Disabled, HIV+ women victims of hospital class prejudice
Healthcare providers are allowing personal prejudice and class bias to influence their recommendations for tubal ligation, with women living with HIV and disabilities, the prime victims of social and cultural stigma, some stakeholders say.
In a Sunday Gleaner article last month, women as young as 19 years old complained that most local doctors were unwilling to tie their tubes, insisting that they pursue less-permanent alternatives.
However, according to project officer at the Jamaica Network of Seropositives, Richard Plummer, medical personnel were often keen on promoting tube-tying for vulnerable women.
Vulnerable groups include women living with disabilities, women in inner-city communities, teenage mothers, and women living with HIV.
Plummer was speaking at a Gleaner Editors’ Forum recently as part of a group of non-governmental organisations that focus on patients’ rights in maternal, neonatal and infant health matters.
“While you have nurses and doctors that are fully trained, fully sensitised in regard to HIV care, pregnancy and childbirth, there are a lot of persons that come with their personal beliefs and morals that a person living with HIV shouldn’t be producing a child, without acknowledging the science behind it that someone that is HIV-positive as a mother and has an undetectable viral load can produce a child that is HIV-negative,” said Plummer.
Lecturer in the Department of Community Health and Psychiatry at The University of the West Indies, Dr Althea Bailey, who focuses on health promotion and has worked in family planning for many years, agrees with Plummer that women are faced with undue burdens when trying to access healthcare.
“It is true that our providers –and some of it is because of the infrastructure or the resources that they have – are biased towards presenting certain choices of contraception to people, and it’s not just about HIV, it’s about how poor they perceive you to be, it’s about how promiscuous they perceive you to be, so they push a certain method to you based on their perception of you.
“People need a choice. Our legislation, our policies, prevent us from giving the wide range of choices, but choices are there and people are supposed to choose,” said Bailey.
The doctor lamented that healthcare workers were generally offering only the Pill and the Depo-Provera injection as family-planning options, saying that hospitals were not wont, or equipped, to provide the implant to women.
“Women want it, they can’t get it. The nurses are not referring them because they have their own hang-ups about it and who should get it,” said Bailey.
Bailey said that behaviour change is required at all levels.
“People don’t intend to be wicked, but it’s their personal bias, the way they see things, and they are not able to see the other person’s perspective, so everybody wants everybody else’s behaviour to change, but how is my behaviour impacting on people,” said Bailey.