TIGblogs - Ntamack John Billong

PREFACE
AIDS is being regarded as one of the most ravaging illness of all times. The fact that as at date there is no known cure, makes the virus more frightening than ever. The illness has been around for over 30 years, but it is a wonder that some people (youth in particular) are just hearing about it. Its origin is no longer of any consequence whether it is a punishment for our immorality or what ever it is, ceases to be of relevance as if now has as victims ,the most innocent i.e. babies and youths.
The AIDS crisis is now the crisis of the developing countries and the World, especially Africa. The clinical syndrome is the greatest enemy to this fatal and most devastating illness, as infected persons continue to spread the infection.
Behavioral change, Acceptance by those infected and their co-operation is the only way toward to fight the spread of this virus.

PREAMBLE
HIV/AIDS. Is it an affliction or a curse? What is this virus that is wrecking havoc in our society and baffling Scientific minds?
We have been told by scientists that HIV stands for Human Immunodeficiency Virus and AIDS stands for Acquired Immune Deficiency Syndrome, which is the last stage of the disease.
If you are HIV positive, you are infected with the virus and your body reacts by producing HIV antibodies. If you have access to an HIV blood test, it will show these anti bodies.
However once and individual is infected with HIV, it takes a certain amount of time before the organism develops antibodies, therefore there is a certain “Window period” when an infected person will test negative. This window period last for often between four weeks and Six Months, in exceptional cases even longer. During this period all HIV infected persons are infectious.
Medical Science has shown that, a few weeks after infection; a minority of infected persons experience some acute Symptoms, often unnoticed.
There after, all HIV infected persons experience a long period without typical serious diseases the so-called “asymptomatic” period. This period can last several years.
During this asymptomatic period, infected persons are able to transmit the virus to others. After this period, the first symptoms of the disruption for immune defense appear in the form of a certain illnesses which have been referred to as AIDS related complex. The final stage of the disease “full blown” AIDS, follows when an HIV infected person develops one or more of the “opportunistic” infections and or cancers. The diseases are called opportunistic because they take advantage of the opportunity presented by the weakened immune system. The progressive weakening of the organism results finally in the death of the patient. No cure of (and no vaccination against) HIV infections or AIDS has yet been discovered.
Drugs like Efavirenz (EFV), Delavirdine (DLV), Nevirapine (NVP), AZT/3TC (Combivir), AZT/3TC/ABC (Trizivir), Zidovudine (AZT) and Didanosine (DDI) when used in combination or with other medication can treat or improve the medical condition and quality of life of the infected person.
These drugs work by lowering the amount of HIV in the blood (viral load) and increase the number of CD4 lymphocyte cells, a type of immune cell in the blood. Scientists have also told us that HIV can be transmitted through
 Having unprotected sex with someone who is HIV positive. About 80 to 90 per cent of the infections are thought to be sexually transmitted.
 Sharing syringes and injecting equipment which has not been properly sterilized.
 Having contaminated medical equipment which have not been properly sterilized or used on people.
 Being given blood transmissions which are infected with HIV.
 Donor insemination with HIV infected semen.
 Vertical transmission of HIV from mother to baby during pregnancy, child birth or breast feeding. HIV/AIDS is on a rampage in must developing countries and Cameroon in particular. It has killed many and it is killing the youthful and resourceful generation of this world.
Africa is now an endemic zone which one can liken to a war zone. No one is free – you are either a victim of the virus or a victim of loss of relative, neighbors, friend or an acquaintance claimed by the virus. We find victims which have been laid out of work for health reasons or high medical bills. No one pronounces the dreaded name of the virus as the real cause of the layoff. It is only whispered. Fear has gripped the hearts of men and anger has consumed some of those who have been declared HIV positive. They have joined forces with the monster virus to infect as many unsuspecting innocent people before they die. The prevalence rate (7.2) of HIV/AIDS in Cameroon has spurred one to write on HIV/AIDS, human rights development etc. so as to sensitize the youths of Cameroon and beyond and bring to the light issues that victims of the virus, medical doctors, and institutions (both public and private) may be faced with. Since HIV/AIDS is a new disease, the Cameroon laws do not reflect the current medical knowledge or some of the socio-legal problems that have developed as a result of HIV/AIDS, etc. Since we are talking of human rights and the law in relation to HIV/AIDS victims, it is necessary to know what human rights and the law is
Human Rights may be define as rules that are equal and inalienable and they are ensure dignity if the human race. These rules are the foundation of freedom; justice and peace in the world they ensure human beings enjoy freedom of speech and belief, and freedom of fear and wants.
Art 25 (1) of the universal declaration of Human Rights “stipulates that every one has the rights to a Standard of Living adequate for health and well being of himself and his family, including food, clothing, housing and medical care, and necessary social services and the right to security in the event of unemployment, sickness, disability, widowhood and old age, or other lack of livelihood in circumstances beyond his control. With regards to the above it is essential that human Rights be protected by the rule of law, if man is not to be compelled to have recourse, as a last resort, to rebellion against tyranny and oppression.

PROTECTION OF HIV/AIDS PATIENTS AGAINST DISCRIMINATION
Discrimination against those living with HIV/AIDS is common place in our society. It is one of the most significant human rights abuses in the area of HIV/AIDS. It impedes the full participation and integration of people living with HIV/Aids in the community.
Discrimination can either be direct or indirect. Direct discrimination occurs where a person treats another less favourably than a third person would have been treated in comparable circumstances.
