1. Forced Sterilization Of HIV Women Is A Country-Wide Problem
In Chile, Says Report
WRITTEN BY DOMINIQUE FARRELL
MONDAY, 7 DECEMBER 2010
Study by Chilean NGO found women living with HIV/AIDS are pressured or forced
to undergo sterilization
Photo courtesy of Flickr
Francisca was in the recovery room after her caesarean surgery at Curicó Hospital in
Southern Chile when the nurse entered and casually informed her that she couldn’t have
any more children.
Francisca was 20 years old and HIV-positive. Although she had taken all the necessary
precautions to avoid transmission of the disease to her child, the doctor had surgically
sterilized Francisca without her consent.
It wasn’t until a year later in 2003 - when someone put Francisca in touch with Vivo
Positivo, an NGO in Chile that advocates on behalf of people while HIV/AIDS - that she
realized what the doctor had done to her was not standard procedure.
On her behalf, Vivo Positivo brought a case against the doctor and hospital. Francisca
lost. They appealed in the Chilean Supreme Court and lost again. The court did not find
that the doctor violated Francisca’s human rights.

2. “I felt vulnerable within the justice system and discriminated against. The only
satisfaction was that it opened other women’s eyes to the fact that it could happen to
them,” said Francisca.
After losing the appeal, Vivo Positivo brought the case to the Center for Reproductive
Rights, a global legal advocacy organization based in the United States.
From research and interviews conducted in five different regions in Chile, the Center for
Reproductive Rights discovered the practice of forced sterilization was more pervasive
than they initially believed. They presented the case before the Inter-American
Commission on Human Rights. Due to a backlog of cases, Francisca’s case is currently
pending.
According to Chilean law, written patient consent is required prior to sterilization, but in
practice, this doesn’t always happen.
Some NGOs point to social and political reasons.
There is an enormous amount of respect bestowed upon doctors, especially in the
countryside, they say. And doctors sometimes occupy positions of political power.
Francisca’s doctor was president of a political party in his community.
“It’s not only a problem within the medical community, but it’s also a problem within the
judiciary system,” said Lilian Sepulveda with the Center for Reproductive Rights. “The
judges didn’t study the case as the case warranted.”
In addition, Vivo Positivo had to search for a year to even find a lawyer willing to take on
Francisca’s case. And as the Director of Institutional Development at Vivo Positivo,
Patricio Nogua, says, the lawyer who ultimately took Francisca’s case lost half his clients
as a result.
Meanwhile, the doctor who sterilized Francisca faced no disciplinary action and continues
to practice medicine.
Even though Chile’s government has ratified both regional and international human
rights treaties, and President Sebastian Piñera has pledged to defend human rights in
Latin America, the reality in Chile can be a much different story. A huge stigma remains
with regards to HIV/AIDS.
Based on a 2008 UNAIDS Global Report, women account for roughly 50 percent of the
33.4 million people living with HIV/AIDS worldwide. Although about 80 percent of those
women become infected while in a marriage or long-term relationship, they are wrongly
assumed to be sex workers or to have had multiple sexual partners.
Due to these misconceptions, many HIV women also encounter delays in accessing
necessary care, humiliating treatment, or in many cases refusal of treatment.
The recent study in Chile found that HIV-positive women in the country are frequently
pressured to not become pregnant, or, in instances like Francisca, are forcibly sterilized
to prevent future pregnancies.
“The pressure comes from a number of places. Doctors pressure the women by saying
they know what is best. Sometimes the doctors say that they won’t give women a

3. caesarean section if they don’t sign the consent form agreeing to be sterilized,” said
Nogua.
The women sterilized are typically between 20 to 30 years old. Francisca was only 20
years old when she was sterilized in 2002. Initially, she did not even know what it
meant.
Many women described being asked repeatedly about sterilization immediately before
going into the delivery room. This puts undue pressure on them when they are
preoccupied with whether or not the child they are about the give birth to will be born
with HIV.
Sepulveda explained that there is not sufficient training for service providers, doctors,
and medical staff who deal with HIV/AIDS. Many do not know how the disease is
transmitted. One HIV-positive woman was told during her post-test counseling to keep
all her plates, cups, and silverware separate from her HIV-negative children and to use
separate bathrooms. Additionally, many doctors and medical staff impart their own
social and moral views on patients.
Confidentiality is oftentimes blatantly ignored. HIV status will be listed on patient’s
medical charts in huge letters or on medical staff nametags. And several women
interviewed reported problems with hospital staff disclosing their HIV status to other
patients or even family members.
“We need to ensure that medical professionals are trained, and it is holistic, and it lasts
for a long time,” said Sepulveda.
Francisca avoids going to the hospital except when she needs to get her Anti Viral
Therapy (ART). And when she goes, the hospital staff treats her poorly. “The staff knows
that it was me who filed the case against the hospital, and they say that they can’t find
my medical records or there are delays,” Francisca said.
Since Francisca was sterilized in 2002, three different governments have been in power
in Chile.
With the arrival of Michele Bachelet as President in 2006, many human rights groups
thought the issue would receive attention because she was a woman and a physician.
But nothing happened.
“It is imperative that the Commission on Human Rights moves this case forward,”
Sepulveda said. “Human dignity is one of the most basic foundations of human rights.”
In March of 2011, Francisca’s case will be being presented in Chile. The Chilean
government will be invited to speak about the issue and the failure to protect the rights
of women with HIV. According to Nogua, without government intervention against the
issue of forced sterilization, doctors will continue to operate as though it were public
policy.
Francisca’s son is now eight years old, healthy, and HIV free. He is not yet aware that
his mother is HIV-positive. “I am seeking justice because I don’t want it this to happen
to anyone else,” said Francisca. “They need to treat us as women and treat us with
respect.”