HIV Positive Laboring Woman Denied Help, Births On Street

Amie Newman

A 28 year-old woman in India, in labor outside of Hyderabad in the town of Suryapet, birthed in the street on Sunday evening covered by saris, with only the assistance of the woman who brought her to a hospital initially along with some local women who stepped up to help.

A 28 year-old woman in India, in labor outside of Hyderabad in the town of Suryapet, birthed in the street on Sunday evening covered by saris, with only the assistance of the woman who brought her to a hospital initially along with some local women who stepped up to help.

The young woman, who is HIV positive, arrived at a government-run hospital in Andhra Pradesh’s Nalgonda district in labor. Piecing together the story, it seems Alivelu’s blood was tested at the hospital. When hospital workers discovered she was HIV positive, they told her that doctors were “unavailable” to assist her and shifted her to what’s called an Observation Room.

The medical staff’s behavior apparently scared Alivelu, coupled with the fact that she was not receiving adequate care and not wanting her village to find out she was HIV positive (for fear of being stigmatized), she left the hospital. At this point, some of her relatives attempted to have her admitted into a private hospital but did not have the money to do so. After experiencing labor pains, Alivelu had no choice but to lie down on the sidewalk and birth with the help of local farm and construction workers – women who came to her aid.

According to various sources, the women who helped bring Alivelu’s baby girl into the world would likely have had numerous cuts on their hands, from the physical labor, and without any rubber gloves or protection of any kind as they assisted in the birth, there is the risk of HIV contraction from Alivelu.

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In addition, of course, there is the risk to the newborn baby of contracting HIV from her mother. If born in the hospital, the baby would have had immediate access to nevirapine, a medication given to babies born from HIV positive mothers to reduce the chance of the baby contracting HIV.

Finally, and something I haven’t seen taken up elsewhere about this story, there is the very important issue of breastfeeding for HIV positive mothers. What sort of advice could Aliveru have received, that she didn’t, had she birthed in a hospital? The evidence overwhelmingly shows that breastfeeding a newborn, when HIV positive, increases the chance that the baby will contract HIV from the mother. In the United States the directive to new mothers who are HIV positive is clear: the risk of mother-to-child HIV transmission is too high weighed against the relative benefits of breastmilk for newborns.

However, the issue is much murkier for women in developing countries. In developing countries, when access to infant food (formula) is unreliable and the formula potentially unsafe, when a mother’s access to HIV/AIDS treatment is virtually non-existent or undependable, the guidelines for HIV positive mothers breastfeeding their babies are more complex. According to Avert, the international AIDS organization,

“In countries with fewer resources, where replacement feeding can be much more hazardous, the recommendations for infant feeding usually depend on a mother’s individual situation…”

“When replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended. Otherwise, exclusive breastfeeding is recommended during the first months of life.” 

So, while the decision depends on a mother’s individual circumstance, the WHO also says that the final decision should reside wtih the mother:

“All HIV-infected mothers should receive counselling, which includes provision of general information about the risks and benefits of various infant feeding options, and specific guidance in selecting the option most likely to be suitable for their situation. Whatever a mother decides, she should be supported in her choice.” 

The Andhra Pradesh State Aids Control Society director, R. V. Chandravadan has ordered an investigation into this young mother’s nightmare and suspended the two duty doctors saying, “There was no reason for a government hospital to deny admission to any HIV-infected person. So action will definitely be taken against those found guilty.”

Alivelu and her baby girl returned to her village but are now staying at a community health center for people living with HIV.

Commentary Sexual Health

‘Not the Enemy, But the Answer’: Elevating the Voices of Black Women Living With HIV

Dazon Dixon Diallo

National HIV Testing Day is June 27. But for longtime advocates, ensuring that the women most affected by the epidemic can get and influence care and policy is the work of many years.

I met Juanita Williams in the mid-1980s. She was the first client at SisterLove, the then-new Atlanta nonprofit I founded for women living with AIDS.

June 27 is National HIV Testing Day, and many women will be tested during the observance. But when I met Williams, HIV was a growing reality in our communities, and women were not even recognized as a population at risk for HIV at that time.

This lack of understanding was reflected in women’s experiences when seeking care. Williams’ attempt to get a tubal ligation had been met with fear, ignorance, and hostility from a medical team who informed her she had AIDS. Not only did they refuse to provide her the medical procedure, the hospital staff promptly ushered her down the back staircase and out the door. Williams was left without information or counseling for what was devastating news.

