ALQ, March 2007 Edition – Sexual and Reproductive Rights

Editorial...

Reproductive rights are central to human rights…they derive from the recognition of the basic right of all individuals and couples to make decisions about reproduction free of discrimination, coercion or violence. They include the right to the highest standard of health and the right to determine the number, timing and spacing of children. They comprise the right to safe childbearing, and the right of all individuals to protect themselves from HIV and other sexually transmitted infections. [UNDPF, 2005]

While sexual and reproductive health and rights are recognised to be essential to the enjoyment of other fundamental rights and freedoms, the extent to which people are in the position to access, claim and enjoy sexual and reproductive health and rights is equally recognised to be indicative of the gendered nature of HIV and AIDS realities and challenges. Taking these recognised correlations into account would also mean that any response to HIV and AIDS has to have, at its core, not only the access to, but also the enjoyment of, sexual and reproductive health and rights.

In reality, however, the extent to which sexual and reproductive health rights are accessible and enjoyable remains to be largely defined by gendered inequalities, imbalances and injustices, as well as prevailing HIV related stigma and discrimination. Moreover, reality is characterised by prevailing beliefs and prejudices that people living with HIV should not engage in sex and/or have children. As a result, access to information and services is denied and sexual and reproductive health and rights are further limited.

It is within this framework that this edition of the ALQ focuses on sexual and reproductive health rights in the context of HIV and AIDS. The various articles in this issue examine a range of sexual and reproductive health rights and needs as they relate to HIV and AIDS realities and challenges. The societal context in which especially women living with HIV and AIDS make choices about sexual and reproductive health and rights; the intersecting health and human rights crises of HIV and AIDS and gender violence; the inseparable link between sexual and reproductive health and HIV and AIDS; as well as human rights instruments as a potential tool to claim sexual and reproductive rights are some of the issues explored in this edition. This issue is also introducing experiences and challenges from Rwanda; ‘making a point’ about the ‘fear factor’ deterring men from accessing HIV testing services; and providing women’s sector comments on the National Strategic Plan for HIV and AIDS.

In this edition, Susan Holland-Muter discusses sexual and reproductive health and rights concerns of women living with HIV. Examining the societal context in which women living with HIV and AIDS ‘make’ decisions regarding sexual and reproductive health and rights, she argues that in order for sexual and reproductive rights to become a reality, the understanding of sexuality and the role it plays in people’s lives has to be re-shaped and re-signified, the social meaning attached to being a woman has to be challenged, and sexuality has to be seen as an integral dimension of being a human being.

Recognising the AU Protocol on the Rights of Women as a tool to claim sexual and reproductive rights, Caroline Murrithi raises the question as to whether or not the Protocol adequately caters for all women, including women living with HIV and AIDS. Examining women’s realities and challenges pertaining to their sexual and reproductive health, and looking at the opportunities within the Protocol to address these, she argues that the Protocol, despite its progressiveness fails to adequately address the needs and realities of women living with HIV and AIDS and thus, calls for further advocacy and lobbying so as to ensure that the sexual and reproductive health rights of all women are equally protected by the Protocol.

The intersecting and mutually reinforcing health and human rights crises of HIV and AIDS and gender-based violence are discussed by Susana Fried. Analysing some of the critical issues surrounding the intersection of gender-based violence and HIV and AIDS, and introducing some promising practices addressing these intersecting crises, she places gender equality at the centre of the debate and argues that only as and when responses are comprehensive, gender-sensitive and human rights-based, will they carry the potential to effectively address the intersection of HIV and AIDS and gender-based violence, and to create conditions for safe, healthy, consensual and diverse sexualities and life choices for all.

The extent to which the access to, and realisation of, sexual and reproductive health and rights impacts on HIV and AIDS realities and challenges in Nigeria are introduced by Busari Olusegun. Exploring various realities of sexual and reproductive health and rights, including practices of female genital mutilation and child marriages, he argues that it is not only vital to develop policies and programmes addressing the inseparable link between sexual and reproductive health and HIV and AIDS, but also crucial to effectively implement these policies and programmes, since the failure to adequately implement policies and programmes is worse than the absence of such policies and programmes.

Some of the specific sexual and reproductive health rights issues of women living with HIV and AIDS are introduced by Nomaphondo Barnabas. Exploring various challenges that contribute to the violation of sexual and reproductive rights and looking at the scope of sexual and reproductive health services, she argues that the absence of informed choices and adequate sexual and reproductive health services not only denies women living with HIV and AIDS their sexual and reproductive health and rights, but also increases their risk of morbidity and mortality.

HIV realties and challenges from Rwanda are introduced by Emmanuel Habumuremyi. Analysing various responses to HIV and AIDS within the Rwandan context, including the use of cell phones to enhance HIV and AIDS treatment, support and care, he argues that, despite many successes and utilisation of innovative measures leading to the decline in HIV infection rates, there are many remaining challenges, including ignorance, continuously threatening the adequate response to HIV and AIDS in Rwanda.

Kent Klindera, Dumisani Rebombo and Andrew Levack are ‘making a point’ about the ‘fear factor’ defining men’s preparedness and willingness to be tested for HIV. Recognising the importance of men accessing HIV testing services and analysing the factors deterring men from utilising available HIV testing services, the article argues that a new form of masculinity is needed to maximise the impact of HIV and AIDS strategies and programmes, since gender roles not only limit men’s involvement in HIV and AIDS efforts, but also limit the success of these efforts.

While the particular examined reality may vary, there seems to be a common underlying reality – one of gendered inequalities, imbalances and injustices, as well as stigma, discrimination and violation of rights based on sex, gender, sexuality, and/or HIV status – which ultimately defines the extent to which sexual and reproductive health rights are accessible and realisable. Thus, sexual and reproductive health and rights are as much limited, as choices are influenced, by the gendered societal context and existing HIV related stigma and discrimination.

If we are to agree that the right to make informed choices ‘free of discrimination, coercion or violence’ is at the core of sexual and reproductive health and rights, then we are to equally agree that the prevailing societal context, not only perpetuating, but also justifying, the occurrence of ‘discrimination, coercion or violence’ based on sex, gender, sexuality and/or HIV status, ‘threatens’ the very core of sexual and reproductive health and rights. Similarly, if we are to agree that rights are only as accessible as the societal context in which choices are made ‘allows’, then we are to agree that it is the very same societal context, which ‘prescribes’ the continuous denial of sexual and reproductive health and rights. Thus, at the core of sexual and reproductive health and rights is the societal context in which choices are made.

So, if we are to create an environment that ‘allows’ individuals to make informed choices and decisions ‘free of discrimination, coercion or violence’, then we are to challenge and transform the societal context in which choices are made. Only as and when the existing societal context ‘denying’ individuals to make free and informed choices, is transformed, will sexual and reproductive health and rights become a reality. Until then, the extent to which people are in the position to make sexual and reproductive choices will continue to be defined by a person’s sex, gender, sexuality and/or HIV status; and will remain to be indicative of HIV and AIDS realities and challenges. Thus, until the societal context is transformed, there will be no ‘freedom of choice’, and individuals who claim their right to make sexual and reproductive choices will continue to be stigmatised, discriminated against and/or violated…