Indirect discrimination on the other hand occurs where unreasonable conditions or requirement, such as mandatory HIV testing, are applied with a substantially higher proportion of person of a different status, must be able to comply with than persons of the same status as the person claiming to have been discriminated against.
Areas of discrimination include marriage, employment, education, medical treatment, accommodation, immigration/emigration and several others.
It should be noted that HIV is not casually transmitted. An example of casual transmission is droplet infection, which occurs with sneezing, coughing or sharing utensils.
Discrimination should therefore be prohibited against persons with actual perceived or suspected HIV status, and the most effective legal remedy is the enactment of general discrimination legislation which prohibits unfair irrelevant distinction beings made on the ground of HIV/AIDS.
It should be noted that in undertaking to end discrimination on such grounds, states are obliged to protect individuals from discrimination not only bye public authorities, but also the private sector and private individuals in public activities.
Reducing prejudice against PLWHA is important and practical as it removes barriers to early diagnosis and treatment. Discriminatory attitudes can therefore be changed by enacting anti-discriminatory and protective laws in parliament, through education, training and the media and ensuring effective administrative procedure for lodging of complaints against such attitudes.
In Cameroon discrimination and stigmatization against people living with HIV/AIDS is very common. The government through its health personnel, NGOs and some private bodies has through lectures and media programmes tried to educate and sensitize the public on the possible ways of contracting the disease. This is in a bit to stop the spreading of the disease and discourage discriminatory attitudes towards HIV/AIDS patients but discrimination still exists and there is still much to be done to eliminate or eradicate it completely.
a) Changing discriminatory attitudes through parliaments: the most effective legal remedy is the enactment of general anti discriminatory legislation which prohibits unfair and irrelevant distinction being made on specified grounds against the PLWHA. Workshops have been held in some countries to raise awareness of HIV/AIDS issue and sensitize politicians to Human Right issues.
These workshops have been successful in creating a climate of non Discrimination and openness in parliament. It is at such workshops that participants living with family members or friends which are HIV infected can publicly acknowledge their relationship with these infected persons. These can change the discriminatory attitudes of other participants and thus pave the way for easy passage through parliaments of anti discriminatory laws. In some countries parliament have created a commission for non discrimination against HIV infected persons whilst other parliamentary bodies have work with other AIDS organization to fight these discrimination. The legislature, in a bid to fight discrimination against PLWHA could enable “Affirmative action” For example a community group may give preference to employment to HIV positive people because they are members of a protected class which has been subjected to general discrimination.
Evidently, Standards of providing discrimination should be addressed by the legislation or example, the legislature could make HIV/ AIDS disability only one of several reasons for doing a discriminatory act; this alone should be sufficient to ground conviction in a case instituted against an individuals, corporation, or body for discriminating against those living with HIV/AIDS.
The legislature could also enact laws, which permit a casual connection rather than proof of conduct between the discriminatory conduct and HIV/AIDS / disability to be a requirement to found a cure.
Parliament could also ensure the creation of effective administrative procedures for lodging complaints and ensure the existence of independent informed and quick avenues for redress such as Human Rights commission which have special procedures for fast tracking cases where the complainants is terminally ill .A few of these complaints properly handled will discourage discrimination. Remedies recognize by the parliament should exist for systemic discrimination by companies especially employers rather than simple individuals case, which have limited application.
Employment, being one main area where discriminatory attitudes are common place against those living with HIV/AIDS, mandatory equipment which states that the person employed if he is able to perform the inherent requirements of the job.
b) Changing Discriminatory attitude through the Judiciary: In some countries, the judiciary has been targeted as an instrument in changing discriminatory attitudes associated with HIV/AIDS. Workshops have been organized to sensitize Judges and create awareness of HIV/AIDS issues that may emerge in the courts e.g. action instituted by PLWHA or on their behalf against individuals or co-operation for discriminatory attitudes towards them.
c) Changing discriminatory attitudes by the states: the state can also change discriminatory attitudes against people living with HIV/AIDS through education, training, and the media. The state, using a broad range of media such as films, television, radio, etc could together with appropriate entities such as media groups, NGO, device and distributed programming to promote and uphold the respect for the right and dignity of people with HIV/AIDS and members of the vulnerable group such Programmes should aim at dispelling myths and assumptions, about living with HIV/AIDS by depicting them as friends, relatives, colleagues, neighbors and partners. Such courage should also reinforce the reassurance concerning the modes of transmission of the virus and the safety of everyday social contact.
The negative effects of attitudes of discrimination and stigmatization associated with HIV/AIDS cannot be over emphasized. People living with the HIV virus are able to live reasonably long and productive lives, particularly with recent advance in antiretroviral treatment.
Attempt to prematurely exclude people living with the virus from the workforce are unfair and a breach of human rights. They are also potentially uneconomical if they can arbitrarily exclude the most qualified person from a position.
These discriminating attitudes must be discouraged and changed. Those living with the virus need to be and feel protected from stigmatization and discrimination by their communities. For these protected measures to be implemented and the desired impact felt, it need the concerted efforts not only of the state alone, or parliament, but everybody in both the private and the public sector to promote the wide and ongoing distribution of creative education, training and media programs explicitly design to change attitudes of discrimination and stigmatization against HIV/AIDS to understanding and acceptance.
