Almost 500 women in South Africa were robbed of the chance to have children after they were sterilised against their wishes because they were HIV positive. This came to light yesterday following the release of the SA National Aids Council's stigma index.It is the largest number of reported forced sterilisation cases ever uncovered in the country.The index was compiled after 10,473 people living with HIV in 18 districts across the country were interviewed to determine the level of stigma and discrimination against people with HIV.The 6,719 women in the sample were asked if they had been forcibly sterilised because of their status. A total of 498 said yes, according to Professor Khangelani Zuma from the Human Sciences Research Council, which conducted the survey.Zuma was confident the data was correct and the women had understood the question.But all respondents were anonymous and cannot be traced so action could not be taken against the Department of Health or hospitals at which sterilisations took place.According to the survey results, the highest percentage of forced sterilisation took place in Eden in Western Cape (22%), Buffalo City in Eastern Cape (20%) and Sedibeng in Gauteng (19%)."This is horrific," said Jody-Lee Fredericks, a lawyer for the Women's Legal Centre.Sethembiso Mthembu, founding director of the NGO Her Rights Initiative, said: "The data of 498 cases basically confirms the practice is widespread. It is systematic."It is not a few rotten apples. This number suggests to us that this is the implementation of some kind of policy that the Department of Health needs to explain."It costs money to sterilise people, therefore it must be coming from a silent government policy. The department must be held accountable," Mthembu said.But the spokesman for the Department of Health, Popo Maja, said it was not government policy to force sterilisation."This is a violation of human rights. It is extremely difficult to investigate the 498 cases because the survey was anonymous, but it is criminal to force anyone to undergo a procedure unless [their condition] is life-threatening," he said.According to the Sterilisation Act, written consent of a patient who understands what they are signing is needed before sterilisation can take place.The head of the SA National Aids Council, Fareed Abdullah, said the sterilisation figures needed to be interpreted with caution as they were based on self-reporting of women rather than biological examinations."The figures must be interpreted with caution because this stigma survey was not set up to measure sterilisation or coerced sterilisation. It was to measure stigma. The only conclusion we can draw is that this might be a problem and the Health Department should investigate it further."It is not the first time forced sterilisation of HIV-positive women has come under the spotlight.The stigma index did not ask the 498 women when the forced sterilisation took place, meaning some the procedures could have happened many years before antiretroviral treatment was made available to South Africans in 2004.Fredericks said: “Unfortunately the statistics are vague, so we don't if the practice is continuing right now.”Fredericks and the NGO Her Rights Initiative have lodged a separate complaint of 48 cases of forced sterilisation, uncovered by the NGO, with the Commission for Gender Equality. In those cases, some of the women found out about the sterilisation only when they struggled to conceive.Many of the 48 were sterilised immediately after giving birth at a hospital and three-quarters of the cases took place after 2004 when ARVs were made available.Because most of the 48 cases are more than three years old, the women cannot sue the health departments or hospitals.The Department of Health has until tomorrow, June 11, to respond to the complaint.OTHER FINDINGS37% of the respondents said that access to ARV treatment was conditional on the use of contraceptives;People were asked if they were discriminated against because of their HIV-positive status or for having TB. Most were not discriminated against at work, but a third reported some social discrimination, including gossip;Positively, 90% said they had disclosed their status to a sexual partner and 68% of parents told their children of their status;A majority (95%) of women reported not being coerced to terminate a pregnancy;14% did not receive ARV treatment during pregnancy despite this being government policy for all HIV-positive pregnant women.In response to the high levels of stigma the survey indicated, The South African National Aids Council has launched a legal support programme for low income people facing discrimination because of their status. The service can be accessed through the toll-free Legal Aid helpline: 0800 110 110.The helpline and support offered is a project run by the council, in conjunction with Section 27, legal firm Webber Wentzel and the International Labour Organisation.The National Aids Council also launched an advertising campaign to promote the service. In the adverts, eight HIV positive people tell their stories of living with the disease. The tagline is: "I can't change my HIV status, but you can change your attitude."..