Khosla Rajat, Van Belle Nuna, Temmerman Marleen
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland;
Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
J Int AIDS Soc. 2015 Dec 1;18(Suppl 5):20280. doi: 10.7448/IAS.18.6.20280. eCollection 2015.
The right to sexual and reproductive health (SRH) is an essential part of the right to health and is dependent upon substantive equality, including freedom from multiple and intersecting forms of discrimination that result in exclusion in both law and practice. Nonetheless, general and specific SRH needs of women living with HIV are often not adequately addressed. For example, services that women living with HIV need may not be available or may have multiple barriers, in particular stigma and discrimination. This study was conducted to review United Nations Human Rights Council, Treaty Monitoring Bodies and Special Rapporteur reports and regional and national mechanisms regarding SRH issues of women living with HIV. The objective is to assess areas of progress, as well as gaps, in relation to health and human rights considerations in the work of these normative bodies on health and human rights.
The review was done using keywords of international, regional and national jurisprudence on findings covering the 2000 to 2014 period for documents in English; searches for the Inter-American Commission on Human Rights and national judgments were also conducted in Spanish. Jurisprudence of UN Treaty Monitoring Bodies, regional mechanisms and national bodies was considered in this regard.
In total, 236 findings were identified using the search strategy, and of these 129 were selected for review based on the inclusion criteria. The results highlight that while jurisprudence from international, regional and national bodies reflects consideration of some health and human rights issues related to women living with HIV and SRH, the approach of these bodies has been largely ad hoc and lacks a systematic integration of human rights concerns of women living with HIV in relation to SRH. Most findings relate to non-discrimination, accessibility, informed decision-making and accountability. There are critical gaps on normative standards regarding the human rights of women living with HIV in relation to SRH.
A systematic approach to health and human rights considerations related to women living with HIV and SRH by international, regional and national bodies is needed to advance the agenda and ensure that policies and programmes related to SRH systematically take into account the health and human rights of women living with HIV.
性与生殖健康权是健康权的重要组成部分,它依赖于实质性平等,包括免受多种交叉形式的歧视,这些歧视在法律和实践中导致排斥。尽管如此,感染艾滋病毒妇女的一般性和特殊性与生殖健康需求往往未得到充分解决。例如,感染艾滋病毒妇女所需的服务可能无法获得,或者可能存在多重障碍,尤其是耻辱感和歧视。本研究旨在审查联合国人权理事会、条约监测机构和特别报告员的报告以及关于感染艾滋病毒妇女的性与生殖健康问题的区域和国家机制。目的是评估这些规范机构在健康与人权工作中,在健康和人权考虑方面的进展领域以及差距。
审查使用了关于2000年至2014年期间英文文件调查结果的国际、区域和国家判例法关键词;还以西班牙语搜索了美洲人权委员会和国家判决。在此方面考虑了联合国条约监测机构、区域机制和国家机构的判例法。
使用搜索策略共识别出236项调查结果,其中129项根据纳入标准被选作审查对象。结果表明,虽然国际、区域和国家机构的判例法反映了对一些与感染艾滋病毒妇女和性与生殖健康相关的健康和人权问题的考虑,但这些机构的做法很大程度上是临时的,并且在将感染艾滋病毒妇女在性与生殖健康方面的人权关切进行系统整合方面存在欠缺。大多数调查结果涉及不歧视、可及性、知情决策和问责制。在与性与生殖健康相关的感染艾滋病毒妇女的人权规范标准方面存在重大差距。
国际、区域和国家机构需要采用一种系统方法来考虑与感染艾滋病毒妇女和性与生殖健康相关的健康和人权问题,以推进议程,并确保与性与生殖健康相关的政策和方案系统地考虑感染艾滋病毒妇女的健康和人权。