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HIV

By Advocate Meenu Padha and Varushi Yadav 

Introduction

It would not be wrong to argue that in India, the concept of human rights was first introduced and systematically institutionalised in 1950 when our country’s Constitution came into force. Many governmental programmes and methods have been created to supplement the rising acknowledgement of an individual’s rights, and the human rights movement has witnessed significant progress and success.

In India, the issue of reproductive rights remains uncertain. While the importance of both men and women’s rights to choose and control their own reproductive functions has grown in prominence, the concept’s introduction in India is particularly difficult due to the country’s complex social structures, where procreation is frequently seen as a social expectation and individual rights are often overlooked. Reproductive rights, in a broader sense, have received greater attention in recent years. This is due, in part, to the unwavering efforts of civil society organisations, who have emphasised the importance of international treaties in the Indian context.

Experts have pointed out that reproductive rights are an intrinsic aspect of human rights in general, as well as our Constitution on a national level, and that India owes them to all its women and those who identify as such. Reproductive rights and a larger human rights framework are mutually interdependent. Reproductive rights receive their meaning and force from long-recognized human rights, just as human rights cannot be realised without championing women’s reproductive rights. However, how the two are combined in practice is unclear. Indeed, explaining to an Indian audience that reproductive rights pertain to everyone, regardless of age or marital status, is a tough notion to grasp. It’s no surprise, then, that reproductive rights have yet to be fully established, despite the fact that they are an inalienable component of every human being.

Miserable Condition That We Need To Be Aware Of

In India, one woman dies every 15 minutes during pregnancy and childbirth due to lack of healthcare. Despite the fact that India legalised abortion over five decades ago, access is highly limited, and one woman in India is believed to die every three hours as a result of unsafe abortion. Despite national legislation prohibiting the marriage of girls under the age of 18, India continues to have the highest number of child weddings; and despite regulations and initiatives ensuring women’s maternal healthcare, India is responsible for 20% of all maternal deaths worldwide. Several states have established coercive population policies that bar families with more than two children from assistance programmes, government jobs, political engagement, and access to education and health care – all without ensuring that couples have access to a full range of contraceptive treatments.

Furthermore, Indian women face one of the world’s highest rates of HIV/AIDS infection and discrimination if infected, as well as forced abortions of female foetuses, trafficking for forced prostitution, custodial rape in government institutions, workplace sexual harassment, and harmful cultural practices that seriously undermine reproductive health. As numerous national and international stakeholders battle to give meaning to essential ideas such as women empowerment, rights, and choice, the right to reproductive health, including abortion, takes on special significance in the Indian context. A woman, for example, should have the freedom to choose whether or not she wants to marry, who she wants to marry, whether or not she wants to have children, how many children she wants to have, and the spacing between them. This is significant because, while both the male and female contribute to procreation, it is the female who is biologically responsible for ensuring the baby’ complete growth.

In the past, India’s reproductive health legislation and policies have failed to embrace a rights-based approach. Simply put, based on the various definitions of reproductive rights, they can be said to include some or all of the following rights: the right to safe and legal abortion; the right to control one’s reproductive functions; the right to access in order to make reproductive choices free of coercion, discrimination, and violence; and the right to access education about contraception and sexually transmitted diseases. The need for us to recognise and address these as rights has become even more apparent in the midst of the pandemic when women have been left to suffer as a result of massive changes in family and social dynamics, disruption in peer support, and a lack of health facilities – because they have not been informed and empowered to demand what is due to them.

According to a new survey issued, over 139 million women and girls in India currently use contemporary contraception techniques. The progress made in family planning over the last eight years is detailed in a study issued by FP2020, a global collaboration that supports the reproductive rights of women and girls.

Reproductive Laws And Rights One Should Be Aware Of

In 2021, the Medical Termination of Pregnancy Amendment Act 2021 was passed with certain amendments in the MTP Act including all women being allowed to seek safe abortion services on grounds of contraceptive failure, increase in gestation limit to 24 weeks for special categories of women, and opinion of one provider required up to 20 weeks of gestation. Abortion can be performed until 24 weeks of pregnancy after the MTP Amendment Act 2021 has come in force by notification in Gazette from 24th September 2021. The government’s public national health insurance funds, Ayushman Bharat and Employees’ State Insurance cover abortion completely, with the package rate for surgical abortion set at Rs 15,500 which includes consultation, therapy, hospital stays, medication, Ultrasonography, and any follow-up treatments. The package rate for medical abortion is Rs1,500 which includes consultation and Ultrasonography. 

Despite the fact that safe abortions are a state-mandated service, only around a quarter of abortions are performed at public health institutions. The majority of public health services in rural areas do not provide safe abortion services due to a lack of resources and equipment. Despite the fact that this law allows women to get safe abortions under specific circumstances, there are still a number of obstacles to overcome.

Covid 19 Impacts On Contraception And Safe Abortion Services

During COVID-19, the Ministry of Health and Family Welfare (MoHFW) deemed contraception and safe abortion services to be essential health care. COVID-19, on the other hand, has increased the existing difficulties in obtaining these services. Abortion is a health care service that saves lives and protects the health and well-being of women and girls. Understanding how organizations have adapted their safe abortion care programmes to maintain service delivery while seeking to protect their clients, staff and communities from contracting COVID-19, is vital, Covid-19 has wreaked havoc on many aspects of our lives across the globe, reproductive health and family planning are no exception. Over the last 18 months, access to women’s health care services, including contraception, family planning and abortion, has been severely disrupted. As a result, an estimated two million women have experienced unwanted pregnancies. Furthermore, a survey conducted by the World Health Organization suggested a 68% disruption to family planning and contraceptive services across 105 countries.