A Black woman who grew up in Syracuse, New York, she had moved to her family’s home state of South Carolina. Her first major decision after her diagnosis was to leave South Carolina and move to Atlanta, where she believed she would get better treatment and support. She was right, and still, it wasn’t easy—not then and not now. Even today, Williams says, “Positive people are not taken seriously, and positive women are taken even less seriously. People think positive people are way down on the totem pole.”

As communities across the United States observe National HIV Testing Day and emphasize taking control of our health and lives, women’s voices are an essential but still neglected part of the conversation. The experiences of Black women living with HIV, within the broader context of their sexual and reproductive health, highlight the need to address systemic health disparities and the promise of a powerful movement at the intersection of sexual and reproductive justice.

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The urgency of adopting an intersectional approach to sexual and reproductive health comes to light when considering the disproportionate impact of HIV on women of color. Black women account for 69 percent of all HIV diagnoses among women in the South. Advocates also acknowledge the history of biomedical and reproductive oppression that Black women have suffered throughout American history, including forced pregnancy and childrearing during slavery to forced sterilization afterward. Keeping these matters in mind helps us understand how the HIV epidemic is a matter of sexual and reproductive justice.

Taking seriously the perspectives of women such as Williams would amplify our collective efforts to eradicate HIV’s impacts while elevating women’s health, dignity, and agency. This is especially pressing for women living with HIV who experience the greatest disparities and access barriers to the broad spectrum of reproductive health, including contraception and abortion.

The policy context has created additional barriers to advancing the reproductive health of women living with HIV. For example, the 2015 National HIV AIDS Strategy Update neglected to mention family planning or reproductive health services as arenas for providing HIV prevention care. Yet, in many instances, a reproductive health clinic is a woman’s primary or only point of access to health care in a given year. Providing HIV prevention and care in family planning clinics is a way to provide a space where women can expect to receive guidance about their risk of exposure to HIV.

As advocates for women living with HIV, we at SisterLove are committed to ensuring that human rights values are at the center of social change efforts to protect and advance the sexual and reproductive health and rights of women and their families. We work to transform the policy frame to one that asserts women’s agency to make decisions that are best for themselves and their loved ones. We draw strength from the resilience and determination of the women we serve.

Several years after becoming deeply involved with SisterLove, Williams became an advocate for her own reproductive health and began speaking out on behalf of other Black women living with HIV. She eventually became a trainer, counselor, and health outreach worker.

Later, in 2004, Williams was the only woman living with HIV invited to be a main speaker at the historic March for Women’s Lives in Washington, D.C. She is a mother, grandmother, and great-grandmother who has returned to South Carolina, where she teaches other women living with HIV about sexual and reproductive justice and human rights. Williams uses her own story and strength to help other women find theirs.

“Give [women living with HIV] a voice and a platform for that voice,” she has said. “Give a safe place to let their voices be heard and validate them …. We need positive women’s voices to continue to fight the stigma. How do we do that? We tell our stories and reflect each other. I am not the enemy, I am the answer.”

Advocates need strength as we work at many critical intersections where the lives of women and girls are shaped. We cannot address HIV and AIDS without access to contraception and abortion care; health and pay equity; recognition of domestic and gender-based violence; and the end of HIV criminalization. And as advocates for sexual and reproductive health in our communities, SisterLove is working alongside our sisters to support National HIV Testing Day and ensure all people have the information, tools, and agency to take control of their health.

Elevating the health and dignity of people living with HIV calls for special attention to the epidemic’s implications for women of color and Black women, particularly those within marginalized communities and in the Deep South. The voices and leadership of the most affected women and people living with HIV are essential to making our efforts more relevant and powerful. Together, we can advance the long-term vision for sexual and reproductive justice while working to eradicate HIV for all people.

News Violence

Family Members and Undocumented Survivors of Orlando Shooting Eligible for U Visas

Tina Vasquez

"The individuals and their families impacted by this horrific tragedy aren’t getting any special treatment or cutting the line," said Immigration Equality Client Programs Director Pamela Denzer, "they are eligible for something that was already established many years ago.”

In the hours after the shooting at an Orlando, Florida, gay nightclub that would leave 49 people dead and more than 50 injured, information emerged that almost all of the victims lived at the intersection of being Latino and LGBTQ-identified. In the days since, it’s become clear that one of the deadliest mass shootings in the United States has also taken its toll on Orlando’s immigrant community.

