A/HRC/32/44 they become pregnant, including following rape. They are held in detention centres in deplorable conditions pending their deportation, or face severe punishment, including the death penalty in countries where sexual relationships outside marriage are criminalized. Indigenous women 54. Indigenous women experience a complex spectrum of mutually reinforcing human rights abuses which is influenced by intersecting forms of discrimination and marginalization, reinforced by patriarchal power structures and past and present forms of violations of the right to self-determination and control of resources. These intersecting forms of discrimination have profound health consequences for indigenous women, especially for their reproductive and sexual health. The Special Rapporteur on the rights of indigenous peoples has reported (see A/HRC/30/41) about the barriers to reproductive and sexual health services encountered by indigenous women as well as past and recurrent human rights violations in relation to their sexual and reproductive rights. For example, indigenous women experience disproportionately higher levels of maternal mortality, indigenous girls are overrepresented among pregnant teenagers and indigenous women have lower rates of contraceptive use and higher rates of sexually transmitted diseases, including HIV/AIDS. Historically, there have also been instances of serious violations of indigenous women’s rights to reproductive health in the context of the denial of the rights of indigenous peoples to self-determination and cultural autonomy. Those violations include forced sterilization of indigenous women and attempts to force them to have children with non-indigenous men as part of policies of cultural assimilation. Indigenous women may also face barriers to preventive care services that support their right to health, such as screening for ovarian and breast cancer. 55. The deplorable health outcomes for indigenous women are linked to decades of oppression and human rights violations against indigenous peoples, and against indigenous women in particular. Furthermore, non-indigenous health systems generally do not take into account the indigenous concept of health and health care, thereby creating barriers to access by indigenous women. Data usually fail to capture information on indigenous communities, rendering them “invisible”. Even when such information exists, it is generally not disaggregated by sex. Additionally, indigenous women are disproportionately affected by illness owing to reduced coping capacity caused by the denial of other human rights and by extreme poverty. Rural women 56. Rural women are particularly affected by patriarchal gender stereotypes and roles and are extremely vulnerable to harmful practices such as early or forced marriage and female genital mutilation, as well as to violence and poverty. These practices have a negative impact on their right to health. Rural women are usually particularly disadvantaged in accessing health-care services, including reproductive and sexual health services. Minority women 57. As highlighted by the Special Rapporteur on minority issues (A/HRC/31/56), minority women, including women affected by discrimination based on caste, are particularly vulnerable to violations of their right to health, including reproductive and sexual health. Women members of “lower caste” groups present the worst health outcomes, especially in terms of life expectancy, access to maternal care, nutrition and incidence of infections. Roma women are the subjects of degrading stereotypes, depicted as “fertile” and “promiscuous”; this increases their vulnerability to gender-based violence and forced sterilization. 11