Although still reeling from the effects of the sudden pandemic onset, the health system over the last year attempted to adapt to meet the growing need for effective women’s care and foster preparedness. One shining example of this was the sudden rise in the provision and adoption of online teleconsultations and digital resources. Availability and accessibility posed two critical components that needed strengthening in care delivery. With the advent of digitalization in the country, spearheaded by the government’s flagship Digital India initiative, we have advanced every day, reaching women from more remote and far-flung corners of rural India with digital platforms. Due to a decline in in-clinic consults, travel restrictions, and overburdened infrastructure and practitioners, Covid provided a significant obstacle to getting such treatment, adding to existing limits in women’s health — social stigma, misinformation, lack of understanding, and family pressures. The health system was forced to prioritize temporary contraceptives like condoms and the oral contraceptive pill above longer-term choices like intra-uterine contraceptive devices (IUCDs) and sterilization, especially during the first lockdown, which limited the basket of treatment options for women.

Conclusion

The social backdrop in India substantially influences women’s reproductive behaviour, defining the pressures, limits, and options available to them. Gender-biased norms and practices that regulate family matters severely limit women’s ability to exercise their reproductive rights. At a higher level, there are various apparent inconsistencies in how policies are made, services are offered, and how demographic trends and aspirations concerning family size and composition impact contraception and abortion demand. Despite the fact that India was one of the first countries in the world to adopt legal and regulatory frameworks ensuring access to abortion and contraception, women and girls still face major obstacles to fully exercising their reproductive rights – it is time to change that. Let us vow to support and steer reproductive rights on this Human Rights Day, not only because we want healthier women, but also because we want empowered women and girls.

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By Sayan Dasgupta

The red and the black earth of Bharat carries with it a myriad of stories. From birth of civilization to fall of empires; the crowning of monarchs to the johar of valiant. In this narration of history, we often tend to neglect the queer tints, away from the maddening crowd of heteronormativity. It was August 11th of 1992 in ITO area of Delhi, when the first voice against exclusion and persecution was raised. 

Prima facie, the provision of Section 377 of IPC may not appear to name any community or class and create classification. However, at the hands of police, it assumed the shape of normalised discrimination and daylight harassment. The Delhi police on August 11th, 1992 started apprehending men from Connaught Place on the ‘suspicion’ of being gay. This did not sit well with the activists of AIDS Bhedbhav Virodhi Andolan (ABVA). ABVA has been a pioneer and a hero for the queer community being the harbinger for rights against discrimination and equal protection of the LGBTQIA+ persons. Its first known involvement was in 1989 protesting against forcible testing of HIV status amongst women of red-light districts by AIIMS and ICMR with the assistance of police. They argued for humane treatment and rehabilitation for HIV positive persons and better contraceptives like condoms etc. 

The protest of 1992 was along the similar lines. They blockaded the entrance to the police headquarter in ITO area of Delhi and were later joined by several women’s rights and human rights organisations. The shining beacon that it was did not fruition into any outcome. However, this was the first protest for LGBTQIA+ rights. ABVA two years later initiated a movement in the Tihar Jail to provide free access to condoms considering high incidence of sodomy and participation of almost 2/3rd prison population in homosexual relations increasing probabilities of spread of HIV. Kiran Bedi, the then Inspector General of Prisons vehemently denied the proposition arguing that it would be a tacit acceptance that such relations were in vogue; and primarily would encourage such relations. Bedi decided a contrarian route to deal with the “menace of homosexuality” as she called it, by mandatory forced testing of the inmates and segregating the HIV-positive inmates.

This state-sponsored discrimination was rooted in the baseless fear of HIV and unequal affording of the right to privacy based on sexuality. ABVA filed a writ petition seeking to test the validity of this step and also subject Section 377 to judicial review for constitutional validity in Delhi HC. The petition however was unsuccessful insofar as the challenge to 377 of IPC is concerned.

However, it is interesting to note the first-ever judicial decision by a US Court on LGBTQIA+ rights at this juncture. While it is the 29th anniversary of the first protest for queer rights in India, it is also the 39th anniversary of the first written judicial decision of the US jurisprudence on rights of persons living with HIV. Much ahead of its time, the case of LaRocca v. Dlasheim (67 N.Y.S.2d 302 (N.Y. Sup. Ct. 1983)) decided by a New York Court issued a ruling in favour of persons with a positive status. Similar to the aforementioned circumstance, the case was instituted by persons incarcerated in state prisons who did not want to be in the vicinity of HIV+ individuals. The arguments derived its rationale from stereotypes and irrational fear praying for a complete segregation and insufficiency of a separate ward. The Court relied on science and not conjecture and held that such unfounded irrational fear (even if honest) cannot be grounds for state discrimination. Such rights of struggle towards the state declared innuendo are plenty. On further observation, it is an obvious conclusion that queer identity is a menace. It is a menace to the status quo, heteronormativity, a lack of nuanced discourse and intolerance towards the different. Queer identity has never been anything but political; riddled with oft ignored rebellions, struggles and frustration. Regardless, India is also laced with narrations of gender fluidity and queer history. The Shatapatha Brahmana (2.4.4.19) appreciates the romantic story ensconcing the two halves of the moon; Varuna, the waxing one; and Mitra, the waning one. The two long for each other and find union on the new moon night. It is believed that they promenade in the celestial skies, and Mitra implants his seed in Varuna, and when the moon wanes, that waning is a product of his seed. Kama Sutra (2.9.36) and the tale of Shikhandi even recognised same-sex marriages. While the fate of struggle plays out, the historical narrations of this land provide poetic justice.

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