Costa Rica

OVERVIEW

In Costa Rica, you can purchase oral contraceptives (birth control) over-the-counter. You can also find other contraceptive options, such as injectables, implants and IUDs. While emergency contraception (the morning after pill) is illegal, there are other methods of preventing pregnancy after unprotected sex in Costa Rica. These methods include taking regular birth control pills as replacement emergency contraception, which we detail in the "Emergency Contraception" section, or you can get an IUD. You can get STI tests at public or private facilities, and there are some recommended specialists for HIV treatment. There are no travel restrictions attached to HIV status. Regarding pregnancy, women receive maternity leave but there seems to be no paternity leave coverage. Finally, abortion is illegal for most cases, except for when the woman's life or health is endangered by the pregnancy. For this reason, most women receive clandestine abortions in Costa Rica, some of which are unsafe, so one must exercise extreme caution if they take this route.

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Costa Rica, you can purchase contraception (birth control) over-the-counter. No prescription is required. According to a 2015 report, 78.9% of Costa Rican women (who are married/in unions and of reproductive age & married) use some form of contraception, including traditional methods, and 6.2% have unmet family planning needs. For these women, the most popular contraceptive methods were female sterilization (27.7%), birth control pills (21%), condoms (11%) and injectables (8.8%).

What to Get & Where to Get It

• In Costa Rica, you can purchase birth control pills ("píldoras anticonceptivas” in Spanish) over-the-counter. You can find phasic and combined pills, and the brands typically come from Germany, the UK and the USA. Some brands you may see are Cilest, Femiane, Gynovin, Harmonet, Lo-Rondal, Microgynon, Microgynon-30, Minulet, Miranova, Mirelle, Nordette, Norgylene, Norinyl, Norinyl 1+50, Qlaira, Trinordiol, Yaz, Yasmin and Yermonil.
• If you want a contraceptive shot/injectable ("anticonceptivo inyectable” in Spanish), you can find options produced in Brazil, Mexico, Costa Rica, USA and Germany. You can get the injection at pharmacies. Some of the brands are Cyclofemina, Depo-Provera SAS 150mg/ml, Mesigyna, Norigynon, Noristerat, Proter, Topasel and Yectames. One local says: "I think injectable contraceptions methods are not being offered by through the public health care system. However you can buy them at a pharmacy. Drugstores in Costa Rica have registered physicians that can apply them."
• If you want a contraceptive implant ("implante anticonceptivo” in Spanish), you can find Norplant, which has Levonorgestrel 36 x 6 mg and is produced by Bayer HealthCare. However, one local reported that they're not commonly used by women in Costa Rica.
• If you want an IUD ("DIU” in Spanish), you can get Mirena, which is a hormonal IUD with Levonorgestrel 52 mg, and it's produced by Bayer HealthCare.

Costs

• If you go through the public health care system, you can get birth control and condoms for free in Costa Rica. Otherwise, you can expect to pay between $10 to $30 USD/per box (one month supply) of birth control pills.
• One local says, "I paid around $20 USD per month on Qlaira birth control pills. I then switched to Mirena (iud) and paid around $300 for getting it placed." (March 2017)

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Costa Rica, emergency contraception (the morning after pill) is illegal. However, you can use regular birth control pills as replacement EC, which we detail in the section below ("What To Get & Where to Get It").

What to Get & Where to Get It

• In Costa Rica, dedicated emergency contraception (the morning after pill) is illegal. However, you can use regular birth control pills as replacement EC. Just remember that, in 28-day packs, only the first 21 pills can be used. Here's what you can do:
  • For any of these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later: Denoval-Wyeth, Neogynon, Nordiol, Ovral, Primovlar
  • For any of these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later: Lo-Rondal, Microgynon-30, Nordette, Norgylene
• You can also get an IUD to prevent pregnancy after unprotected sex. See the "Contraception (Birth Control)" section for details.

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Costa Rica, there are no travel or residency restrictions related to HIV status. You can enter the country without being asked for a medical certificate. Furthermore, you won't be deported if you test positive for HIV when you're in the country.

Regarding HPV, according to the HPV Information Centre, "About 3.3% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 62.9% of invasive cervical cancers are attributed to HPVs 16 or 18."

Testing Facilities

• In Costa Rica, you can get an STI test at a public clinic or private clinic. If you want to go to a public clinic, the services should be pretty good. However, if you want the highest-quality and fastest services, you can choose to go to a private clinic. Some of the best private hospitals/clinics in the city are The Clínica Bíblica, Cima Hospital and the Clínica Católica.