The shield of confidentiality
Confidentiality is drawn from the broad base universally accepted principle of a person is right to privacy. A right which is judicially approved as a shield from the unwarranted appropriation of a one’s personality, the publicizing of ones private affairs with which the public has no legitimate concern. This is an independent legal right of the individual and its violation constitutes a tort. Dean Prosser, in his work of on tort, distinguished four categories of torts embraced within the rights of privacy, confidentiality being one of such. A right which is predicted upon the constitutional guarantee of life, liberty and the pursuit of happiness Drawing inspiration from the universal declaration of human rights, which uphold the inalienable and sacred rights of the person, it can be said that when the law guarantees to one the right to enjoy his life, a gift to him something more than just the right to breathe. The liberty which he drives from natural law and recognize by the national constitutions includes the right to live as one chooses so long as that choice does not interfere with the right of the another or the public. It is within this spirit that international laws as enshrined in the universal declaration of human rights guarantees the right to privacy with the law as the watch dog. Confidentiality however distinguishes itself from all the other rights of privacy in that, it arises from fiduciary relationship from which flows disclosures revealed on a platform of trust, confidence and the scrupulous good faith and candour which it requires.
The confidential physician patient relationship falls within this category. Confidentiality allows an intimate exchange of information facilitating appropriate care and correct diagnosis. The physician duty constitutes a protective shield against the unwanted intrusion from others. With the advent of the HIV virus, most hospitals upholding strongly the principle of confidentiality have developed passwords which can only be interpreted by the medical professionals themselves to indicate the virus. Infact the health care provider is set to own the medical records but the patient owns the information with the records.
The principle of confidentiality is not absolute Ethical, legal and statutory obligations may permit physicians to disclose information when legally requested by the court or for the purpose of legal investigations or referred to him in his capacity as a medical expert. At a minimum health care professionals have an ethical duty to inform patients prior to testing, as well as upon receipt of result that the, information obtained may have familiar implications. A person tested positive with the HIV virus automatically puts the wife/husband at risk. In such case exceptional disclosures are permissible when: -
 Attempts to encourage disclosure on the part of patients have failed
 The harm is highly likely to occur and if serious, imminent and foreseeable.
 The “at risk” relatives are identifiable and
 The disease is preventable

WOMEN’S VULNERABILITY TO HIV/AIDS IN CAMEROON
Of the 18million people living in Cameroon, about 52% are girls and women belonging to diverse cultures and religions. These women or girls represent a fascinating weave of modernity and tradition, progress and backwardness. A common stand that runs through this weaves is that of inequality between the privilege and not so privilege, between urban and rural, between men and women. The woman however have continued to make strides towards equality with men; whenever they are educated able to generate income and enjoy equal protection under the law, they are in a position to have some control over their economic, social and personal life. However, these goals are still remote for millions of Cameroonians who are vulnerable to HIV infections. This vulnerability is no doubt due to the number of factors
a) Biological Vulnerability; this applies generally to all women, the Cameroonian women inclusive. It is gathered from several sources that the risk of being infected with HIV as with other transmissible diseases during unprotected sexual intercourse, is as much as two to four times higher for women than men. This is because, as compared to men, women have a larger mucosal surface exposed during intercourse to their partner’s secretion. Since semen that is infected contains a higher concentration of the virus than a woman’s sexual secretions, this makes male to female transmission more efficient than female to male. In young girls their physiological immune cervix and scant secretion puts up fewer barriers to HIV so that they are at even greater biological risk. Tearing and bleeding during sexual intercourse whether from rough sex, rape, or prior genital mutilation (female circumcision), multiplies the risk of HIV infections in women. Anal intercourse practiced by some women as a means of preserving virginity or avoiding risk of pregnancy, often tears the delicate tissue and affords easy entry of the virus.
Another biological factor of great importance is an untreated sexually transmitted infection (STI)
in either partner, which multiplies the risk of HIV transmission by up to 10-fold.
Women are also epidemically vulnerable through blood transfusion during pregnancy or child birth.
b) Social vulnerability; social vulnerability despite constitutional and legislative guarantees, the unequal states of women is greatly manifested in almost all social aspects. For most Cameroonian women, their social standing and interaction in a male dominated society greatly contributed to the deadly diseases. The situation is such that most men expect sex with any woman who receives their support resulting in sexual subordination thus creating a very unhealthy atmosphere for AIDS prevention .Social attitudes are such that initiative and decision making in sex is left to the dominants males. Thus most women have no skills to resist or say no to unwanted and unsafe sex. Another issue of concern is the growing demand for younger sex partners, the sugar daddy phenomenon where old men offer young girls gifts and huge sums of money in exchange for sex. In other instances sex is the “currency” for pass grades, jobs opportunities. The high rate of promiscuity and acceptable infidelity is dangerous fertile grounds for women’s vulnerability.
c) Economic Vulnerability: due to the economic situation and circumstances, women’s autonomy is crippled. Lacking economic resources of their own, most women are vulnerable because they depend on the on men for support. In almost all cases men expect sex with any woman who receives their supports. Being fearful of abandonment or violence on the part of their male partners, they have little or no control over how and when they have sex and when and hence over the risk of becoming infected with HIV. In some areas, women have several male partners who provide support for their children’s needs and other necessities. The drastic cut in salaries in the 90’s and the economic crisis having dealt most Cameroonians a blow, women’s dependence on men’s support drastically increased. Furthermore, women also face a double burden relative to the epidemic. They are not only more vulnerable than men to acquiring the infection, but they also bear the greatest responsibility in providing care to infected family members.
