Week 3: Welcome and Introduction
Welcome to week #3 of our four-week discussion on “Client and Provider Perspectives on Integration of Family Planning Counseling and HIV/AIDS Services." This week we will focus on client perspectives on integration.
Our expert for the week is Anne Namwamba-Ntombela. Anne has been living with HIV for the past 15 years. She is a widow and mother of one child. She started on ARVs in 2002 and is currently doing okay. Anne is the project manager and co-founder of Springs of Hope Support Group. She is also presently pursuing a Masters Degree in Education at the University of Kwazulu-Natal in South Africa. She is specializing in Adult Educations (counselling, motivational talks, HIV and AIDS education, Life skills).
Anne has been involved in HIV and AIDS work since 1996. She is a member of the International Community of Women Living with AIDS (see ICW website at http://www.icw.org/tiki-view_articles.php ). She also also an activist in the Treatment Action Campaign (http://www.tac.org.za/ ) and an advocate for counseling and testing.
Anne’s main interest throughout her work is to restore dignity for people living with HIV and ensure that they are able to access their rights. (Especially women and children).
In today’s posting, Anne shares with us her own experiences with counseling and sexual and reproductive health services/providers. She also talks about what typically happens to women and what issues are most pressing.
We look forward to more of these rich and interesting discussions. Thanks to everyone for participating and for sharing your questions, concerns, and experiences!
Best regards,
HCP and INFO Teams
Anne Namwamba-Ntombela
When I tested HIV positive in 1992, I was not counselled at all, three months later when I had my second test the doctors counselled on SRH issue. Probably these issues were raised because of the particular health problems I was presenting at that particular time. Also having had my child through C/S the doctor discussed other birth control methods with me because I was struggling with the pill. The doctors advised me at this point, that because of my HIV status I should be sterilized. Though I did not have enough information at this point, sterilization was not an option for me.
Unfortunately for many women who find themselves testing HIV positive, they are not given this choice; they are forced to take them. In most cases, most women are finding out about their HIV status during their pregnancy. Many health workers make decisions for this women or choose to give them selective information, making them make such choices like abortion, sterilization etc. In some cases a condition is attached to a service, e.g. We will perform an abortion for you on condition that you consent sterilization.
Some of the issues that concern me include the following;
The fact that many young school girls attend family planning clinics for contraceptives and in the process they are not offered proper SRH counselling and in most cases issues around HIV are not discussed. In such cases the girl’s concern is fear of falling pregnant, not contracting HIV. So she might not insist on her partner using a condom.
An HIV positive woman with a sexual and reproductive problem gets subjected to negative treatment and attitudes from health workers and this makes it so hard for her to go back for further treatment.
There is still a lot of assumption that HIV positive people do not want to have children, so we are not give enough information to support us to experience safe pregnancy. Ensuring that the mother, the father and child are safe. This has resulted in too many unnecessary deaths in HIV positive mothers.
Another challenging issue is the facilities providing SRH services in most cases are in different locations, e.g. one goes for HIV treatment in one hospital and might be referred to another hospital for pap smear. Sadly enough the person is not even made to understand the importance of the test. In most cases, because of the different locations, transport expenses the arise from the whole process.
There is still very little information around ARVs and family planning and how these two affect the SRH of a woman living with HIV.
My experiences as a client have made me a more sensitive service provider. Running an organization for people living with HIV, we provide on-going counselling, which includes a SRH component. Our other efforts include running workshops with people living with HIV on SRH and rights. We make all possible attempts to ensure that they get as much information as possible for them to make decisions that are suitable for them.
My son is now 14 years. Like many other HIV positive women across the world, I have not given up hope that I can have another child and be healthy.
Having been on ARV treatment for 4 years now, my CD4 count has improved from 15 to over 650 today.
I understand that there are other factors that I have to consider as I prepare myself towards motherhood.
But no one has a right to deny me, the right information, support, care and treatment to be a healthy mother, just because I am HIV positive.
These are choices I have rights to make on my own, on the other hand I have the right to proper information to guide me towards making the right decision.
Anne Namwamba-Ntombela