JOHANNESBURG (AP) — Namibia’s government sterilized three women infected with HIV without getting proper consent, forcing them to sign forms they didn’t understand as they suffered through the pains of labor, a judge ruled Monday.

Activists applauded the decision by Judge Elton Hoff, though the ruling rejected lawyers’ accusations that doctors sterilized the women specifically because they had HIV in a country where the virus remains endemic. The activists say they worry more women in the southern African nation are coerced into the procedure, as other cases pending before courts allege women suffered similar treatment at the hands of doctors.