1) Cultural and Traditional Practices: most of the campaigns on the fight against HIV/AIDS have so far been focused on orthodox means such as multiple sex partners , sharing of needles, blood transfusion and congenial infection from an infected mother to an unborn child among others. Research have shown that rooted in people’s cultures and traditional practices in Cameroon as in other African countries, are practice that are more dangerous potentials means of spreading the dreaded Virus. Some of these practices involve skin cut, lesions, wife inheritance, and widowhood rights, tribal marks, body scarification, tattoos, blood letting and female circumcision as explain below.
 Scarification by native / traditional doctors; this practice is pervasive amongst most Cameroonian even the elites. People still secretly visit these native doctors for charms and native powers to induce diverse kinds of favors such as promotion, monetary rewards, and insurance against perceived enemies including witches and wizards. Most native doctors satisfy these discrete but pervasive wishes by scarifying their clients and applying substances believed to possess powers to produce the desired results. There is the practice of scarifying the face in most tribes leaving terrible and sometimes very frightful and embarrassing tribal marks. The truth is that the surgical knives, blades, broken bottles, or sharp edged stones often used by these native doctors and elders of these tribes are not sterilized and the same tools are used on as many clients as possible. In the course of these practices, there is inevitable blood transfusion, a channel of contracting the HIV virus
 Widowhood rites / Wife Inheritance: In many African countries and Cameroonian tribes, a widow is compelled to sleep with her brother-in-law, presumably to make her pure and free from the curse of being a widow or being revisited by the dead husband. It is nobody’s business to know if the woman or brother-in-law is HIV positive. In other cases, the late husband’s brother, cousin or other male relation not minding the health status of either parties inherit the widow. There is also the practice in some villages whereby elderly and most often single men without children marry younger women of child bearing age to bear children for them, with no regard to the health status of the man or the woman.
 Female circumcision:- Despite international efforts and national and official attempts to outlaw it, female circumcision is still practiced in some parts of Cameroon especially the South and North West Provinces. It is considered an important cultural practice, which curbs immoral behaviour and gives guidance to the initiates on important matters of life. In most cases, older women carryout the circumcision as it is the case with scarification, the same instruments are employed for several cases with no regard to the health risks involved. Any campaign against AIDS that does not consider these cultural practices is not likely to succeed. But the question is, can the people be removed from these ingrained practices? How far are we ready to change these practices?
 Prostitution:- It constitutes another setting in which women have little power to protect themselves from HIV. Most young girls involved in prostitution are ignorant of the risk of contracting the HIV virus. Sexual exploitation of young girls in Cameroon is the most pernicious form of child abuse. While for some women, prostitution is a choice, many turn to occasional or steady sex work as an alternative to fight poverty, exchanging sex for basic necessities of life for themselves and their children. Some of these women are either divorcees or widows who because of inequitable laws and customs have lost their property as well as their husband’s earning power. The situation of economically unstable and not too viable single mother is most alarming.
 No Female Control Preventive Methods:- The Cameroonian woman does not have a suitable barrier method available for HIV prevention. The much-talked about female condom is little known and not yet widely used. Those who have heard of it or seen it complain that usage is not easy at all for various reasons. The only widely available effective method to prevent the heterosexual transmission of HIV is the male condom. There are no counseling services in the rural communities. Even where they exist most women will not seek HIV related counseling, testing, treatment and support for fear of being identified or face discrimination in case of positive result.
 Ignorance:- Most Cameroonian women do not have access to formal education for varied reasons and despite the available facilities. They therefore have very little information about their own bodies and education about HIV/AIDS. There are quite a large number of women who haven’t heard anything yet about AIDS and they remain ignorant of its existence, not to talk of its prevention.
Haven exposed the dangers of some of our cultures and tradition; it is obvious that the situation calls for a remedy – the empowerment of the rural woman. The Cameroonian woman needs to be empowered to have greater access/ control over the rate of HIV infections. Suggestions for such empowerment include:-
a) Literacy and adult education programmes as an important first approach. Steps should be taken to ensure that all, if not; most women in the very remote and rural areas of Cameroon and Africa in particular have education and information in its simplest form about basic human rights and HIV/AIDS. Women should be taught and encourage to negotiate safer sex and to say “NO” and be able to resist unsafe sex.
b) Women should be exposed to more income generating projects to allow the more autonomy. An economically independent woman does not need to exchange sex for her basic needs.
c) More healthy, available and accessible counseling services should be provided for women.
d) A forum should be made available for women to come together to expose cultural taboos that are detrimental to women’s health.
e) Female – controlled and easy to use preventive methods should be developed.
f) There should also be policy changes, particularly specific anti-discriminatory provisions for greater protection of women’s rights and increase economic independence and legal status. This should include a greater political voice for women.

HIV/AIDS AND MEDICAL CARE
The universal declaration of Human Rights in its Article 25 (1), the Cameroon 1996 constitution and WHO charter in its article 1, states that it is an individual’s inalienable right to get medical care when he is sick. Right now, the human race is perplexed by the HIV epidemic which has no vaccine or cure. The testing for HIV virus should be voluntary. It is an individual’s right to refuse to go for testing but such refusal is morally wrong where medical institution may want to conduct this test for statistical purposes, the consent of the blood donor / patient should be sought. It will be a medical malpractice if a doctor or a health institution conducts an HIV test on anyone without his consent. It has been poorly argued that for statistical purposes patients may be screened without their knowledge. Such an argument is unfounded and is in violation of the right of the patient, since the health status of an individual is a personal matter. HIV/AIDS is not a contagious illness. We have already seen that HIV could be contracted through coming in contact with HIV contaminated blood, semen or breast milk through blood infusions, blood contact, sexual intercourse, sharing needles or syringe. Therefore a doctor or medical institution that isolates HIV/AIDS patients may be liaised for discrimination and causing additional emotional pain and suffering. Is being HIV positive patient not enough punishment?
