Reproductive coercion experienced by women living with HIV - a global scoping review

Biomedical advancements in HIV prevention and treatment have provided opportunities for women living with HIV to move through pregnancy, give birth, and breastfeed while effectively removing the risk of vertical transmission of HIV to their child. However, existing evidence suggests that the reproductive health and rights of women living with HIV are threatened through coercive practices in healthcare settings because of their HIV status. The objective of this scoping review was to synthesise evidence and identify gaps in the literature on reproductive coercion experienced by women living with HIV in clinical settings. This review focused specifically on reproductive coercion in the context of clinical healthcare globally, as opposed to intimate partnerships, and included forced or covertly performed sterilisation, forced abortion, restricted or forced contraceptive methods, forced or denied caesarean sections, and general coercion by healthcare providers regarding fertility-, sexual-, and reproductive-related decision-making. We searched three databases (Embase, PubMed, and LILACS) for quantitative, qualitative, and mixed methods studies. After 2888 unique publications were screened, thirteen publications met the inclusion criteria. Sterilisation was the most common coercion type assessed, and Mexico, the United States, and South Africa were common study settings. Variation in reproductive coercion definitions, study methods, and reporting was observed. Evidence from these studies suggests that reproductive coercion among women living with HIV is severe and pervasive. Therefore, there is a need to expand research on coercion and stigma that women living with HIV face while navigating reproductive healthcare. Additionally, prevention mechanisms and resource expansion for survivors beyond legal settings should be implemented globally.