Inter Press Service - October 8, 2003
Marwaan Macan-Markar

That is because the 35-year-old from southern Thailand's Ranong province has been living with HIV for the past 12 years. She was infected by her husband.

"The community I live in has accepted me as a person with HIV, but when I get pregnant that will change for sure. I know," says Marisa, an unusually tall and broad-shouldered woman for a Thai. "They will condemn me for my pregnancy."

She expects as hostile a reception from any of the hospitals she may turn to when its time to deliver her baby. "I will have to face discrimination and comments from the doctors and nurses because I am an HIV-positive woman."

Yet Marisa is determined to face this harsh world because of her desire to enjoy the pleasures of motherhood. "I will not stop loving, not stop becoming pregnant, not stop having a family as the society expects me to," she asserts, her voice rising to make the point. "I want a normal family life. I would like the society to open up and tolerate HIV-positive women as human beings."

There are other Thai women like Marisa who feel as combative, such as Junsuda, whose fear of being taunted by her community forces her not to reveal her last name. This 34-year-old from Bangkok has been living with HIV since she was 17 years old.

Junsuda has already endured the humiliation that Marisa anticipates. She was rejected by four hospitals when it was time to deliver her baby two years ago, because she requested a caesarean operation.

Such a climate, however, has not beaten down into silence these people who are living with HIV, as reflected in their active presence at a week-long conference here on the reproductive health in the Asia and the Pacific.

The Second Asia Pacific Conference on Reproductive and Sexual Health offered a platform to raise regional and global consciousness about the need for clear policies to ease the hostility women with HIV face when they want to get pregnant.

Susan Paxton of Australia, for one, made a strong case against the practice of subjecting pregnant women to test for HIV. This is an "act of discrimination" in the health sector, said Paxton of the Asia-Pacific Network of People Living with HIV/AIDS.

Until such time that hospitals have a mechanism sensitive to the particular concerns of women with HIV including counselling facilities this attempt at testing should be put on hold, Paxton argued during a well-attended session on Tuesday afternoon.

"The main purpose of such testing is not for the woman's health but to advise her against child birth," she added during a later discussion. "The decision about becoming pregnant is not always under the women's control."

To drive home the point that discrimination like this cuts across both South and South-east Asia, Paxton quoted from the first-ever regional study on AIDS-related discrimination. Of the 753 people surveyed from India, Indonesia, Philippines and India, some 46 percent were women, out of which nearly half, who were pregnant, admitted that they had been coerced into taking an HIV test.

The report also exposed other disturbing figures: 40 percent of women said they were had not been provided pre-test counselling, 52 percent said there had been no post-test counselling and 21 percent said they were not advised about such a test.

Once the tests revealed HIV-positive status, 14 percent of the women were told to have an abortion, a third of the women were told not to have the child and three percent had their baby taken away from them.

Such accounts, in fact, have brought to the fore a reproductive health issue that was not in the spotlight during the 1994 International Conference on Population and Development, the U.N. conference in Cairo that produced a document aimed at shaping the world's reproductive health agenda.

"The reproductive health issues that matter to HIV-positive women have gained in importance since the ICPD, and it is an issue that is still evolving, because it is very sensitive," Michael Mbizvo, a reproductive health expert at the World Health Organisation, told IPS.

"We need more research to be done to ensure that the women with HIV have a right to be pregnant and to be mothers," he added. "Hopefully when we mark the 10 years since the ICPD, we will have a new document that has addressed this problem in concrete language based on evidence."

This development comes in the wake of more girls and women being infected with HIV/AIDS. At the end of 2002, for instance, 19.2 million women across the world had been struck by the pandemic, and they amounted to some 46 percent of the 42 million people living with HIV/AIDS.

In the Asia-Pacific region, women make up 13 percent of the HIV-positive adults living in East Asia and the Pacific, while across South and South-east Asia 35 percent of those afflicted with the deadly virus are women, states a report released this year by the Economic and Social Commission for Asia and the Pacific (ESCAP), a regional U.N. agency.

Marisa and Junsuda are among them. While they try to draw attention to their predicament as members of Power of Life, a group of Thais living with HIV/AIDS, they are determined to stand tall against the social and cultural pressure they face.

"There is no concern about our feelings, about how we live in society," says Junsuda. "So we have to say 'no' to this system, reject it and fight to be able to control our lives." (END/IPS/AP/PR/HE/HD/MMM/JS/03)

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