HEALTH: The Divergence of AIDS, and Sexual and Reproductive Rights

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Rosemary Okello*

LONDON, Sep 8 2004 (IPS) - AIDS prevention efforts and initiatives to support sexual and reproductive health would seem to be natural allies. Why is it then that projects to advance these causes so often proceed in isolation of each other?

This question took centre stage recently at ‘Countdown 2015: Sexual and Reproductive Health and Rights for All’, a three-day conference in London.

The meeting, held under the auspices of the International Planned Parenthood Federation and other civic groups, analysed the extent to which goals agreed at the International Conference on Population and Development (ICPD) had been implemented. (The ICPD took place in Cairo, in 1994.)

Various suggestions were put forward in London as to why AIDS prevention and sexual and reproductive health are not dealt with jointly to a greater degree – even though most adult HIV infections in Africa, the continent worst-affected by AIDS, occur via heterosexual transmission.

“The issue is not that the two cannot be combined. But as the (AIDS) epidemic became more serious, it received greater awareness, more funding, more political leadership and support,” said Thoraya Ahmed Obaid, executive director of the United Nations Population Fund.

Other delegates noted there were fears amongst AIDS campaigners that a close association with reproductive health efforts could jeopardize support for HIV-related initiatives. This reportedly stemmed from the fact that the United States’ government under President George Bush had cut funding to organisations that made any reference to abortion.

U.S. officials have also stipulated that a third of funds for the President’s Emergency Plan for AIDS Relief (PEPFAR) – a 15-billion- dollar project launched last year – should be spent on programmes that promote abstinence as the best way to avoid contracting HIV. (PEPFAR money will be allocated to 12 African countries, amongst others.)

Many health workers argue that it would be preferable to advocate the full range of options available to prevent HIV-transmission – including condom use.

Mercela Howell, director for the Youth in the U.S. group, believes a failure promote all preventive options will have especially grave consequences for the youth.

“Young people make up almost half of all new HIV infections, with an average 6,000 young people becoming infected each day,” she says. At present, there are 1.1 billion people between the ages of 15 and 24 around the globe.

Howell’s sentiments were echoed by Obaid. “Young people should be supported to have access to information, contraceptives and health care,” she noted.

The need to link AIDS and reproductive health efforts becomes even more pressing, noted delegates, when one considers that many who find they are HIV-positive do not equate this diagnosis with a termination of their sex life.

“Sexual pleasure is a right even for those who are HIV/AIDS positive,” said Promise Mthembu, a young woman from South Africa who is living with AIDS.

She noted that the failure to include HIV-positive women in reproductive health initiatives could lead to recriminations in the event that they fell pregnant: “When she is found to be pregnant, she can expect to be asked ‘How did you get pregnant in the first place?’.”

The situation is worsened when women living with AIDS are unable to get hold of the anti-retroviral drugs that prevent mother-to-child transmission of HIV.

According to research undertaken by the International Community of Women Living with HIV/AIDS (ICW) on the situation of HIV-positive women in francophone Africa, the sexual and reproductive health of these women is not a priority in national policies to combat AIDS. Twelve countries were surveyed for the research.

The IWC is critical of international donors, national governments and non-governmental organisations for failing to allocate funds that would allow HIV-positive women to receive more assistance with their sexual and reproductive health.

Said Fred Sai, special advisor to the Ghanaian president on issues of reproductive health, “Today we are trying to get society to understand that HIV/AIDS is a problem and needs to be linked to reproductive health.” Sai also headed an ICPD committee that played a key role in developing the programme of action that emerged from the Cairo gathering.

In their recommendations, conveners of ‘Countdown 2015’ said the opportunity should be seized to integrate HIV/AIDS and reproductive health programmes. This also offered health officials the chance to reduce project costs, increase effectiveness and provide a better service to their clients, they observed.

‘Countdown 2015’ wrapped up Sep. 2.

* This report was produced jointly by IPS and the African Women and Child Information Network.