Monitoring policy on implementing PMTCT in Thailand: unmet needs on sexual reproductive rights of women living with HIV/AIDS (WLHA)
S. Talawat1, R. Phiromchai2, P. Panitchpakdi3, S. Baotip3, A. Nilo4, Thai Positive Women Network
1Raks Thai Foundation, Program, Phayathai, Thailand, 2Raks Thai Foundation's consultant, Phayathai, Thailand, 3Raks Thai Foundation, Phayathai, Thailand, 4GESTOS, Recife, Brazil
Issues: The SRH services do not meet needs of WLHA on sexual reproductive rights such as informed choices, reproductive rights, and comprehensive counseling.
Description: This study aims to monitor the progress of PMTCT and it gaps between practice and policy by utilizing structured interviews for a total of 326 interviews (24 SRH providers, 238 pregnant women and couples, 64 PLHA including male and female) in five regions.The findings revealed that the PMTCT counseling emphasized on the effectiveness of HIV prevention (62.5%) and only 45.8% mentioned the problem with resistance of nevirapine. Most WLHA told their serostatus to their partner (82.7%). 24.5% of women encountered problems after disclosure. 68% of counselors never had training on informing clients of their child's blood test result. 66.7% of service providers felt that the woman should abort an unplanned pregnancy.About half of WLHA said they felt pressured to have a sterilization (58.5%) and 43% actually agreed to a sterilization. Advice on contraception for WLHA and non-infected women is not identical. 59.6% of WLHA said that they knew that they were HIV+ before getting pregnant. However, if they wants to have a child, only 4.5% of counselors are “very confident” in giving good advice.
Lessons learned: There are areas of discrepancy between service provision and needs of WLHA in the area of counseling on PMTCT, HIV disclosure, family planning etc.
Next steps: SRH services for WLHA must reduce the focus on the women as the driver of the epidemic, and instead view her as a client with human rights and who is entitled to equal services with informed consent in every service outlet. Staff must see that controlling the decision-making and options of women is a form of discrimination and rights violation. There is a need to build strength of the system of counseling in government, NGO and community groups.
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