CARLA is 37 years old and lives in rural Jamaica. She was diagnosed with HIV 10 years ago and had her daughter less than two years ago. The rambunctious child had her final tests done at 18 months and she is HIV-negative.

"I am in a relationship with a man who is negative and continues to be negative now," said Clara. "I know a lot about the PMTCT (prevention of mother-to-child transmission) programme and so I knew it was possible to have a child and not pass on the virus. My partner was the first one to broach the subject and we discussed it, but I wasn't convinced I wanted to go that route because I was concerned that he could get it.

"I remember returning from Barbados one day and he told me he had gone to my doctor and discussed the possibility of having a child and he has now made up his mind and he wants to have the child. I told him the risks involved and that at the end of the day he might become positive. We basically planned and timed it so he would be at the least risk. After that, I came off the medication I was on as I knew I should not take them if I was pregnant. I worked with my doctor, got the medication changed and also moved from the treatment site to a high-risk clinic.

"From the outset, I did all the research needed to protect my baby. I told the doctor he should schedule a C-section for me as the risk seems to be lower, based on the research I read. I was admitted two weeks before my due date and one day before the surgery the head of gynaecology told me I did not need to have the surgery. I told him I was scheduled for the surgery and that I was entitled to having the procedure done if that is what I wanted.

"I think due to the fact that I stood up to him I was made to wait a very long time before they would take me to the theatre. That's when some people, all of a sudden, got cuts on their finger and were unable to do the surgery. Then they found out that I worked in the sector and ,all of a sudden I was able to get it done.

"A lot of people asked me why I got pregnant, and I guess, apart from the fact that I wanted to have a child, I also just wanted to prove to persons that as women living with HIV, we have the right to have children.

"My experience was good. The nurses and doctors were generally OK, but I know others do not have similar experience. I remember being in the hospital and there was this young girl who was being coerced by the doctor to sign a consent form for a tubal ligation. I had a session right there in the hospital and explained to her what HIV was and what her rights were as a woman living with HIV.

"I think once you are positive you have to learn about the disease and how it affects you. You have to know your rights or you will be treated as outcasts. I have heard nurses asking women why they are positive and pregnant. As a woman living with HIV, you must demand information about your sexual and reproductive health and rights and then you choose if you want to have children.

"One of the major issues that the hospitals need to address is the nurses aids who come around and insist that you breast feed the baby. They should be taught that the breast is not always best.

"A lot of the problems experienced by our women are that they don't have basic knowledge of HIV and so are not able to stand up for their own rights. There are people who feel that because you are HIV-positive you are no longer human. That is why it is important to get as much information as you can so persons won't deny you your rights."