The victims came from all over, including South Africa and the Dominican Republic, and Fusion was able to confirm that two survivors of Sunday’s shooting are undocumented. A third undocumented man, a 31-year-old from Mexico, was also killed during the attack.

Survivors as well as the spouses, partners, or close relatives of those killed in the attack could qualify for U visas, which, according to U.S. Citizenship and Immigration Services, are “set aside for victims of certain crimes who have suffered mental or physical abuse and are helpful to law enforcement or government officials in the investigation or prosecution of criminal activity.” After three years and if certain requirements are met, U-visa holders become eligible to adjust their status and become lawful permanent residents.

Immigration Equality, an immigrant rights organization based in New York that provides assistance to LGBTQ and HIV-positive communities, is currently offering to help those affected by the massacre apply for U visas. Through its national hotline, the organization is offering help accessing attorneys, filing the proper paperwork, and addressing any language barriers.

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Its client programs director, Pamela Denzer, told Rewire that like many others, her organization became aware of how hard-hit immigrant communities were by the attack thanks to news reports. But before long, survivors, friends, and family members of victims were contacting the immigrant rights organization inquiring about the services available, and what the organization could do on behalf of undocumented families affected by the tragedy.

Denzer told Rewire both immigrant and undocumented victims and their families have benefits available to them other than U visas. Immigration Equality is currently offering victims’ families assistance filing the various forms required for a visa or humanitarian parole, as well as assisting those who speak English as a second language to provide a detailed explanation and evidence of their circumstances, as is required.

“Parents or family members of victims who don’t live in the country and who want to see their child or attend their funeral, might need help getting a visa or getting humanitarian parole. If their child passed away or is critically injured, they need to be with them, and we can help with that,” Denzer said.

This was the case for the mother of 26-year-old Oscar Aracena-Montero, who moved to Florida from the Dominican Republic when he was a child. He was killed in Sunday’s attack, and in the days since, his image has circulated on social media in the hope that someone “who can help” would see the plea and assist his mother in obtaining a visa so she could attend Aracena-Montero’s funeral. The Dominican Republic-based newspaper Listin Diario has since reported that Aracena-Montero’s mother was able to obtain a visa, but now needs assistance ensuring Aracena-Montero’s siblings in the Dominican Republic are also able to attend his funeral.

As Fusion reported, immigration status is creating additional challenges for survivors of Sunday’s attack and for the families of those who lost their lives. There is uncertainty about whether they qualify for state and federal assistance programs that would assist with hospital care.

Over the years, as the number of undocumented people in the United States has risen, many states have attempted to narrow the definition of “emergency” as a way of limiting what hospitals will cover for undocumented patients. PBS reported that in 2012, “Florida changed its policy to pay for emergency services for eligible undocumented immigrants only until their conditions had been ‘stabilized.’ Previously, its policy was to pay for care that was ‘medically necessary to relieve or eliminate the emergency medical condition.’”

Immigrant families were also not prepared for the costs of burying their loved ones, many of whom were only in their 20s and 30s. That process would require repatriating and burying their bodies in their countries of origin. The family of the undocumented man from Mexico who was killed in Sunday’s attack told Fusion that it would cost them up to $6,000.

Many of these families are turning to online fundraisers to help with the costs of medical care or funerals. The family of victim Eric Ortiz has created an online fundraiser to help pay for the costs of cremation and spreading Ortiz’s ashes in his native Puerto Rico.

Those showing support online for the undocumented victims of Sunday’s shooting and spreading information about the possibility of U visas for survivors and family members are already fielding negative responses from anti-immigrant social media users, who are comparing the Orlando shooting to “winning the lottery,” and claiming that victims are benefiting from a tragedy.

The U-visa program has existed since 2000, and Denzel said there is nothing that “uniquely qualifies” victims of this shooting for this visa.

“There are a wide range of scenarios that make a person qualified for this, from being kidnapped to experiencing the murder of a loved one. If a person survived this tragedy, it entitles them to a U visa because they are not a citizen and they experienced a violent crime,” Denzel told Rewire. “We’re not doing anything we don’t already do; we’re not creating services that didn’t already exist. This isn’t a special project. The individuals and their families impacted by this horrific tragedy aren’t getting any special treatment or cutting the line; they are eligible for something that was already established many years ago.”