Towards treatment guidelines for women of reproductive age: recognising the right to choose

abstract

One of the striking features of the HIV epidemic in sub-Saharan Africa is that it is increasingly feminised, with women comprising a growing proportion of those infected and affected. While access to HIV treatment has been an area of contestation in South Africa, women's sexual and reproductive health has been neglected. Historically, the paradigm of Prevention of Mother-to-Child Transmission (PMTCT) led the way as a clear, evidenced-based method of prevention. Many HIV-positive women, after dealing with their initial diagnosis and stabilisation on treatment, express the desire to have a child. There is an absence of treatment guidelines for women of reproductive age that include options for Highly Active Antiretroviral Therapy (HAART) and options around fertility intentions. Abortion and HIV services are not integrated, linked or regulated. There are limited spaces to address sexual and reproductive health and rights. There is a need to move from an HIV and AIDS maternal health paradigm to one that embraces women's sexual and reproductive health and rights.

keywords:

• Women's Health
• HIV and AIDS
• treatment guidelines
• choice
• prevention