Paraguay

OVERVIEW

In Paraguay, you can purchase contraception (birth control) without a prescription. You should be able to access many forms of contraception, including condoms, pills, injectables and IUDs in Paraguay. You can also obtain emergency contraception (the morning after pill) without a prescription. While you may technically need a prescription, locals have confirmed that pharmacists sell EC without a prescription. You can receive STI tests at various clinics, and there are specialized testing resources provided by the AIDS Healthcare Foundation (AHF) and SOMOSGAY for the LGBT community. You can find pads and tampons sold in pharmacies and supermarkets. If you are interested in menstrual cups, there is a local seller, which we have included in the "Menstruation" section. Regarding pregnancy and recommended ob/gyns, we have included some information below. Note that women receive 12 weeks of maternity leave but only 9 weeks include wage coverage. Finally, abortion is completely illegal except for cases when the woman's life is endangered by the pregnancy. This law is strictly enforced. While there is an underground abortion network in Paraguay, there are many unsafe and untrained providers, so it's recommended that you exercise extreme caution if you are considering 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. It is recommended that you consult with a health practitioner to determine the best contraceptive choice for you. If you want to find which hormonal contraceptives are available by brand, manufacturer or country, click here.

Laws & Social Stigmas

In Paraguay, you can obtain contraception (birth control) without a prescription. According to a 2015 report, 77.4% of Paraguayan women (who are of reproductive age and married/in unions) use some form of contraception, including traditional methods. The most common contraceptive methods were birth control pills (17.4%), injectables (16%), male condoms (12.8%) and female sterilization (9.6%). Furthermore, according to WHO data, Paraguay ranks in the list of top 10 countries in terms of the prevalence of condom use. Some Paraguayan women do not have adequate access to family planning resources (it was estimated that 6.4% had unmet family planning needs), yet the rate of unmet needs is lower than many neighboring countries.

Historically, Paraguay has faced challenges in offering family planning services. In 1966, Centro Paraguayo de Estudios de Población (CEPEP), the national family planning association, was founded, which provides subsidized family planning services, gynecological exams, pregnancy care and contraception. However, family planning services were discouraged or even illegal in Paraguay for decades. This began to change in the 1980s, as family planning services expanded in the country. Finally, the 1992 Constitution of Paraguay guaranteed the right to family planning. During this period, Paraguayan usage of modern contraception grew from 35% in 1990 to 49% in 1998. The total fertility rate in Paraguay dropped from an estimated 4.2 children per woman in 1995-2000 to 1.91 children born per woman in 2016.

What to Get & Where to Get It

• For a list of available contraceptives in Paraguay, click here. You will that the pharmaceutical products with distribution in Paraguay come from many countries, including Paraguay, Chile, Argentina, Brazil, USA, UK and Germany.
• In Paraguay, you can find condoms in many stores. If you're a low-income Paraguayan, especially if you're an adolescent or young adult, you can get Pantera condoms from * Population Service International (PSI) Paraguay. They have been providing these condoms since 1998.
• In Paraguay, you can purchase birth control pills without a prescription. If you go to a pharmacy, you can find many brands, produced both inside and outside of Paraguay, including Anulette 20, Anulette CD, Anuit, Cilest, Dal, Diane-35, Exluton, Femiane, Gynovin, Harmonet, Lerogin, Lerogin 20, Linosun, Marvelon, Microgen, Microgynon, Minulet, Neolette, Nordette, Norgeal, Norvetal, Norvetal 20, Qlaira, Selene, Triciclomex, Triquilar, Yasmin and Yaz.
  • Note: If you're a low-income Paraguayan, especially if you're an adolescent or young adult, you may want to contact Population Service International (PSI) Paraguay. They have been offering low-cost birth control, called Segura, in Paraguay since 2001.
• If you would like a contraceptive shot/injection, you can find Acefil, Ciclomes, Clinomin, Cycloven, Ginestest, Gynogen, Mesigyna, Neogestar, Neolutin N, Oterol, Ovoginal, Perlutal, Perlutin-Unifarma, Permisil, Segura, Unigalen, Vagital and Yectuna in Paraguay.
• If you would like a contraceptive implant, we're not sure which options are available in Paraguay (being researched).
• If you would like an IUD, you can find Mirena in Paraguay.

