Is it a rights violation or lack of knowledge about options? An examination of HIV counselors views on whether women infected with HIV should procreate

Abstract

Prior to the widespread availability of antiretroviral therapy (ART), the desire to conceive among HIV-positive women was discouraged due to a high perinatal transmission risk [1]. The recent advancement in HIV therapy has transformed the conceptualization of the infection. In particular, highly effective prevention strategies have led to a near elimination of the pediatric HIV epidemic in the United States and Europe [2, 3]. “Virtual elimination”of pediatric HIV infection is a now touted as a near-term target [4], and the proportion of HIV-positive individuals who desire to exercise their fundamental right to reproduction is increasing.

With this reality, experts currently advise that health professionals to approach the HIV-positive client as a person with rights just as any other individual [5, 6]. As to whether the Ghanaian healthcare provider is abreast of the fact that HIV-positive persons have reproductive rightsmotivated the investigation from which this commentary metamorphosed. I examine in this short communication how knowledgeablea group of Ghanaian healthcare workers are on the subject of HIV and reproductive rights.

A survey of nurse counselors (32) and medical officers (3) providing counseling and testing services to HIV-positive clients in two Ghanaian districts was completed. Figure 1 depicts the results obtained. The study uncovers two main perspectives. On the one hand, there was an overwhelmingly high level of approbation by the providers on HIV-positive women's right to reproduction (94.3%), on the other providers demonstrated a disappointingly high level of ignorance regarding the various reproductive options available to women infected with HIV in Ghana. It is worthy of note that Articles 1 and 16 of the Universal Declarations of Human Rights recognize the reproductive rights of all humans. (“All human beings are born free and equal in dignity and rights...”)...(“men and women of full age, without any limitation, have the right to marry and to found a family...”) [7].Women infected with the AIDS virus clearly fall within this scope.Only about 10% of theproviders were aware of some reproductive options for HIV-positive women. A quarter would advise HIV-positive women to have unprotected intercourse as an option to conceive. Some of the providers openly expressed their inability to give qualified and relevant advice to HIV-positive women on the options tabled for discussion. There are no specific policies with regard to reproductive rights and options for HIV persons accessing services in Ghanaian hospitals. Other constraints mentioned were lack of resources and knowledge upgrade refresher trainings.In a related study in Tanzania, Leshabari et al. revealed a high level of stress, frustration, and acknowledgment of incompetence by the nurse-counselors [8].