'Even if you're positive, you still have rights because you are a person': Human rights and the reproductive choice of HIV-positive persons
'Even if you're positive, you still have rights because you are a person': Human rights and the reproductive choice of HIV-positive persons
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DOI：
10.1111/j.1471-8847.2007.00223.x
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发表时间：
2008-04-01
影响因子：
2.2
通讯作者：
Myer, Landon
中科院分区：
文献类型：
--
作者：
London, Leslie;Orner, Phyllis J.;Myer, Landon
最近，关于艾滋病毒/艾滋病控制办法的全球辩论已经偏离了一贯强调的以人权为基础的重点。公共卫生功利主义在制定国家和国际政策方面变得越来越重要。然而，潜在的相互矛盾的必要条件可能需要将个人生殖权利和其他人权与公共卫生目标相协调。目前的生殖健康准则在很大程度上仍然没有规定艾滋病毒抗体阳性夫妇是否可以怀孕，主要依靠有效的咨询，使客户能够自主作出决定。然而，卫生保健提供者的价值观和态度可能会对非规范性指南的有效性产生重大影响，特别是在有关生育的社会规范和陈规定型观念强大的地方，以及提供者受到双重忠诚压力的地方，对服务用户的权利可能产生不利影响。使用了一项关于用户对生殖服务和艾滋病毒/艾滋病服务的经验和看法的研究的数据，以说明对生殖健康政策应如何将权利观点纳入服务与艾滋病毒抗体阳性者接触的方式及其生殖选择的权利分析。分析借鉴了为评估卫生政策对人权的影响而开发的公认工具，以及为南非卫生公平研究而开发的模式，以主张更多地承认受艾滋病毒/艾滋病影响的人在制定生殖选择政策及其内容方面的作用。最后，我们提出了基于人权和公共卫生办法之间的协同作用的战略，以制定关于艾滋病毒/艾滋病患者生殖健康选择的政策。
Global debates in approaches to HIV/AIDS control have recently moved away from a uniformly strong human rights-based focus. Public health utilitarianism has become increasingly important in shaping national and international policies. However, potentially contradictory imperatives may require reconciliation of individual reproductive and other human rights with public health objectives. Current reproductive health guidelines remain largely nonprescriptive on the advisability of pregnancy amongst HIV-positive couples, mainly relying on effective counselling to enable autonomous decision-making by clients. Yet, health care provider values and attitudes may substantially impact on the effectiveness of nonprescriptive guidelines, particularly where social norms and stereotypes regarding childbearing are powerful, and where providers are subjected to dual loyalty pressures, with potentially adverse impacts on rights of service users. Data from a study of user experiences and perceptions of reproductive and HIV/AIDS services are used to illustrate a rights analysis of how reproductive health policy should integrate a rights perspective into the way services engage with HIV-positive persons and their reproductive choices. The analysis draws on recognised tools developed to evaluate health policies for their human rights impacts and on a model developed for health equity research in South Africa to argue for greater recognition of agency on the part of persons affected by HIV/AIDS in the development and content of policies on reproductive choices. We conclude by proposing strategies that are based upon a synergy between human rights and public health approaches to policy on reproductive health choices for persons with HIV/AIDS.