Updated 19 September 2013

HIV+ and sterilised

The forced sterilisation debate was triggered by reports of HIV+ women allegedly being sterilised against their will or without their proper knowledge.


In June 2010 eTV's 3rd Degree screened a programme entitled Forced Sterilisation. The report covered allegations that some state hospitals are forcibly sterilising HIV-positive women, and that a similar situation may be happening in certain state hospitals in Namibia.

The day after the screening of the show, Health24's HIV Peer Forum was abuzz with opinion on this issue. Here are some of the things that users had to say:

QUESTION: What's the price on your (in)ability to have a child? Can women be paid a sum to get sterilised? And can forcible sterilisation ever be justified?


  • Honestly, I don't think there should be a price tag. When God made us he didn't put a price tag, and I believe that a child is the greatest gift He can give. If we can get up and go to work, by taxi or otherwise, then a child will eat, sleep and live where we eat.
  • The price we pay for not having kids in my community is to be reminded that you are not a woman. When I think of my situation sometimes I get very depressed. I don't have kids and I won't be able to. No man and HIV+, no money and still helping my parents. They have being married for 35 years and my father still abuses my mother till today. She does not want to leave him but I have to console her every time my dad is at it again I hate my life. Life sucks.
  • The programme was showing women in KZN who were forcefully sterilised before or after giving birth just because they are HIV+. But then I know lot of negative people I would like to sterilise – it's a Catch 22 situation. I asked to be sterilised, I guess these ladies should go give birth at the hospital I went to, or use my gynae. People should be given choices, and at least pray that the medical personnel respect our decisions. But I do have a problem with ladies that continuously fall pregnant without a cent to their names, knowing very well they are HIV+ and then breastfeed the children, and go through their pregnancy as if they are in a better condition than the so called negative ladies - this infuriates me.
  • As harsh as it is, at times I also lean towards that sterilisation. Yes, MTCT (mother-to-child-transmission) has decreased and we have major success in not infecting kids, but on some days I actually would be the first to line up in that queue and get that sterilisation. Not only do you produce a whole football team, you die and you leave a whole population of orphans. And the grandparents or relatives are left with the burden of looking after your offspring.
  • If you are HIV+, yes, your chances of being hit by a bus are the same as a negative person, but we HIV+ people constantly have ''what will happen to…..when I am gone'' thoughts – we need to think more about that. I found out about my status when I was already pregnant. If I had known before, I might have gone this route because there are too many orphans out there.
  • I like your thinking. Even with ARV's, the babies can get infected in utero and there is nothing as painful as watching a child suffer due to an incurable illness like HIV encephalopathy. I have such patients in the ward and this morning, as I looked at one child crying in pain, a 6-year-old dying of heart failure and 7-year-old with Kaposi's sarcoma, I nearly collapsed from heartache. Their mommies knew before falling pregnant and were on treatment - and the children are also on treatment. Some mothers are no longer alive and poor grannies have to sleep on a bench while the grandchild is being treated, its so painful indeed.
  • I made a decision to have a child 3 years after I tested positive and I don't regret that. I agree that it's very stressful – caesarian section, drops and the testing of the child thereafter. I still think it should be left to the women concerned to decide whether they want to be sterilised or not. That story of a lady with a paralysed child was just too painful because she's financially able and she's not living with the elder child due to health reasons.
  • I agree with you. It is still a positive woman's right and choice to have children.
  • I have a 5-month-old and decided to have him 5 yrs after being diagnosed as HIV+. I weighed my options and decided to go ahead and get pregnant. I took treatment during pregnancy, delivered him by c-section. I asked my gynae to be sterilised and he refused. I am going to find a doctor who will do the procedure. But it is my choice, and to be sterilised against your will is totally wrong.
  • It is inhuman to sterilise people against their will.
  • HIV+ or negative, people die every day. No one should take away the right to choose from any human being. They still have a right to choose if they want to be sterilised or not. I also had my first child 7 years after diagnosis and my life feels complete since I experienced motherhood. I wish I had the guts to fall pregnant sooner after diagnosis. But I must also mention, as much as I'd like to have another child, the fear is just killing me. I feel the pain of watching any child die from the effects of this virus. Catch 22 situation, but each person's right must not be violated.
  • Freedom of choice is a democratic right, but with that choice comes with responsibility. Amongst others is taking ownership of the HIV infection, and learning as much as possible about HIV in pregnancy and modes of transmission to minimise chances of infecting the baby.
  • Watching the programme yesterday, I was a bit disturbed about some of the choices we make.

Let's imagine I am Jane, uneducated, unemployed with the only source of income being grants (child grants, illness grants etc). I am a disempowered woman with no recourse or voice, therefore I cannot insist on condom usage with my partner.

So what do I do? I have condomless sex and risk infection.

Once I am HIV+, logic then tells me that even if healthcare professionals/ HIV volunteers drill the do's and dont’s into me, I am not likely to adhere to therapy as I stand to lose financially.

So I will skip my pills to keep my CD4 low, get it even lower for to qualify for TB grants and give birth to as many kids as possible because grants are my sole source of income. I will only start taking my treatment when I’ m nearing my deathbed. (Remember: I am also being told that ARVs save lives, no matter how low the CD4, so no problem.)

Logic also tells me that should anything happen to me, orphan grants will also take care of my kids.

This, unfortunately, is the socio-economic manifestation of the pandemic for most people, and the vicious cycle continues, where grants, which were meant to eradicate poverty, actually exacerbate the situation. However, does that then mean that every HIV positive person's freedom of choice should be revoked? We will always have white, grey and black in any given situation and therefore cannot paint everyone with the same brush.

  • Sad truth. I think people are over critical of HIV+ people. My domestic worker has 10 children. She was married to a mine-worker who died of that disease that mineworkers get (I forgot what it is called). She literally survives on government grants, getting R1250 as 5 children are under 14.

If this is the thinking, why was she not sterilised? Was it because she was HIV negative? Those children will be a government responsibility for their lifetime as their mom does not have money to educate them – she can only afford food. If the “sterilisation mentality” is only going to apply to HIV+ people, this is a huge injustice. Even people who have a formal record of child abuse and neglect do not have sterility imposed on them.

  • Babies may be a gift from God, but what's the point of bearing a gift if it's going to be abused and neglected?
  • And then there was the 18yr old who has 5 kids - twins and a set of triplets. A good argument for sterilisation.

That's where the debate is right now. Do you have an opinion on this difficult question? Let us know in the comment box below.

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Women's vulnerability to HIV

(Joanne Hart, Health24, June 2010)

Photo:  Hospital theatre from Shutterstock


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