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Abstract
BackgroundPeople living with HIV have the right to healthy, satisfying sex lives and to appropriate services to ensure their sexual and reproductive health, including having healthy children. The reproductive rights of people living with HIV/AIDS are, however, often met with skepticism and discrimination, despite recent advances in HIV treatment. ObjectiveTo assess the attitudes of community members in Kano, Nigeria, toward the right of persons living with HIV/AIDS to have healthy sexual relationships and bear children. MethodsA cross-section of 399 adults was interviewed using pretested structured questionnaires. Logistic regression analysis was used to obtain adjusted estimates for predictors of agreement with the rights of persons with HIV/AIDS to bear children. FindingsA substantial proportion of respondents (28.6%) strongly agreed and agreed (10.5%) that persons with HIV/AIDS should not be allowed to marry. More than a fifth of the respondents disagreed (16.0%) and strongly disagreed (8.0%) with the rights of HIV-infected persons to bear children. Agreement with the statement “HIV-infected persons should have biological children” was independently associated with higher educational status (adjusted odds ratio: 2.26, 95% confidence interval: 1.82-6.73) and awareness of prevention of mother-to-child HIV transmission effectiveness (adjusted odds ratio: 2.53, 95% confidence interval: 1.92-5.37). Of those who agreed that HIV-infected persons should have children (n = 253), 17.8% and 26.1% strongly agreed and agreed, respectively, that persons living with HIV/AIDS should be restricted to having fewer children. Further, 11.5% and 4.8% of respondents disagreed and strongly disagreed, respectively, that infertile HIV-infected couples should receive fertility treatment. ConclusionsPeople living with HIV/AIDS face discriminatory attitudes to their reproductive rights in northern Nigeria. There is a need for effective, culturally appropriate information, education, and communication approaches to improving community perceptions of sexual and reproductive rights of people living with HIV/AIDS.
Highlights
Before the advent of effective antiretroviral treatment, recommendations that HIV-infected women cease childbearing altogether were not unusual.[1]
Highly active antiretroviral therapy has transformed HIV infection from a lethal disease to a chronic manageable condition.[3]. This changed landscape has dramatically improved the quality of life of and renewed hope for people living with HIV/AIDS (PLWHA)
The World Health Organization requires that all persons respect the sexual and reproductive rights of others, including the right to equality and nondiscrimination, to marry and form families, to decide the number and spacing of one’s children, and to access the highest standard of sexual and reproductive health care.[6]
Summary
Before the advent of effective antiretroviral treatment, recommendations that HIV-infected women cease childbearing altogether were not unusual.[1]. In many developing countries health systems and community attitudes often still do not support the rights of PLWHA to enter into relationships, marry, and bear children.[4] The Cairo Declaration and the Beijing Platform of Action recognize sexual and reproductive rights as essential human rights for PLWHA.[5] These include the right to access information and services regarding sexuality and fertility, access to sexually transmitted infection treatment, and the right to choose to reproduce or not. HIV have the right to healthy, satisfying sex lives and to appropriate services to ensure their sexual and reproductive health, including having healthy children. The reproductive rights of people living with HIV/AIDS are, often met with skepticism and discrimination, despite recent advances in HIV treatment
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