Peru

OVERVIEW

In Peru, contraception, such as the birth control pills, is accessible without a prescription. While emergency contraception is also available, it is not sold in public hospitals, and many pharmacies refuse to sell the pill or sell fake pills. For this reason, exercise caution and do you research before buying EC. There are some menstrual cups available for purchase in Lima, and many medications are available as well. Peru is also one of the few countries that have PrEP trials in place. Perhaps the most severe of restrictions is tied to abortion. Abortion is illegal under all but very special circumstances, causing many Peruvian women to endure unsafe, underground abortions, and putting them at risk of imprisonment.

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

Contraception, including the birth control pill ("la píldora" in Spanish), is legal and available with prescription. About 70% of Peruvian women are on some form of contraceptive. According to a 2000 study, implants and withdrawal seem to be more common than the pill. Condom usage also appears to be high, with one study finding Peru among the top 15 nations with most prevalent condom usage. n other brands.

What to Get & Where to Get It

• For a complete list of contraceptive options available in Peru, click here.
• At Peruvian pharmacies ("farmacias" or "boticas"), you can buy birth control pills without a prescription. There are over 30 brands of birth control pills, including Anulette, Cerazette, Diane-35, Exluton, Gynera, Lo-Femenal, Marvelon, Mercilon, Microgen, Microgynon, Nordette, Trinordiol, Yasmin and more. For a full list of pill options, click here.
• If you are buying condoms, it is recommended to ask for a brand-name condom. Otherwise, you will be sold the cheap rainbow brand, which may be less effective than some other brands. Some recommended pharmacies are Boticas BTL, InkaFarma and Boticas FASA. Hospitals should also have pharmacies.
• If you want the contraceptive implant, you can find Implanon, Jadelle and Norplant in Peru.
• If you want the contraceptive shot/injectable, there are a lot of options. You can find Cyclofem, Cyclofemina, Depo-Provera, Exuna, Megestron, Mesigyna, Mesigyna Instayect, Patector, Perlutal and Soluna in Peru.
• If you want the contraceptive patch, you can find Evra in Peru.
• If you want an IUD, you can find Mirena in Peru.

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. 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

Emergency contraceptives are available over the counter in Peru (no prescription needed).

Be careful: Pharmacies: Many pharmacies in Peru sell "emergency contraception" pills that are not in fact EC. According to Refinery29: "The country's Catholic roots made it slow to warm to regular contraception, much less Plan B. Now, it has some pretty suspicious stuff going on with women’s reproductive rights. A while back, the folks at Prosalud Inter Americana (a nonprofit organization that works to raise awareness about sexual health throughout South American countries) began to suspect something was up with emergency contraception coming through the pharmacies in Peru. So, they decided to do a little digging and sent pill samples to the U.S. for testing at the University of Nevada School of Medicine. What they found: One in four pills wasn’t actually emergency contraception at all. The levonorgestrel (which makes the morning-after pill work) was subbed out for cheap antibiotics. So, when women were heading to the pharmacy to pick up what they thought was protection against an unwanted pregnancy, 25% of the time they were being duped."

More on fake medicine from a travel blogger in Peru: "Sales of fake medicines or medicines past their expiration time (re-branded to appear as new) or medicines of dubious origins are a constant problem in Lima, Peru. Most of these medicines are sold around the poorest areas of Lima and as long as you stick to any of the good pharmacies mentioned above everything should be okay. Always look at your medicine and check the expiration date anyways."

Be careful: Public Hospitals: Peru has banned the distribution of EC in public hospitals. Don't waste your time trying to get EC there. As reported by teh Center for Reproductive Rights in May 2016: "Peru’s ban on the distribution of emergency contraception in public hospitals denied a rape survivor access to essential medical treatment following her assault, according to a new case filed in the Inter-American Commission on Human Rights (IACHR) – a principal human rights body for the Americas.... Peru has the highest reported rate of rape in South America, yet in 2009, Peru’s Constitutional Tribunal ordered the Ministry of Health to stop distributing emergency contraception in public hospitals, wrongfully claiming the medicine induces abortion and that the government therefore cannot distribute it through public institutions."

