception, family planning, and other maternity services. Meanwhile, other HIV-infected women are expelled from their homes, since they are blamed for having brought the virus into the home.
Access to reproductive health services
According to AVVH+, there are no associations for women living with HIV, dealing [specifically] with questions of sexuality and reproductive health for HIV-positive women. However, the Central African Association for Family Wellbeing (ACABEF) center offers counseling on these subjects. Their counseling similarly informs any health care center interested in the parent-infant transmission prevention program (PTPE).
In addition, violations of medical confidentiality have been observed in Bangui. According to workshop participants, certain healthcare professionals have allowed themselves to reveal the serological status of their patients, in public. Other patients are compelled to have abortions, or thereafter forced to resort to sterilization. Nevertheless, there are numerous HIV-infected women who feel sexual desires and demand the right of safely having a child.
Despite the availability of parent-child transmission prevention services (PTPE) in every prefectural and regional hospital, HIV-positive women may not find the answers to their questions. There are numerous patients, so midwives and attending physicians do not always have the time to provide patients with a great deal of attention.
Therefore, the question of sexual and reproductive rights for women infected with HIV deserves more attention. For the AHVV+, “It’s at the service level that infected persons can be informed about their rights.”
HIV-positive women, who may want to have children, are in need of information, and, oftentimes, the associations fighting against AIDS are the first sources they consult. They generally use their physicians, or they may approach parent-child transmission prevention services (PTPE). The desire for children is likewise addressed in support group discussions, which are organized by organizations of persons living with HIV.
These questions cannot remain unaddressed. Both the response of human rights organizations, and the struggle against aids, is proven to be essential. Additionally, in the 2006-2010 strategic framework for the fight against AIDS in Central Africa, the strengthened and/or additional protection of affected persons–which includes vulnerable, orphan children (OEV)—happens to be one of the three highly ranked topics. This led to the passage of a law to protect people living with HIV in the country.
The additional value of a regional advocacy project for the rights of people living with HIV
Thanks to the support from the National Foundation for Democracy (NED), for the African AIDS network, AVVH+ will lead activities, which aim to reduce the discrimination and stigma against people living with HIV, in collaboration with associations of women living with AIDS in central Africa.
AVVH+ has participated in radio programs, in order to explain the written contents of the law–signed on September 12, 2006, by the Chief of State–which establishes the rights and obligations of persons living with HIV. Awareness activities have been scheduled for the global Fight against Aids Day, and 40 member organizations supporting people infected with AIDS will participate.
Other public campaigns, HIV/AIDS film screenings, and debates over the rights of HIV-positive persons, were organized on December 8 and 9, 2009, northwest of Bangui and in the 8th arrondissement. During these campaigns, speakers presented on the following themes, which were especially chosen for this educational day : “I am secure, I am accepted, I am receiving treatment, I am in firm possession of my rights, the right to live, and to wellbeing.”
Especially, since Chapter II of law number 06.030, of September 12, 2006, provides protection to people living with HIV in Central Africa and access is guaranteed on these terms.
“Access to care in private and public health facilities is guaranteed to all people living with HIV/AIDS” (Article 9); and “access to additional exams, ARV, and the medications necessary for the treatment of opportunistic infections, are all guaranteed for persons living with HIV” (Article 10).
The AHVV+ works in collaboration with The National Committee in the Fight against Aids (CNLS), and the Central African Network on the rights and ethics of people living with HIV, in their efforts to promote the rights of people living with HIV/AIDS. This is principally because, although this law should be advertised in rural areas, it has been hereto unknown.
The Association of Men Living with HIV (AHVV+) also engages in other activities; for example, it provides psychosocial help, and psychological observation, through three care centers in Bangui, and in two rural zones. The association, which is composed of 136 male and joint members, is also undertaking awareness projects concerning HIV and children.
By September 2010, the AVVH+ will have organized support group meetings concerning the rights and duties of people living with HIV/AIDS (PLA), a workshop on the rights of PLA, and on the fight against discrimination against PLA, with government groups and private enterprises in Bangui. Additionally, it will organize another meeting with the leaders of PLA organizations, concerning their rights and duties, and the means by which they can defend their rights.
While there are workshops and campaigns aiming to bring awareness of the law protecting people living with HIV, very few workshops have been organized in Central Africa specifically for persons infected with HIV. As a result, the work performed by the AHVV+ in this area is responding to needs that were previously unsatisfied.
Remaining Challenges in Bringing Awareness of the law: Reaching Rural Women
It will take a greater degree of effort to bring awareness of this law to HIV-positive persons living in rural areas. It will be necessary to hold awareness campaigns in these areas. Additionally, it will be necessary to hold sessions with HIV-positive women on the means by which they can fight stigmatization and discrimination.
Organizations of people living with HIV, such as the AHVV+, encounter difficulties when acting in rural areas, as a result of logistics and a shortage of resources. The exchanges are generally difficult, and the associations must rely on their members, who labor in these areas, in order to provide the information on rights and responsibilities.
Written by Blandine Louzolo and Sylvie Niombo
Translated from French by Patricia Santiago

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