In August 2012, the African Gender and Media Initiative, a Kenyan NGO, released a report documenting cases of forced and coerced sterilizations of HIV-positive women, carried out by both private and government-run health facilities.
Some of the women interviewed had reportedly been threatened with the withdrawal of their HIV treatment if they refused sterilization; others were offered cash in exchange for long-term contraception. Similar cases have been recorded in a number of African countries, including Malawi, Namibia, South Africa and Zambia.
National guidelines on family planning emphasize informed and voluntary consent prior to female surgical sterilization. Through the Kenya Medical Practitioners and Dentist Board, the government has pledged to launch investigations into the claims and take legal action against the health workers involved.
Rita*, a 30-year-old HIV-positive mother of one living in the Kenyan capital, Nairobi, told IRIN/PlusNews how she was pressured into being sterilized five years ago:
"When I got pregnant, I started my antenatal visits at a private clinic here in Nairobi. During the time, I had known my HIV status, and I was already on antiretroviral drugs. I was not married then - I must have got the pregnancy from my boyfriend at the time, but he has since died.
"The doctor first asked me if I wanted to continue having children. When I said yes, he told me it would be unnecessary, since I would be giving birth to sick children who would die. He also said I might not live long enough.
"He convinced me that I needed to permanently stop giving birth, and I agreed because then I saw sense in what he was saying. I paid 30,000 shillings [about US$350 today] and he sterilized me [after I gave birth].
"The bad thing is that they didn't even help me deliver an HIV-free child. My child is also positive like me, but that doesn't worry me because I know there are drugs. Maybe they wanted me to deliver an HIV-positive child to make me see the sense in what they were saying.
"Despite the fact that I am HIV-positive, I feel cheated of my right to decide whether to give birth or not. Now if I lose my child today, I will never have a child again.
"I know women who are HIV-positive and have very healthy babies, and I admire them but I have no choice but to stay with one child.
"I hope that the legal action, if taken, against these people who are stopping HIV-positive women from giving birth succeeds - many poor women out there who are taken advantage of will get help."