Young women and girls living with HIV often face multiple barriers and restrictions when it comes to their sexual and reproductive health and rights (SRHR), which diminishes their ability to live a life with dignity and respect. This September 28, the Global Day of Action for Access to Safe & Legal Abortion, we as members of the More Than Our Status Campaign call for the mobilization of communities and governments in ensuring access to safe and legal abortion as an integral part of sexual and reproductive health services and realizing the SRHR of all women, including young women and girls living with HIV.

While abortion continues to be a controversial topic in different countries, young women and girls around the world continue to grapple with lasting effects of unplanned pregnancies and unsafe abortion services. For young women and girls living with HIV, who are often multiply marginalized as a result of their age, gender, economic situation, and HIV status, accessing safe abortion services becomes even more difficult for them.

Not only do they confront the abortion stigma experienced by all individuals who need and seek abortions, they also face additional stigma because of myths and misinformation surrounding HIV, which act as barriers to their accessing SRHR services. Their access to contraceptive methods is limited as they are presumed to be sexually inactive, or are told that they should be. There are also instances where, because of myths surrounding HIV, coupled with abortion-related stigma, service providers refused to provide SRHR services to young girls and women living with HIV, including safe abortion services.

In turn, these myths and stigma surrounding both abortion and HIV feed and perpetuate further stigma and discrimination, forcing individuals seeking abortion to resort to unsafe measures.

The World Health Organization defines unsafe abortion as a procedure for terminating a pregnancy that is performed by an individual lacking the necessary skills, or in an environment that does not conform to minimal medical standards, or both. In countries where abortion remains unsafe and illegal, it is a leading cause of maternal mortality. Worldwide, the consequences of an unsafe abortion can be fatal:

• Each year, roughly 6.9 million women are hospitalized for treatment of abortion-related complications such as hemorrhage and sepsis. These complications can have short- or long-term consequences, including anemia, prolonged weakness, chronic inflammation of the reproductive tract and secondary infertility.
• About 47,000 women die worldwide each year because of unsafe abortion, accounting for an estimated 13% of all maternal deaths worldwide.

Social justice and human rights require that women and girls who are living with and affected by HIV be able to make informed decisions regarding their sexual and reproductive health. Therefore laws and policies that criminalize, penalize or prevent access to sexual and reproductive health information and services, including safe abortion, form a major obstacle to these women and girls being able to enjoy their full sexual and reproductive rights.

A woman living with HIV, like any other woman or girl, may need access to safe abortion for various reasons – such as in cases of contraceptive failure, socioeconomic reasons, cases of rape or incest, or cases where the pregnancy poses a threat to her health or her life, among many other situations.

As such, facilitating access to safe and legal abortion information and services is critical to ensuring that women and girls living with HIV are provided with the best quality sexual and reproductive health care.

It means very little to talk about the human rights of young women living with HIV, without recognizing their rights to exercise meaningful decision-making power and control over their own bodies. Young women and girls living with HIV are unable to enjoy their full sexual and reproductive rights unless they can access safe and legal abortion. Young women and girls living with HIV are more than their status and their access to safe abortion services should not be defined by their status.

As more developing countries reform their abortion laws, new evidence is accumulating that access to safe and legal abortion saves women’s lives, and improves health conditions among women and girls.

We therefore demand that governments ensure access to safe, legal and affordable abortion services for all who may need them, including young women living with HIV.

Our bodies, our sexual and reproductive rights!