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Regional Session on Latin America 21 July - 2010

Regional Session on Latin America 21 July - 2010. Lilián Abracinskas Uruguay. The costs of not including care for PLHIV in comprehensive policies on sexual and reproductive health and rights. Talking points: Information about the situation in the region

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Regional Session on Latin America 21 July - 2010

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  1. Regional Session on Latin America 21 July - 2010 Lilián Abracinskas Uruguay

  2. The costs of not including care for PLHIV in comprehensive policies on sexual and reproductive health and rights Talking points: Information about the situation in the region Link between HIV, Violence and SRH: a comparative study within MERCOSUR Future challenges (Key actions)

  3. 1. Some significant data Latin America is the region that: has signed the most international Human Rights treaties, has developed more public policies within the framework of CEDAW, ICPD, UNGASS, MDG, among others.

  4. It has experienced a 30% to 70% reduction in the global fertility rate in the last 50 years. From 6 children per woman in 1960 to an average 2.5 in 2000(CELADE; CEPAL; UNFPA, 2005) Use of Contraception Methods is the most important factor determining the decrease in fertility(CEPAL, 2009) Behavioral changes make processes of secularization and changes of values apparent.

  5. Education plays a key role in reducing fertility because: it boosts self-determination, develops women's ambitions beyond maternity and promotes reflection and the questioning of authoritarian traditions and practices.

  6. In view of the reductions in fertility and mortality rates, it is possible to speak of a process towards a second demographic transition in many countries in the region. A particularly significant population structure is shaped; DEMOGRAPHIC DIVIDEND – high concentration of the working population aged 15 to 64 and especially 15 to 24(UNFPA, 2006). GENDER DIVIDEND-massive incorporation of women into the labor market in the last 3 decades; acknowledgment of the discrimination based on the sexual division of labor: reproductive and unpaid care tasks, pay gap, employment flexibility and precariousness, among others.

  7. Adolescent fertility has not dropped as much as the GFR, but rather it has increased in some countries in the region. Teenagers who have become mothers are characterized by higher levels of social, emotional and health vulnerability. Generational transmission of poverty and exclusion(ECLAC, CELADE, 2005) Population aging and increase in assistance and care requirements. Women live longer, but that doesn't mean they have a good health condition. Causes of disease among women over 60 are connected with the behavior and living conditions they had when they were teenagers or young women.

  8. It is the most unequal region in the planet: 4 out of 10 people are poor and 1 in 6 live in extreme poverty (UNFPA, 2007). Social and demographic lags among the poor, indigenous and afrodescendant populations which have a lower life expectancy, higher fertility and growth rates with a population structure in which children, adolescents and women of childbearing age prevail.

  9. 2 million people living with HIV in the region, with a significant increase in the number of infected people (PAHO, 2008). LA: prevalence of infection 0.5%. Caribbean, 0.1 to 2.2% (second most affected sub-region in the world). 11 million births in the region, only 54% of the pregnant women were tested for HIV. ARV prophylaxis for HIV-infected pregnant women was 54% in 2007. Women and children bear a great burden of disease and indexes for new infections, related diseases and mortality from HIV (55,000 children under 15 with HIV, of which 6,000 died in 2007- the main cause was vertical transmission)

  10. Syphilis infection: 12 million newly infected each year, more than 2 million in pregnant women. Maternal syphilis in LAC is higher than in any other region, 3.9% between 1997 and 2003 with variations between Argentina (1.4%) Haiti (5.75%) and Bolivia (5%) (PAHO-CLAP, 2010)

  11. Almost half of all abortions in 2003 were performed under unsafe conditions. World total 41.6 million abortions/year – 19.7% under unsafe conditions LAC: 94% of induced abortions were unsafewith an average rate of 33 abortions every 1,000 women aged 15 to 44(Guttmacher Institute in The Lancet 2007). Reduction of maternal mortality: even though there is a general trend towards decreasing maternal mortality, it remains unacceptably high in most of the countries in the region. Maternal mortality rate in Bolivia, Ecuador, Guatemala, Guyana, Haiti, Honduras and Peru is 200 deaths per 100,000 live births(ECLAC/UNFPA,2009)

  12. Violence against women(UN, 2009) Half of all women who die from homicide are killed by their current or former partners. For women between the ages of 15 and 44, violence is the main cause of death and disability. More than 80% of the victims of human trafficking are women.

