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HIV-positive women in Chile face forced sterilization

Report says women in Chile with HIV face abuse and sterilization without consent.

A year and several hospitalizations later, Matilde’s viral load was undetectable, and given the low risk of mother-to-child transmission, she and her partner decided to have a baby.

Access to treatment and attention by specialized medical staff working with HIV/AIDS patients is usually not the problem. The lack of attention and humiliating treatment comes in the maternity wards, labs or doctors' offices, where women go for their regular checkups or to seek help for other health problems.

“A number of women are made to wait until all the non-HIV patients are treated first. Or they may be turned away entirely because health care professionals don’t want to touch them. One woman was told not to hug or kiss her baby because she would infect him,” said Phillips.

When Matilde would go to routine check-ups at the hospital, the staff there “instead of supporting me, asked me why on earth I wanted to have a baby, if I didn’t know that I was bringing a sick child to the world and that I would live a short life. What they were subtly telling me was that I should have aborted,” she said.

Three months into her pregnancy she experienced abnormal vaginal discharges and sought help in the emergency room of a public hospital. However, when the paramedic learned she was HIV-positive, she said, he stopped short and told her to go home, scolding her for being pregnant in the first place.

She returned two days later for her regular checkup. Already hemorrhaging and in severe pain, she had to wait for the staff to assist all the HIV-negative patients first. Her baby’s heart was no longer beating.

“I am more than certain that if a doctor had attended me from the beginning, I wouldn’t have lost my baby,” she said.

The first cases of HIV/AIDS in Chile appeared in 1984, and the first HIV-positive woman was reported a year later. The number of reported HIV/AIDS cases through last year was 22,115.

Most are young adult males, and 87.4 percent were infected through sexual transmission, mainly homosexual and bisexual. However, the ratio between men and women with AIDS has steadily fallen, from 9.7 in 1990 to 5.7 in 2009, and among men and women with HIV, the ratio dropped from 6.2 to 3.7 in that same period.

“Government prevention campaigns have always focused on the general population and on occasion, specifically on the homosexual community, but never on women. Public health centers distribute condoms to sexual workers, homosexuals and people with HIV, but not to women in general because they are not regarded as a group at risk,” said Sonia Covarrubias, of the NGO EPES, which provides education to working women.

At the time, Francisca thought that the sterilization of HIV-positive women was normal procedure in hospitals. “I had absolutely no information about HIV and at that moment I was very frightened and more concerned about my son’s health,” she recalled.

She later learned her rights after being contacted by Vivo Positivo and in 2003 the NGO filed a lawsuit on her behalf in a local court against the Curico hospital staff responsible for her sterilization. The case was dismissed five years later after hospital officials claimed she had given verbal consent. She says she had not, and even if she had, Chilean law requires written informed consent.

In March 2009, the Center for Reproductive Rights and Vivo Positivo submitted Francisca’s case to the Inter American Human Rights Commission.

“I wanted to have more children,” said Francisca. “It hurts when my son asks for a little brother or sister — how can I explain to him that I can’t?”