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) For combined pills, 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 Paraguay, you can purchase emergency contraception (the morning after pill) without a prescription. There are no age restrictions. In the public sector, the lowest cadre of health workers that is allowed to sell or dispense EC is auxiliary nurses. In the private sector, the lowest cadre of health workers that is allowed to sell/dispense EC is pharmacy dependents. From a legal standpoint, you may technically need a prescription (this is still being confirmed). However, according to locals, it's very easy and common to purchase EC in Paraguay over-the-counter from pharmacists. In fact, many locals don't even seem to know if a prescription is technically required.

What to Get & Where to Get It

• In Paraguay, you should be able to purchase emergency contraception (the morning after pill) at public sector clinics, pharmacies, IPPF-affiliated systems and social marketing programs (e.g. PSI, DKT, MSI and PSIA). For progestin-only pills, you can find Imediat N, Postinor-2, Pregnon and Pronta (for these, take 2 pills within 120 hours after unprotected sex).
• If you can't access dedicated emergency contraception, you can use regular birth control pills as replacement EC. To do this, you can take Control NF (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Anulit (take 8 pills within 120 hours after unprotected sex). You can take Norgeal (take 40 pills within 120 hours after unprotected sex). You can also take combined progestin-estrogen pills as replacement EC but you should remember that, in 28-day packs, only the first 21 pills can be used. To do this, you can take Control or Neogynon (for these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can take Microgynon (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Norvetal 20 (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).
• This information was provided by the Princeton EC website, so refer to that website for more 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

If you are visiting Paraguay as a short-term visitor tourist, you do not need take an HIV test or show any medical records. However, if you're a foreigner and plan to apply for permanent residency, you will need to take an HIV test. If you are found to be HIV positive, you will only be granted residency if you pay for your own medication. As reported by HIVTravel, "The Migration Department informed us by telephone that the presence of foreigners with infectious diseases is not tolerated. In reality, people with HIV/AIDS get a residency permit if they can prove that they can bear the cost of treatment themselves, without the support of public funds. They do this in order not to discriminate against people with HIV/AIDS, but it is not a legal entitlement."

There are an estimated 17,000 adults (between the ages of 15 and 49) who are living with HIV in Paraguay, which is 0.4% of the population, according to 2015 data.

Regarding HPV, according to the HPV Information Centre, "Cervical cancer ranks as the 2nd most frequent cancer among women in Paraguay and the 1st most frequent cancer among women between 15 and 44 years of age. About 4.8% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 59.1% of invasive cervical cancers are attributed to HPVs 16 or 18."

Testing Facilities

• Kumbaé Clinic - AIDS Healthcare Foundation (AHF) Paraguay: Focuses on the LGBT community. "AHF Paraguay offers rapid HIV testing and care, Hepatitis B vaccines, sexually transmitted disease testing and treatment, and educational and prevention services free of charge." Address: Independencia Nacional 1032, c/ Manduvirá. CP 1250. Asunción, Paraguay.

Support

• AIDS Healthcare Foundation (AHF) Paraguay: "AHF Paraguay established its first clinic in the capital city of Asuncion in 2013 with support from SOMOSGAY, a local organization. The clinic focuses on HIV/AIDS prevention services for men who have sex with men (MSM) and the Lesbian, Gay, Bisexual, and Transgender (LGBT) community." Address: Independencia Nacional 1032, c/ Manduvirá. CP 1250. Asunción, Paraguay.
• SOMOSGAY: "Hello! We are SOMOSGAY, and we are building a solidary association; we are committed with the innovation effective strategies against homophobia, improving HIV and AIDS prevention; defending the rights of those affected by this virus and the advancement of human rights in Paraguay." Address: INDEPENDENCIA NACIONAL 1032 CASI MANDUVIRÁ. Phone: (+595) 981 616 203, (+595) 21 495 802. Whatsapp: +595986173200. Email: HOLA@SOMOSGAY.ORG.
• Lic. Rocio Duria : Provides HIV information/support. Presidente de la Fundación Marco Aguayo, Avda. Choferes del Chaco 1585, Asuncion / Paraguay. Phone: +595 21 612 978.