  13. 2. Study: HIV-Violence and SRH in MERCOSUR. Multicenter study: "Violence against women and feminization of HIV-AIDS. A quantitative and qualitative approach,"on the intersection between violence against women and HIV/AIDS in Argentina, Brazil, Chile and Uruguay. Survey of 400 women over 18 years with HIV(FEIM , 2009/10). 83.7% of women surveyed were employed at some point, while only 33.1% is currently employed. This indicates that the frequency of employment has dropped by 49.7% among these women, resulting in a loss of economic autonomy in their current life. 96.6% can read and write, 62% completed general or basic education; 31% has a secondary or middle level of education. 3% claim to have had no access to any level of the education system. Almost half of women surveyed are the main sources of family income; taking second place after husbands/partners and before parental figureS

  14. The first intercourse took place, on average, at 16 years of age. For 88.4% the first intercourse was consented/wanted, and for the remaining 11.6%, it took place under duress; whether through physical violence (9.1%), threats (1%) or manipulation through games (1.5%). 61.4% of women are sexually active today. Among sexually active women, 86 % use some BCM, but the number drops to 62% for those using double protection. On average, women were diagnosed with HIV at the age of 30, for the youngest one was at 14 and the oldest one at 69.

  15. MERCOSUR Study- III 78.1% of women surveyed suffered some form of violence during their lives. 69.9% situations of psychological violence 55.6% physical violence 36.5% sexual violence 32.8% sexual abuse during childhood 75.7% of cases, violence was committed by their partners. VIOLENCE WAS A CAUSE OR CONSEQUENCE OF CONTRACTING HIV

  16. 3 - Future challenges – Key actions To promote public policies concerning the equality of opportunities and rights with a generational, gender, ethnic and racial dimension, with comprehensive services (promotion, prevention, care, treatment and remedy) in BC, HIV, Abortion, Violence against women and gender violence, Sexual abuse, pleasurable sexual lives, responsible parenthood, among others. To reactivate social welfare policies not exclusively based on employment in order to move forward towards protecting Human Rights under the broadest and most inclusive conception, especially addressed at the neglected majorities.

  17. To promote CO-RESPONSIBILITY among families, community, State and market for adequately present and future needs of care. To overcome the SEXUAL DIVISION OF WORK, promoting a redistribution of power, resources and time, especially in highly unequal societies. To allocate ECONOMIC AND FINANCIAL RESOURCES beyond vertical interventions and that take into account the necessary complexity for approaching these issues.

  18. Including a GENDER APPROACH for health financing and care for all is pressing and essential. National budgets and FINANCIAL RESOURCES (national and international) must be understanding and sensitive to the differences between what is invested in the health of men and women, as well as in the various programs and policies. Unless THE INVESTMENT (or expenditure) GAPS AND DIFFERENCES FOUND between regions, countries, target populations and actions are overcome, existing inequities will not be overcome.

  19. It is necessary WORK ARTICULATED between various organizations (Feminist, SRR, HIV, Human Rights, Sexual diversity, development, Youth, Unions and associations) . Promoting actions of political advocacy and enforceability of rights generating SYNERGIES between the different agendas and on an international, national and local level. INFLUENCING FOR TRANSFORMING: Public policy contents and structures Social relations in the public and private spheres The world of symbols in order to rebuild the relationships between society and State with innovative policies that restore the social and gender justice paradigm.

  20. IT IS NOT EASY BUT IT IS POSSIBLE Thank you Lilián Abracinskas Director MYSU – Women and Health in Uruguay www.mysu.org.uy labracinskas@mysu.org.uy

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