What to Get & Where to Get It

Note: The longest-lasting EC is currently ellaOne. It lasts up to 5 days (120 hours) after unprotected sex. Check to see if your country carries ellaOne. If your country doesn't carry ellaOne, copper IUDs may also prevent pregnancy up to 5 days after unprotected sex. If none of these options are available, and it's been over 3 days since you had unprotected sex, you can still take EC, which may work up to 5 days. Note that EC pills are not 100% effective and should be taken as soon as possible.

Pill Details

For dedicated EC that is progestin-only, you can find tons of brands in Peru: Dia S MP, Glanique 1, Impreviat, Postinor 1 (Take 1 pill within 120 hours after unprotected sex). There's also Auxxil, D-Sigyent, Emkit, Glanique, Glanix, Gynotrel 2, L Novafem, Lenor 72, Mergynex, Nogestrol, Nortrel 2, Novanor 2, Pill 72, Pillex, PostDay, Postinor-2, Pregnon, Prevemb, Preventol, Tibex and Zintemore (take 2 pills within 120 hours after unprotected sex). If you cannot access EC in time, you can use some oral contraceptives as EC. Make sure to only take from the first 21 pills in the 28-day pack. Here are the oral contraceptives you can use: Ovral (Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). There's also Anulette, Famila-28, Lo-Femenal, Microgynon, Minigynon, Nordette and Rigevidon 21 + 7 (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). And there's also Loette Suave (Take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).

Avoiding Fake Pills

While you cannot always predict which pharmacies sell fake EC, you can reduce the chances by doing the following: 1) Go to larger and trusted pharmacies, like Boticas Fasa, Boticas InkaFarma and Boticas Mifarma, or pharmacies attached to large hospitals. These pharmacies are more likely to be legit and sell real medicine. 2) Go to pharmacies in central urban areas, as they are also more likely to sell real medicine.

Some bigger pharmacies in Lima offer a 24 hours delivery service. You order by phone and a motorbike courier delivers to your home. Here are some pharmacies that deliver and seem to also cater to foreigners/travelers:

• Pharmax (Av. La Encalada 1541, Monterrico; 24/7 delivery service; tel. number: 434 1460)
• Pharmax (Av. Salaverry 3100, San Isidro; 24/7 delivery service; tel. number 264 2282)
• Farmacia Deza (Av. Conquistadores 1140, San Isidro; 24/7 delivery service; tel. number:440 3798)
• Las Colonias (Santa Elena Norte 102 - 104 Street, Monterrico, 21st block of Primavera Av.)

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.

Testing Facilities

• Via Libre: "VÍA LIBRE trabaja a favor del acceso universal a la salud integral; con énfasis en la salud sexual, reproductiva y VIH; generando evidencias a partir de programas, servicios e investigaciones." Address: Paraguay 478, Distrito de Lima LIMA 01, Peru. Phone: +51 1 2039900. Facebook: https://www.facebook.com/vialibre.org/
• Clínica Gonzalez: Cheaper but may not have any English speakers. Address: Av. Ignacio Merino 1884, Lince 15046, Peru. Phone: +51 1 4711579
• Inparres: Tests for HIV/AIDS and maybe more STDs/STIs as well. Address: Centro Médico. Dirección: Av. Giuseppe Garibaldi 125 (antes Gregorio Escobedo).
• Hospital Nacional Arzobispo Loayza: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Address: Av. Alfonso Ugarte 848, Lima, Perú. Phone: (+51) 16144646

Support

• Acción en SIDA: "Publishes a bulletin of HIV/AIDS-related information aimed at the Latin American and Caribbean communities. Website features regional forums and a resource bank of articles. Offices in Lima.
• Para Ti: "Offers research studies, a free telephone hotline and information groups for HIV-positive women in Lima."
• SIDA Perú: "A list of Peruvian organizations offering legal assistance, prevention and education workshops, courses and chats, psychological assistance, HIV and STD testing, treatment, medical care, social work, medicine banks, group therapy, nutritional assistance, telephone hotlines, prevention events, publications and articles for HIV-positive people."

