Okaingona Choices in Theory, Choices in Practice? Presented by Kanjoo Mbaindjikua, Programme Officer Lironga Eparu-National Association of PLWHA NAMIBIA

Understanding Reproductive health “Despite the hardship and complexities that is part of our daily lives, the need to have families of our own cannot be ignored. Be it to have children or just sharing life with a partner and enjoy the benefits of a good relationship and a healthy sexual life”. Support group member-Khomas region

The issues Teenage pregnancies and early onset of sexual activities High incidents of rape and sexual violence Non-integrated treatment, care, support and reproductive health services. Reproductive health policy is there…but not clearly known to the general public It greatly covers adolescence, maternal and child health services. HIV and AIDS is addressed as an STI under prevention. Most importantly, it does not address the sexual and reproductive needs of PLWHA. Lack of information and discussions on sexual and reproductive health

Missed opportunities Unable to conceive due to reproductive health related cancers. Few counselling services to make an informed choice. Involuntary sterilisation Stigma Living in isolation (especially from other PLWHA) Unavailability of female control methods. No voluntary pregnancy termination services available. Majority of fathers not meeting their parenting responsibility.

Why reproductive health is important to HIV positive people (1) The Lironga Eparu treatment consultation of 2003 found that reproductive right are very important to HIV positive people as they see having children a basic human right and an inspiration to live. At the same time there was also fear that the children could be orphaned should the parents die. The cultural norms, dictate childbearing as valuable asset.

Why reproductive health is important to HIV positive people (2) 49% of HIV positive respondents of the second Lironga Eparu treatment consultation (still to be published) said that they had children after they found out about their HIV positive status and 100% said that having children was important. PLWHA from our support groups are having babies. LE have not determined if pregnancies among members are planned, safe and wanted.

How do we support each other? Mothers supporting mothers (Orange Babies Project)-targeting 150 mothers and babies. Infant feeding support Counselling on reproductive health Referrals and linkages in partnership with hospitals. Information sharing through support groups. Support to disclose to partners and families.

Conclusion Safe reproduction require access to sustainable and affordable medical care including family planning for PLWHA. The lack of women’s health clinic means that HIV positive women’s health needs cannot be address. Reproductive health means a safe and secure relationship, free from abuse and neglect. The knowledge that we can be parents or choose not to be without being frown at is very important for HIV positive people to safely exercise their rights.