Reproductive Justice for people living with HIV: Lessons learned from research in southern and eastern Africa

I recently gave a talk on reproductive justice and HIV sharing the lessons I have learned from my research in Southern and Eastern Africa. I became passionate about this work after meeting and talking with men and women in support groups for people living with HIV in KwaZulu-Natal, South Africa. People I talked with were so concerned about having children and making sure the child was safe. But no one knew that there are also ways to protect an HIV negative partner when you are trying to conceive a child. This has been a game changer for so many people.

Before I started talking with people living with HIV about safer conception, couples had the attitude that either they should not have children or that they would take the risk and leave it up to God to protect their partners from infection. I kept saying, “We can help God out. There are ways to protect your partner.” But the problem was that health care providers often did not have the knowledge on how to counsel couples to safely conceive. Many providers continued to discourage people living with HIV from having children.

Gender norms have skewed our knowledge of HIV and who is at risk. In African settings where the primary mode of transmission is heterosexual sex, more women are infected with HIV than are men. What we don’t think about is that this means that:

there are more women in sero-discordant relationships who could infect a sero-negative male partner.

Men are often highly motivated to have children since there is familial pressure to maintain the ancestral line. Sadly, however,

men often assume their HIV status will be the same as their female partners (proxy testing).

This is absolutely not true. Men need to test to know their own status. A consequence of this is that

men often show up for healthcare services late in the infection stages. Consequently, more men die of AIDS than women because they are often too ill to recover despite medical interventions.

If you are interested in knowing more about these issues you can listen to my full talk here:

You can also read an interview with me by Justin Chapman at Pasadena Now.