“I feel like half a woman all the time”: The impacts of coerced and forced sterilisations on HIV-positive women in South Africa

abstract

HIV-positive women are entitled to sexual and reproductive health rights, including access to contraceptives of their choice. One such option is sterilisation. Given its permanency, a woman's decision to sterilise should be voluntary and fully informed. However, there have been multiple reports that HIV-positive women are being sterilised without their informed consent, and sometimes without their knowledge, in southern Africa and elsewhere.

The Article explores the socio-cultural, physical and emotional/psychological impacts of coerced and forced sterilisations on HIV-positive women. It is part of a larger qualitative study, conducted in South Africa, which explored the experiences of 22 HIV-positive women who reported being sterilised without their informed consent.

Involuntary sterilisation has devastating impacts on women, affecting them mentally and physically, and impacting on their relationships with their partners, families and the wider community. Many interviewees reported that being sterilised profoundly affected their perceptions of themselves as women. Involuntary sterilisations have grave social and emotional implications for already marginalised HIV-positive women. Therefore efforts should be made to address human rights violations in South African healthcare settings and to prevent further gender-based abuses.

Keywords:

• HIV-positive women
• coerced sterilisation
• forced sterilisation
• stigma and discrimination

Acknowledgements

We would like to acknowledge the contributions of all who continued to this research. While we cannot mention everyone by name, their contributions are greatly appreciated.

 In particular we would like to thank the participants in the study; the fieldworkers; Justice and Women, Positive Women's Network and Women's Legal Centre; Professor Govender, Dr Misselhorn and Mr Gunthorpe of HEARD; Lydia Guttermann of OSI; Dr Tallis of OSISA; Dr Kehler of The AIDS Legal Network; and Ms Patel of the Southern Africa Litigation Centre. Furthermore, Sethembiso Mthembu, Her Rights Initiative, who conceptualised the study, obtained funding for it and acted as the over-arching project manager. Without her courage, determination and commitment to the sexual and reproductive rights of women living with HIV this study would not have been possible. Finally, this article has been strengthened through the feedback of reviewers and Dr Tallis.

Notes

1. Litigation has begun against coerced and forced sterilisation at the Inter-American Commission for Human Rights in Chile and at the Namibian High Court (Nair, 2010).

2. Ethics approval number: HSS/1006/010.