One can even classify such isolation, as punitive if the patient has contagious HIV related diseases. Why would anyone punish an HIV/AIDS patient? It is an actionable tort when a patient is given HIV contaminated blood or treated with HIV unspecialized medical instruments.
Antiretroviral drugs can reduce the level of HIV in blood and also treat HIV related infections, but in Cameroon, many infected persons especially those in rural communities have no access to these ARV’s. It is estimated that in many developing countries and Africa in particular, four out of every five person visit traditional health practitioners and use traditional treatments. Traditional healers already treat large numbers of people living with HIV and AIDS. It is therefore important to look into this area of healthcare. It is also important to improve the approaches to working with traditional doctors, this can improve HIV prevention and care services while continuing to advocate for improved access to modern medicine and treatment.
To help the Cameroonian population in the rural areas and most developing countries at large, medical officers should come up with programmes to train traditional health practitioners on the necessity of sterilizing blades and other sharp objects they use in administering their treatment, so as to minimize the risk of HIV infection. Appropriate training encourages traditional health practitioners to replace harmful practices or myths about HIV with safer practices. They should discourage the practice of witchcraft by not classifying the AIDS symptoms as caused by witchcraft. These traditional healers should be encouraged to promote sexual abstinence among youths and fidelity within married adults. Such values often agree with traditional beliefs about the causes of sexually transmitted infections and other illnesses and it is now recognized that reduction in the number of sex partners is a powerful factor in reducing HIV transmission. To pass on proper training in handling HIV/ AIDS cases to our traditional healers, workshops and seminars should be organized by the Ministry of Public Health. As far as legal issues are concerned, traditional healers must be made to understand that accusing people of being responsible of one’s misfortune or illness or death through witchcraft without proof is a defamatory statement and could lead to criminal prosecution.
AIDS AND EMPLOYMENT
An HIV infected person has right as all human beings do, amongst them, the right to work. The universal declaration of Human Rights states that “Every person shall have the right and obligations to work”. AIDS is an issue of human rights and it is necessary to protect the right of working men and women living with the virus, these rights inter alia are access to productive and decent work, social security benefits, health care and the right to confidentiality. In Cameroon, HIV/AIDS infected persons have had their rights to work trampled upon by employers. Applications of job seekers have been rejected because of their HIV/AIDS status. Working men and women with HIV/AIDS have suffered all forms of discrimination at their job sites. Gaining access to employment is a major problem for HIV infected persons. A number of companies now require job seekers to pass an HIV/AIDS test before employment. Men and women including those with HIV/AIDS have the right to work in condition of freedom, equity, security and human dignity. One of an employee’s greatest nightmares begins when he is known or presumed to be HIV positive. He suffers all forms of discrimination. He is isolated by his colleagues. In the private sector, he may be passed over for promotion and is not taken into consideration for training programmes no matter how hard he may work. At worst, the employer dismisses him. When one looks at the discrimination going on in the world of work against HIV/AIDS person, one might fear that in the long run such persons will be completely kept out of work. However this might not be the case as there are some employers who are beginning to realize that these person’s rights as human beings must be respected. Nevertheless, such actions will not go a long way in protecting the rights of HIV/AIDS persons on the whole, as some of the important issues to be addressed by the proposed law that will be of help to people living with AIDS are:
 A person should not be discriminated against with regard to terms and conditions of employment because of his HIV status, if he is otherwise qualified.
 The law should prohibit an employer from inquiring about an employee or job applicant medical status. This law should also provide for reasonable accommodations to enable HIV/AIDS workers perform the essential function of a job, that is, flexible working hours, time off for doctors appointment etc. this law must also lay out the various remedies available for HIV/AIDS persons where their rights have been violated. It doesn’t suffice to lay out the rights.