Medications & Vaccines

What to Get & Where to Get It

• If you have a yeast infection, you can ask the pharmacist for Fluconazole.
• In Paraguay, you can get an HPV vaccine. There is also a nationwide vaccination program, which was established in 2013 and targets 10 year old girls.
• There is no official PrEP program in Paraguay.

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 Paraguay, pads are the most common menstrual product. Tampons are found in pharmacies and supermarkets in cities, like Asunción. As for menstrual cups, you can buy Maggacup, an Argentine menstrual cup brand, from Maggacup Paraguay for 165,000 PYG (price includes delivery to Asunción). Here's a video (in Spanish) about how to use Maggacup. You can send them a message online or email them: ivygarcia1@hotmail.com. We don't know about any other sellers of menstrual cups in Paraguay. However, you may be able to purchase some brands, like DivaCup and MoonCup, online and then have them mailed to your address in Paraguay.

Gynecological Exams

What to Get & Where to Get It

For local recommendations, visit the city pages, like the Asunción page.

Pregnancy

Laws & Social Stigmas

Paraguay offers 12 weeks of maternity leave. For the first 9 weeks, 50% of wages covered. For the remaining 3 weeks, no wages are covered. Paternity leave is offered with 100% of wage coverage, but it is for under one week.

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 Paraguay, abortion is generally prohibited, according to the The Paraguayan Penal Code (1997). The only exception to this rule is when the woman's life is endangered by the pregnancy. In all other cases, including when when the woman's physical health (but not life is endangered by the pregnancy, when the woman's mental health is endangered by the pregnancy, when the pregnancy is the result of rape or incest, when there is risk of fetal impairment, or when the woman has economic or social reasons for requesting an abortion, the law prohibits abortion. If anyone illegally performs an abortion in Paraguay, they can face up to 15-30 months in prison. If the woman does not consent to the abortion, the prison sentence can have an additional 2-5 years added. If the woman dies during the abortion procedure, the prison sentence can have an additional 4-6 years in prison (if the woman consented to the abortion) or an additional 5-10 years in prison (if the woman did not consent to the abortion).

Paraguay dealt with a particularly controversial abortion case in 2015. The case focused on an 11-year old girl, who had been raped and impregnated by her stepfather when she was 10 years old. Her mother believed she was entitled to an abortion and hired a lawyer to take on the case. However, the Paraguayan government denied the petition, stating that she was healthy (and could, therefore, deliver the baby). The girl later delivered by the baby by cesarean section. While this case was denied, it opened up a wider conversation about abortion in Paraguay.

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 looking to obtain an abortion, there is an underground network of pro-choice doctors and feminists who may help you. Ask around.
• If you are considering leaving the country to obtain a legal abortion, you can legal abortions on request in Uruguay, Guyana, French Guiana, Mexico City and the United States. You can get abortions when the woman's life endangered or to preserve the woman's physical/mental health in Argentina and Peru.

Costs

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

If you are pregnant and considering getting an abortion outside Paraguay, 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

• The women's organization, Kuña Aty Foundation, closed in 2015 due to lack of funds.
• SOMOSGAY: "Hello! We are SOMOSGAY, and we are building a solidary association; we are committed with the innovation effective strategies against homophobia, improving HIV and AIDS prevention; defending the rights of those affected by this virus and the advancement of human rights in Paraguay."