Medications & Vaccines

What to Get & Where to Get It

• Here's a fantastic site for locating medications in Peru: Observatorio de Productos Farmacueticos.
• 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.
• Regarding HPV, there has been an HPV vaccination program in Peru since 2011. It targets 10 year olds for immunization.. For Peru, vaccine coverage was 82.6% in Peru under school-based outreach between 2006-2010.
• Regarding HIV/AIDS, people are allowed to import antiretrovirals. Also, there are treatment facilities offered to all people, including foreigners. The "TARGA" treatment is provided to Peruvians and foreigners at no charge, which you can find at public hospitals and the Health Centres Network.
• Regarding PrEP, according to PrEPWatch: "Peru hosted three sites in the phase III iPrEx trial, and the open-label extension of iPrEx. Several studies have shown the cost-effectiveness of rolling out PrEP in Peru, as well as looked at delivery issues such as provider attitudes and acceptability. Truvada is registered for treatment. In April 2016 the Peru Ministry of Health approved the use of fixed-dose combination of tenofovir disoproxyl fumarate and emtricitabine for PrEP. There is no national PrEP policy or guidance at present. Peruvian NGOs, such as Epicentro and Investigaciones Médicas en Salud (Inmensa), have worked on PrEP research and advocacy."

Menstruation

What to Get & Where to Get It

In major supermarkets, like Plaza Vea, Santa Isabel or Wong, you can find pads (large selection) and tampons (limited selection). In pharmacies and smaller supermarkets, you'll be able to find pads and may/may not also see tampons. You can also find pads in many corner stores.

As for menstrual cups, there are some local sellers. For MoonCup, there is one registered seller in Miraflores, Peru: Dimawe - Tel: 011-511-4478012. Contact: Linda Rojas. Email: linda.r@dimawe.com. For Mooncup, there is one seller in Lima: Paolo Solis H. - Jiron Sucre 560 casa 96, San Miguel, Lima, Peru. Telephone: 987624667 and two in Arequipa. There are no registered LadyCup sellers in Peru.

Gynecological Exams

What to Get & Where to Get It

While we don't have much information yet on recommended gynecologists (note to users: please add ob/gyn recs!), the following hospitals/clinics are recommended by foreign embassies, so we can at least assume that they follow more global/international standards of care:

• Clinica Miraflores: Gynecology and fertility clinic. Street: José Antonio Encinas 141. Info: Av. Benavides block 18. Miraflores, Lima. Phone: (+511) 610-9696. Email: ginefert@igf.com.pe.
• Clinica Anglo Americana: Address: Calle Alfredo Salazar 350, San Isidro 15073, Peru. Phone: +51 1 6168900
• Clinica Good Hope: Address: Malecón Balta 956, Miraflores, Peru. Phone: +51 1 6107300.
• Clinica San Pablo: Address: El Polo 789, Santiago de Surco, Peru. Phone: +51 1 6103333
• SANNA Clinica El Golf: Address: Av. Aurelio Miró Quesada 1030, San Isidro., Distrito de Lima, Peru. Phone: +51 1 6355000
• Clinica San Felipe: Address: Av. Gregorio Escobedo 650, Jesús María 15072, Peru. Phone:+51 1 2190000
• Clinica Javier Prado: Address: Av. Javier Prado Este 499, San Isidro 15046, Peru. Phone: +51 1 2114141
• Clinica Ricardo Palma: Address: Av. Javier Prado Este 1066, San Isidro 15036, Peru. Phone: +51 1 2242224
• SANNA Clinica San Borja: Address: Av. Guardia Civil 337, Distrito de Lima, Peru. Phone: +51 1 6355000
• Clinica Maison de Sante del Sur: Address: Av Chorrillos 171, Chorrillos, Peru. Phone: +51 1 6196007
• [www.stellamaris.com.pe Clinica Stella Maris]: Address: Av Paso de Los Andes 923, Pueblo Libre 15084, Peru. Phone: +51 1 4636666
• Clinica Tezza: Address: El Polo 570, Santiago de Surco, Peru. Phone: +51 1 6105070
• Emergency Hospital Jose Casimiro Ulloa: Address: av, Av. República de Panamá 6399, Miraflores 15048, Peru. Phone: +51 1 2040900
• Clinica Montesur: Address: El Polo 505, Santiago de Surco, Peru. Phone: +51 1 3174000

