In this article published online at the Open Democracy website, the author discusses public health policies and legislation which are not rooted in the experience of women and are damaging the rights of women, particularly HIV positive women. Welbourn illustrates the infringement of rights of women who test positive by describing their abandonment by their families, communities, and government health systems. What is lacking, as stated in the article, when legislation binds every pregnant woman to take an HIV test, is social responsibility on the part of the state and health institutions for the welfare of people in challenging socio-economic situations so that they can continue to live normal and healthy lives.
The article describes the intent of some international development agencies, including the United Nations Children's Fund (UNICEF)and the World Health Organization (WHO), to promote an "Aids-free generation" through ante-natal testing of pregnant women as leading to perception of women "as vessels and vectors", rather than as individuals with rights and as those on whose lives their children depend. This, as stated here, has led to laws that not only violate women's rights, but also imperil their children. In Sierra Leone, for example, HIV transmission from a woman to her unborn child has become a criminal offence punishable by 7 years imprisonment. This model of law also promotes the mandatory disclosure of a woman's status to her husband, regardless of consequences.
The author points to the legal situation and the state of women regarding HIV infection in the United States (US). According to research, testing, though voluntary, can carry the pressure of stigmatisation, if it is done on an "opt-out" (meaning that the test is given unless the woman expressly requests that it not be done) basis. A study from one "opt-out" programme showed that fewer than half of the respondents felt comfortable refusing the test and 16% did not know if they had been tested. A report from the American Civil Liberties Union (ACLU) points to the fact that women receiving mandatory testing are less likely to be prepared for the results, less likely to have received counselling and information, and less likely to seek follow-up care. Those who are pregnant and receive HIV positive test results without preparation and support, are the most vulnerable.
The author addresses power imbalances that cause the focus of testing to be on pregnant women, suggesting that, ideally, voluntary and frequent testing should be a norm that would alert people to their status before pregnancy. She cites forced sterilisation of HIV positive women in some countries as the path down which mandatory testing might lead, rather than the path to well-supported and safe pregnancies.
A project called "Parliamentarians for Women's Health”, located in four African countries and coordinated by the International Community of Women livingwith HIV/AIDS (ICW), with the Center for the Study of Aids, the Ethical Globalization Initiative, and the International Center for Research on Women, is designed to allow women, including HIV positive women to take "their collective, politicised experiences to an audience which has the power to create legislative change." According to the author, the participation of women with members of parliament allows for them to address the spread of judgemental, punitive laws, and policies which negatively affect them and their children and advocate for those that preserve the rights of HIV positive women and their children.
The ICW maintains a website on this topic, which contains links to more articles, a sign-on letter written by civil society organisations (CSOs), and a link to alternative language, authored by the Joint United Nations Programme on HIV/AIDS (UNAIDS), to the Francophone and Lusophone West Africa Model AIDS Law.
