Pending Issues in Sexual Health in Latin America and the Caribbean
In 2010, the World Association for Sexual Health proclaimed September 4 as World Sexual Health Day as an invitation to promote this aspect of health, as well as the well-being and rights of all people.
But what is sexual health? For the World Health Organization, this concept does not focus only on the absence of disease, dysfunction, or disability, but is “a state of physical, mental and social well-being in relation to sexuality.”
This requires a “positive and respectful approach to sexuality and sexual relationships” which allows for pleasant and safe sexual experiences, free from coercion, discrimination, and violence.
Organizations like these have called on countries to guarantee, through laws and other strategies, the sexual rights of all people, which are, some of the human rights specifically applicable to sexuality, for example, the right to equality and non-discrimination, the right to privacy, the right to the highest level of health, the right to information and education, the right to freedom of expression, among others.
Among the main obstacles to accessing sexual rights are social inequalities. The United Nations Population Fund (UNFPA) in Latin America and the Caribbean reports that the most excluded populations, such as the poorest people, those living in rural areas, indigenous peoples and Afro-descendants, undocumented migrants, people of sexual diversity (lesbians, gays, bisexuals, trans or intersex, known by the acronym LGBTI) as well as adolescents and young people are the ones who experience these inequalities the most.
On the other hand, this organism of the United Nations (UN) registers an unmet demand for contraceptive methods of 10% for Latin America and 17% for the Caribbean. This means that, out of women between the ages of 15 and 49 who are in a relationship, these percentages do not have access to contraceptives, even though they want to use them.
UNFPA identifies some challenges for reproductive health services, such as geographical and quality barriers. In addition, in some countries, there are legal problems to access these services, which affect the use of contraceptive methods, the availability of emergency contraception, access to a legal termination of pregnancy or care after an abortion. These last problems are faced, in particular, by adolescents.
Adolescents and Young People, Exposed to Risks
The adolescent and young population of Latin America and the Caribbean is estimated to be between 24 and 30% of the total population of the region, depending on the consulted source .
According to the OAS website, in some Central American countries, approximately half of women between 15 and 24 years of age began their sexual relations at 15 years of age, and the proportion is higher in rural areas and with less education.
On the other hand, although 90% of young people in Latin America and the Caribbean know at least one contraceptive method, between 48 and 53% of those who already have sexual intercourse have never used one, and among those who did use it, 40% did not do so regularly.
When talking about teenage pregnancy, it is observed that half of the countries in the region have pregnancy rates of more than 72 for every thousand women between 15 and 19 years of age, and it is estimated that 40% of these pregnancies are unplanned. It should be remembered that pregnant adolescents are prone to more health risks than adult women, they are less likely to continue their studies and their children suffer more health problems.
Furthermore, in Latin America and the Caribbean, 45% of deaths caused by unsafe abortions are registered in women under 24 years of age.
Regarding sexually transmitted infections to which young people are exposed, the OAS reports that, annually, one in 20 adolescents contract one, the main ones being chlamydia, gonorrhea, syphilis, and trichomoniasis.
If only HIV/AIDS is considered, in 2014 it was the fifth leading cause of death in people between 10 and 19 years of age, according to data from the study “Quality standards: Sexual and reproductive health services for adolescents in Latin America and the Caribbean ”, Prepared by UNFPA.
Obstacles to Overcome
The same UNFPA report mentions a calculation made by the United Nations Population Division, which predicts that the fertility rate among adolescents in Latin America is probably the highest in the world and that it will remain practically stable for the next few decades (among the years 2020 and 2100).
Since these projections are based on trends in adolescent fertility in the region in the last 30 years, UNFPA considers that in order to eliminate the barriers that prevent access to sexual and reproductive health services for adolescents, it is necessary to adapt the services to the needs of this population.
To assess the quality of sexual and reproductive health services, the WHO launched, in 2014, 8 quality standards that are the parameters to measure whether health care is adequate for adolescents. These standards can be summarized as:
- Adolescents are well informed about their health and know where and when to obtain health services.
- Parents, guardians, and other adults recognize the value of adolescent health services and support their use.
- The health center offers a package of services (information, counseling, diagnosis, and treatment).
- Health personnel are competent to provide services, in addition to respecting and protecting adolescents’ rights to information, privacy, and confidentiality.
- The health center has a friendly, private, and confidential environment, and has the necessary technology and medications.
- The health center provides quality services regardless of economic condition, age, sex, marital status, educational level, ethnic origin, sexual orientation, or other characteristics of adolescents.
- The health center collects and analyzes data on the users of the services, categorized by sex and age, to improve what is required.
- The adolescent population is involved in the planning and evaluation of health services, as well as in decisions about their own care.
However, UNFPA research found that, for example, financial resources to achieve these quality standards are not assured in many countries in the region.
Another very important challenge is to adapt the hours of the health centers so that all adolescents can attend, reduce the waiting time, and have the necessary educational material available.
In general, UNFPA reported that almost all the countries of the region have some of the quality standards, indicated on paper in the national programs. However, in practice, there are still significant gaps in access and quality of services, especially for the most vulnerable groups.
The political will, the investment of resources, and the comprehensive training of health personnel seem to be the fundamental aspects to provide optimal sexual and reproductive health services for these populations.
No matter your age, at AHF Latin America and the Caribbean we work to improve your sexual health. Come to our services like free HIV tests and condoms at no cost. Locate the closest center in your country.