A report of the largest forced sterilisation in South Africa has come to light, with up to 500 HIV positive women said to have been sterilised against their wishes.
South Africa's National Aids Council released a 'stigma index' this week, in which 10,473 people infected with HIV were surveyed to find out if they faced discrimination and stigma.
Of the 6,719 women surveyed, 498 said they were forcibly sterilised, South Africa's Times Live has reported.
Since the respondents were anonymous, it may not be possible to take action against the hospitals where the forcible sterilisations took place, the report said.
"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 it is life-threatening," spokesman for the Department of Health, Popo Maja, was quoted as saying.
Most cases were reported from Eden in Western Cape (22%), followed by Buffalo City in Eastern Cape (20%) and Sedibeng in Gauteng (19%).
Women rights activists have called for the health department to be held accountable.
"The data of 498 cases basically confirms the practice is widespread. This number suggests to us that this is the implementation of some kind of policy that the Department of Health needs to explain," Sethembiso Mthembu, head of the NGO Her Rights Initiative, told the newspaper.
"It costs money to sterilise people, therefore it must be coming from a silent government policy. The department must be held accountable," Mthembu said.
The NGO had earlier filed a complaint about 48 cases of forced sterilisation of HIV women, some of whom realised they were sterilised only when they were unable to conceive.
In some positives from the HIV survey, it was found that most respondents did not face discrimination at work, 90% of them had revealed their status to their sexual partners and 95% women said that they were not forced to terminate pregnancy.