HIV/AIDS AND REPRODUCTIVE RIGHTS
In many African countries and Cameroon included there is an experience of growth in HIV/AIDS and this is evidence and increasing in ages between 18 to 40 years. This age bracket is considered to be that when the woman is sexually active and of child bearing age. Women are one of the fastest growing populations being infected with HIV and the number of AIDS cases among women is increasing steadily each year. Because the time of infection to developing AIDS can be variably long, many of these women acquire HIV in their teens or as soon as they become sexually active. Women are more at risk to be infected as male to female transmission is estimated to be eight times more likely than female to male. This is so because HIV is more easily transmitted from men to women due to greater expose surface area in the female genital track. Women do not as yet wear the condom, therefore they are not capable of protecting themselves from HIV infections. They can therefore not rely on their own skills, attitudes and behaviors regarding condom use. They have to rely on their ability to convince their partner to use a condom. Gender, culture and power may be barriers to maintaining safer sex practices. Women are disproportionally represented among the poor and the less likely to have access to health care services. Most of them will have to struggle for daily survival and may have no concern about HIV infections when having sexual relations and the impact may be felt many years later. Like many people in committed relationships, women might find intimacy in their relationships to be more important than protection against HIV. Usually, unsafe sex may be linked to emotional, social and possibly financial dependence on men. Women are furthermore vulnerable to be infected with HIV because they are mostly passive partners in sexual relations and can not be heard to refuse sex to their husbands or partners even if infection is suspected. They are vulnerable and not in a position to avoid infection because they either do not receive preventive education or information or cannot act on it, and when infected are disempowered to cope with the impact. The woman’s subordinate status limits opportunities to be informed about HIV/AIDS making them more vulnerable to infections and impairing their ability to deal with possible consequences of infection which require care and support. Women some times can not negotiate safer sex or leave their partners because of social and legal norms and economic dependency norms that promote motherhood as the ideal form of self worth. This increases the vulnerability to HIV and constrains reproductive choices for HIV positive women. Double standard about chastity and fidelity means that many monogamously married women are powerless to avoid infection by their husband. For many women, many of their HIV diagnoses can carry with it the devastating assumptions that they can and will never have children. Many others receive their diagnoses while pregnant this is so because many women are not tested for HIV unless they become pregnant or ill. And some women infected with HIV may decide to have their babies while others chose to have a termination. The decision to terminate a pregnancy is very personal since the Cameroonian law allows for termination on grounds of ill health. This article is an attempt to look at the reproductive right of unborn child and to say that the woman infected with HIV can still become pregnant and have a baby. Being pregnant will not increase the chances of developing AIDS. Research has shown that pregnancy does not speed HIV disease progression. Yes, a woman with an HIV positive test result has a right to become pregnant. The unborn baby has a right to live not withstanding the fact that his mother is HIV positive and stands the risk of being infected with the virus. It has been scientifically proven that not all babies born to an infected mother will have the virus at the time of birth. All babies born to mothers with HIV are born with HIVanti bodies but babies who are not infected loose their anti bodies by the time they are 18 months old. There is a possibility of the decline in numbers of the perinatally infected infant. This is due to:
The implementation of new knowledge in perinatal HIV prevention and treatment for pregnant women with HIV infection. AZT is the most commonly used and approved therapy for preventing transmission from mother to child. Delivery by elective caesarean sections also reduces the risk of a baby becoming infected. It is usually best for a baby to be breast fed. However, if the mother has HIV, breastfeeding will increase the risk of her baby becoming infected. Therefore a mother with HIV may not have to breast feed as bottle feeding is a safer alternative. The reduction in HIV transmission from mother to infant with the use of anti HIV drugs has been a remarkable success story. This major advance can be shared if there is easy access to the necessary drugs, adequate prenatal care, improved nutrition and prevention of breast feeding by the mother. All pregnant women ought to benefit from the informed counseling of the potential risk and benefits of using an optional and potent anti HIV regimen during pregnancy and then be allowed to make their own decision, unfortunately, little is known about the long term effects of this compound to the child. Due to so many unanswered questions, any HIV positive woman who is pregnant or considering pregnancy should seek the care or an advice of a clinician with experience and or knowledge of the latest break through in HIV research, this ensure the best possible prenatal care and the best possible out come for both the mother and child.
WOMEN AND HIV/AIDS-APRAGMATIC APPROACH
The health and wellbeing of women every where is of great important in its own rights. It is also the key to the health and wellbeing of their, family, communities and societies .but every year, millions of women in developing countries die in pregnancy and /or child birth. HIV presents an enormous challenge to safe motherhood. In sub Saharan Africa, millions of pregnant women are HIV positive. Women with HIV are likely to have complication during pregnancy and/or delivery, or abortion. They are also more vulnerable to anemia, malaria, pneumonia and tuberculosis (TB)both HIV prevention and care is an essential part of safe motherhood maternity services could play a crucial role by improving for pregnant women with HIV/AIDS before, during and after pregnancy. Fewer resources will be needed if programs work together.
 The vulnerability element: while it is important for men’s own health, that they become more involved in HIV prevention and care, there are important benefits for women too. Some of this links to women’s heightened vulnerability to HIV infection others tie more closely to equality and equity in care. Women’s vulnerability to HIV transmission is particularly a matter of biology. because virginal tissues if fragile , particularly in younger women, during unprotected virginal intercourse, an HIV man is twice as likely , to transmit the virus to an uninfected woman as an HIV positive is to infect her male partner . Women also made vulnerable by men’s greater economics and social power and by unequal gender relations. It is men who generally decided when and with whom to have sex and whether to use condoms or not. This leaves women with little or no control over these exposure to the deadly Virus it is men too who are usually the perpetrators of sexual violence whether in war or civil unrest or within ongoing relationships. in 1999 during the follow-up to the Beijing Fourth World Conferences on women, the 43rd session of the United Nation Commission on the statues of women attention was drawn to the need to educate women and men particularly young people, with a view to promoting equal relationships between men and women and to encourage to accept their responsibilities in matters relating to sexuality, reproduction and child bearing.