Support

• Ospedal San Juan de Dios: This hospitals specializes in HiV/AIDS treatment.
• Ospedal México: This hospitals specializes in HiV/AIDS treatment.
• There are no specialized private clinics for HIV/AIDS in Costa Rica.
• The following physicians are recommended (among others) for HIV/AIDS treatment: Sr. Dr. Moya (Phone: 257 2890) and Sr. Dr. Ignácio Salón (Beeper: 256 7890)

Medications & Vaccines

What to Get & Where to Get It

• If you have a yeast infection ("infección por levaduras" in Spanish), you can ask the pharmacist for Fluconazole, which is antifungal medication. They'll be able to give you Fluconazole or something similar.
• If you have a urinary tract infection ("Infecciones de las vías urinarias" in Spanish), you can contact a doctor/pharmacist to find out next steps.
• Costa Rica has no national HPV vaccination program, according to a 2016 report. However, you should probably be able to find the HPV vaccine in hospitals and clinics.
• There appears to be no national PrEP (Pre-Exposure Prophylaxis) program.
• You can obtain non-occupational Post Exposure Prophylaxis Medication (NPEP) after being exposed to HIV within 70 hours at "La Caja de Seguro Social ( referenced: as per interview with head Pharmacist at UNIBE ClINICA EBAIS TIBAS, 2016) However, all 3 medications will come at a cost of over $1500 USD (for non-residents). You will need to purchase one months worth of 3 sets of pills: Tenofovir, Raltegravir and Lamiduvine; (OR), Tenovovir, Kaletra and Lamiduvine.

Costs

If you're registered with Costa Rican social insurance, or if you're a foreigner who legally resides in Costa Rica and pays contributions to the social insurance system, you can receive free HIV treatment.

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

What to Get & Where to Get It

In Costa Rica, you can find pads, tampons and menstrual cups. Pads are the most readily accessible, and they can be found in pharmacies and grocery stores. Regarding tampons, you can find them in Costa Rican cities. You can purchase menstrual cups from FemmeCup Costa Rica. They have Femmecup (small size) in 20,000, Fleurcup (small size and large size) 18,000 (no pouch) and Naturcup (L) in 22,000. You can also buy DivaCup online from Mama Ecologica (Avenida 3 Calles 2 y 4 Santo Domingo, Heredia Province, Costa Rica).

Here's what some locals sayː

• Local Testimonial 1ː "You can get tampons everywhere! Drugstores, supermarkets, mini-markets, 'pulperias.' Wherever you can get groceries, you will find tampons."
• Local Testimonial 2ː "Tampons you can find in every supermarket and every convenience store. In the smallest remote towns you might not be able to, because it's little known or taboo. But even in most little beach towns, for example, you can definitely find them. Also most every drug store carries them. Now we're starting to see the menstrual cup be also available, but just in the cities."

Gynecological Exams

What to Get & Where to Get It

Check out the city pages, like the San José (Costa Rica) page, for some local recommendations.

Pregnancy

Laws & Social Stigmas

In Costa Rica, mothers receive 17 weeks of maternity leave with 100% of wages covered. There appears to be no paternity leave policy.

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

In Costa Rica, abortions are generally prohibited. They are only allowed to save the life or preserve the health of the pregnant woman. The law does not specify if "health" includes mental health. In all other cases, including when the pregnancy is the result of rape or incest, when there is risk of fetal impairment or social/economic reasons, abortion is not permitted. Furthermore, if a doctor suspects that a woman has received an illegal abortion, the doctor is supposed to report her to Judicial Investigation Organization (OIJ). If a woman is found to have illegally obtained an abortion, she can be imprisoned for between six months to two years (for pregnancies up to second trimester) or for one to three years (for pregnancies after the second trimester). However, according to Article 120 of the Costa Rican Penal Code of 1970, the woman's sentence can be reduced to between three months to two years if the abortion was done to “conceal the woman’s dishonor."

What to Get & Where to Get It

• You can potentially get the "abortion pill" by mail. Check out this link for details
• If you are considering leaving the country to obtain a legal abortion, you can legal abortions on request in Mexico City, Uruguay, Guyana, French Guiana and the United States.

Costs

There are underground abortion providers in Costa Rica. We don't know the costs.

If you are pregnant and considering getting an abortion outside Costa Rica, you will need to consider the following costs: transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

List of Additional Resources

• Ministry of Health
• Asociación Demográfica Costarricense (ADC): "ADC is a strong advocate of sexual and reproductive health and rights in Costa Rica through research, education, and campaigns aimed at influencing national policies." The website currently seems to be down but they have a Facebook page. Email: info@adc-cr.org
• The Agua Buena Human Rights Association: "Working for access to medication and treatment for people that lives with VIH/AIDS in Latin América & the Carribean." Email: rastern@racsa.co.cr
• Center for Research and Promotion for Central America of Human Right (CIPA): This is an LGBT rights organization, established in 1999. Call +506 2280 7821. Email: cipacdh@racsa.co.cr
• Tips for LGBT Travelers in Costa Rica