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

Since 1924, abortion has been generally illegal in Peru. It is only permitted (for up to 22 weeks of gestation) under specific circumstances, which include: to save the life of the woman, to preserve physical health and to preserve mental health. In the following other cases, abortion is not permitted: rape or incest, risk of fetal impairment, economic/social reasons, or available upon request. To perform a legal abortion, two or three physicians (this number needs to be confirmed) have to consult with the pregnant woman and recommend the abortion. If a woman causes or consents to her own abortion, she may be subject to up to two years in prison or 52-104 days of community service. If a physician illegally performs an abortion (with the consent of the pregnant woman), the physician faces one to four in prison. If the pregnant woman does not consent to the abortion, the physician faces three to five years in prison. If a woman dies when physicians are trying to induce an abortion, the health personnel involved with be suspended from their practices, among other penalties.

From a legal standpoint, Peru has many laws that encode these strict regulations. The Criminal Code of 11 January 1924, amended in 1991, clearly states that abortion is generally illegal: "The woman that causes her abortion, or consents to another performing it, will be punished with the penalty of imprisonment of no more than two years or with community service from fifty two to one hundred four days." Furthermore, according to the Health Code, written in 1969 and amended in 1981, human life begins at conception. Additionally, according to the National Population Policy, written in 1995, the government promises an individual's right to life, which begins at conception.

In 2005, the United Nations Convention on Human Rights found that Peru had violated several articles of the International Covenant on Civil and Political Rights. This came about after a 17 year old Peruvian girl, known as "K.L.," was denied an abortion at a hospital, even though the fetus had anencephaly at 14 weeks’ gestation, which is often fatal. The woman was forced to continue her pregnancy and deliver the baby, which died four days later. After the 2005 ruling, the UN ordered that Peru pay K.L. for its “cruel, inhuman, and degrading treatment.” Fifteen years later, the reparations were paid. As reported by the Huffington Post, "This marked the first time a United Nations Committee had held a country accountable for failing to ensure access to safe, legal abortion."

In recent years, Peruvian abortion laws have been altered or challenged. In 2014, Peru finally created national guidelines for legal abortions. Up until that point, there were no standard rules for women who fit under the recognized criteria, so the 2014 were applauded by many human rights groups. However, in 2015, Peruvian lawmakers rejected a bill that would allow women to receive abortions when they have been raped.

Despite the strong restrictions, Peru has some of the most abortions performed in Latin American. It is estimated that 376,000 illegal abortions happen every year.

What to Get & Where to Get It

• Peruvian Abortion Hotline: Phone: 01-945411951. "A public hotline giving women information about safe abortion using pills Misoprostol, was launched in Lima, Peru... The hotline was launched by the Colectivo para la Libre Información de las Mujeres (CLIM), or Collective for Free Information for Women, a feminist organization dedicated to democratizing vital health information. The hotline is supported by Women on Waves (Netherlands) and is one of similar initiatives that Women on Waves has supported in Ecuador, Argentina, and Chile in the past two years."

• Be Careful: Clandestine Abortions: There are many unsafe methods of illegal, underground abortions being performed in Peru, especially in rural areas. Remember to be safe and keep your medical facts straight. For a detailed report on clandestine abortion practices in Peru, click here.

Advocacy & Counseling

What to Get & Where to Get It

From the Shelters National Network (Peru):

• Refugio la Voz de la Mujer Cercado de Lima
• “la voz de la mujer” shelter Center of Lima
• “tierra viva” women shelter district of Puente Piedra
• Women shelter for develpment and life Ate Vitarte huaycan district
• The shelter of the Philological and physical hurt woman San Juan de Lurigancho District.
• warmikolleq shelter Comas - Collique district
• llantaqchispaq shelter Chorrillos district
• “Los Quinuales” shelters Huancavelica Yauli region
• Children and women departmental association and another unprotected AMUNIDE in Moquegua region
• “Abrec unidos” shelter Villa maria el triunfo district
• Rural development center of Yanavaca Junin region
• Santo toribio shelter Ancash - Huaylas district.
• Woman for the peace shelter Chorrilos district
• Female union Ate Vitarte district
• “Paradigma” association Callao province. Ventanilla district
• “Nuevo Amanecer” association San Martin de Porras district
• Shelter of the women “San Martinence” San Martin selva region
• Shelter of the woman from Ayacucho Ayacucho region