 Prevention through sex: there are many ways preventing the sexual transmission of HIV between women and their partners these includes abstinence, mutual fidelity, sex that does not involve virginal or anal penetration and condom use. However most prevention massages are simplicity and not tailored to the complex, and often hidden reality of men’s relationships with women or other men National AIDS campaigns have promoted abstinence outside marriage and fidelity within it wit some success. However, abstinence for young men is difficult and a menu of risk reduction option needs to be offered. The consistence use of male and female and female condoms in virginal or and sex also protects HIV and STI’s. Condoms, however, are under used for a variety of reason. In casual or commercial sex, men’s condom use is more common than in marriage but still often inconsistent in a study that was conducted in Zimbabwe, some two years ago, men interviewed had sex with prostitutes on an average of seven times a month but only used Condoms in about half of those encounters. Studies in many other countires have confirmed that female condom is an alternatives which some men and women find more comfortable than the male version. Like the male condom the female version can also be used for anal intercourse. Female condoms are, however much more expensive and difficult to acquire and because they remain visible during intercourse they still require male consent. When condoms are not used the prevalence of unsafe sex before an outside marriage plus the lack of HIV testing, means that millions of couple around the world, do not know whether they are practicing safer sex or not. Except when the goal is contraception introducing condoms use in a regular relationship, can be difficult. One problem is the difficulty of acknowledging premarital or casual sex and discussing the possibility of infection. For couples who wish to have children, the challenged is compounded by the fact that condoms interfere with procreation. A great deal of HIV transmission occurs as a result.
 Reproductive rights and choices: all women, regardless of their HIV status have the rights to choice whether and when to have children a woman who knows she is HIV positive , needs information about the HIV related risk of pregnancy for her self and her baby and how they can be reduced. But she most still be free to make her own decisions about whether or not to have children and should be supported in her choice.
 Ensuring mother’s rights to be healthy: All women need care and advice to help them remain healthy during their pregnancy. Protect women from HIV. The only completely reliable way to stop mother to child transmission of HIV is to prevent young girls and women from becoming HIV positive.
 Promote safe sex: Even after becoming pregnant, women should continue to practice safe sex unless they are absolutely certain that their partner is not HIV positive. Continuing to use condoms will also prevent STI’s. Keeping to one sexual partner makes sex safe on the condition that the partner is faithful.
 Test for, and treat all infection: An essential part of care for a pregnant woman is to look for, ask about and treat any infection she might have, especially those who are HIV positive. It is difficult for many women to decide what to eat because of poverty, customs or their status-leaving them fewer choices. Education about which local foods are most nutritious and the importance of pregnant women being well fed need to be un going. Discourage smoking and the use of alcohol and other drugs. Smoking cigarettes, drinking alcohol and the use of some drugs and herbal remedies can harm the unborn child. HIV positive women need to be especially careful because anything that damages their health can lower C D 4 counts.
 Provide Voluntary Counseling and Testing for HIV: Many women knowing their HIV status will help them make decisions that reduce the risk of transmitting HIV to their babies. The counselor might be a health worker such as a mid wife or a nurse, or may be a lay person. Peer counselors such as people who are themselves HIV positive. Can be very valuable.
 Points for Action:
 Gender awareness: promote understanding of the way in which gender stereotypes and expectation affects women and men. Support works that enhance gender equality and equity. Encourage discussion about the way girls are brought up and are expected to behave.
 Sexual communication and Negotiations: Encourage women to talk about sex with their partners enhance women’s capacity to determine when, where, and whether to have sex or not. Enhance both men and women access to appropriate sources to information, counseling and support. Promote greater understanding and acceptance of HIV/AIDS.
 Support and Care: Help women in their role as mother and providers of care and support within the family and community at large.
HUMAN RIGHTS, HIV/AIDS AND THE WOMAN
At the dawn of a new century, we still look at the future dominated by the deadly disease, which just a few decades ago were totally unknown. It may be shocking to know that over 75% of those infected with HIV live in the developing world, to which Cameroon belong. In this section, we will be considering the AIDS pandemic and HIV and how it affects women and children and what we can do about it.
1. The physiology of the woman: The mere fact that one is a woman has been proven, to make that person more vulnerable to contracting AIDS. Studies have confirmed that there is greater transmissibility of HIV from male to female. It has been estimated through research that the woman’s risk of being infected by HIV is at least twice that of a man. This is largely due to their physiological make up which has an extensive area of mucous membrane through which the virus get into the vaginal and to the cervix. Younger women, especially teenagers even run a greater risk due to their immature cervix and relatively low vaginal mucous. Production which are suspected to prevent less of a hindrance to HIV.
2. Childhood Marriages: In Cameroon like most African countries, young girls are given out to marriage as early as twelve years or even sooner. A girl child find herself married to a man who has maybe two other wives or children older than herself. He therefore has been sexually active for much longer and it is quite possible that he is already infected with HIV and as such, the girl child is of a very disadvantaged and pitiful position because as soon as soon as she indulges in sexual intercourse with her supposed husband, she finds herself with HIV.
3. Reproductive Health of Women: The fact that women carry pregnancies and are very dedicated during this period, makes them more vulnerable to epidemic. With complicated pregnancies and the need for blood transmission, the possibility of being infected is greater.
4. Labour Migration: Labour migration has been known to facilitate the spread of the disease with the woman again as the victim. Labour migration usually separates couples and leads to the establishment of temporarily migrant communities which are usually dominated by single sex most often man. This usually creates a market for prostitution as such; men have the money and need sex, so they are ready to pay for it. The examples are alive in Cameroon as we notice that wherever there has been the construction of roads, involving expatriate companies, who are Caucasians, we find a sudden prevalence of (mulatto) children (half-cast) which goes to demonstrate the sexual involvement of these workers in the community. The presence of these children is evidence that intercourse was done with no precaution. These types of women are far more prone to being infected with HIV.
5. Gender Inequality: Women in developing countries especially Cameroon and Africa at large are economically disadvantaged due to poor education, early marriages and no skill training which render them mostly unemployed. They are therefore dependent on men economically, which limits their choice on matters relating to health and sexuality. Also, the woman’s low social status and cultural demands which compares her to be always submissive to the male in sexual relations, further hampers her from controlling her sex life, she can not be heard to insist on the use of condoms. Also, the marital system of Polygamy which is prevalent in our towns and villages has the women at a disadvantaged position, as the husband goes from wife to wife can be infected by one wayward wife and the other wives will automatically be infected.
6. Women’s Attitude towards AIDS: The attitude of the woman herself in Cameroon to the issue of AIDS is quite alarming and a cause for concern. A study carried out with some female sex workers in Kumba, in the South West Province of Cameroon reveals that they all agree that AIDS exist, but they are doing nothing to protect themselves especially when the men are ready to pay huge sums of money. Some say they never use a condom with such clients the reason is simple. To these women, AIDS is not a reality as of now. For them, AIDS is something that affects other people not them. In their complacency, they feel out of the reach of AIDS. This non challence with which women in Cameroon have embraced the issue of AIDS requires that something more has to be done and urgently to raise awareness especially among female sex workers, female student on the dangers of AIDS and the fact that it is real.
7. Human Rights and Health: The universal declaration of Human Rights of 1948 gave the rights to every one to have a living standard sufficient to ensure one and his family good health as concerns food, clothing, housing, medical care and social services. Also, article 12 of the International Covenant on Economy, Social and Cultural rights also recognizes the right to the enjoyment of the highest attainable standards of physical and mental health. These documents are the best legal and ideological weapons for protecting legal rights and autonomy of an individual. It therefore follows that for women to enjoy their human rights relating to health the following must be done;
 There has to be a cultural change which gives the woman the status of a partner in her marriage and not sub servant to her husband even on issues which concerns her health.
 There also has to be a free medical screening of HIV in all of the main towns of Cameroon where women can be encouraged at no cost to check themselves. For now, the cost of an HIV screening in Cameroon is 500 FRS ($1). This is still expensive.
 Empowerment of the woman economically is very important as it will make her independent to be able to control her sexuality if women are empowered economically, (by giving them some skills and small short term loans), they will find satisfaction in life and not continue to sell sex for a living.
 There has been a steep drop in our standards of morality. Infact, nowadays, you find high school and university girls kept by more than one “sugar daddies” who finance their acquired high taste. We call on the judges to do more in this area of moral rectitude to the girls and women whom the men have taken advantage of their vulnerability.
HIV/AIDS AND SOCIAL CONTROL
In the absence of a vaccine or cure, prevention is the only feasible strategy for fighting the HIV epidemic. This message of prevention has been preached for years, yet the spread of HIV virus is still on the increase. The estimated cumulative number of HIV infections worldwide has risen. About 80 - 90% is thought to be sexually transmitted. So has the prevention work?
The rise of the infection in developing countries seems to indicate a massive defeat of international response. However, as nobody knows the real virulence of HIV, of what would have happened with no planned prevention intervention, the score has to remain open. It may be that all the information, education and communication efforts and all the blood testing and counseling have infact prevented a much more devastating explosion internationally or in a certain local/national areas. Even without knowing precisely the impact of prevention effort on the spread of global HIV, the challenge remains in the absence of a vaccine prevention interventions will remain the key to HIV control. The information, education and communication approaches in the fight against HIV have stressed the change of behaviour in relation to sexual attitudes. Those who are sexually active are advised to adopt sexual behaviors that reduce the risk of infection. The intervention to break the chain of transmission is seen basically as a technique to physical barriers like condoms, behavioral barriers like the abstinence or partner reduction, to stop the passage of the virus from one person to another. Youths have been identified as the target of the information and education campaigns. To stop these youths from behaving sexually as they did in the past became the prime task of the prevention of all sexual transmission. Although it is true that in the end, each individual who acts sexually has to take responsibility for his/her action, it is nevertheless obvious that sexual behavior and consumption patterns are strongly influenced by gender, social, cultural and economic factors. What a given society regards as sexually right or wrong as a taboo, deviant or normal is decided by the individual actor, and not by a set of norms and values to which different gratifications and sanctions are attached. For example, in Africa the social inequality between men and women is most responsible for the spread of the virus. Women, especially youths generally lack the social power to set the terms of sexual relationships. Social isolation and lack of education limits their knowledge of prevention behavior. Young girls and women living in poverty are often enticed or coerced to trade sex for support or social promotion and maybe forced into prostitution or polygamous marriages, why inheritance and societal promotion and concentration of the male infidelity are factors which have been identified as favourable in the transmission of the virus and the AIDS disease. As a result of these factors, which centres largely on the vulnerability of a woman to HIV infection, the complete success of the prevention method a major break through is conceptual thinking has been negative. Therefore, a shift in emphasis must take place from concentration on individual behavioral change to addressing the social and cultural structure of sexual relations and the individual as part of a community and a network. In doing so, the state or community should also enhance the ability of women to control their sexual relationships. Men and women should talk openly about sex, sexuality and HIV/AIDS. The state or community should also encourage men to take care of themselves, their partners and families. Our society is plagued with some men who are irresponsible in every conceivable way. They have a denial syndrome and they blame everything on the woman. Our society also suffers from some promiscuous married women in the rural and urban cities, who have discriminate extra marital sex as a routine. The state or community must provide good and quality education of sexual health; HIV/AIDS and life preserving skills for youths in and out of schools.