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Tbilisi

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Revision as of 19:27, 9 March 2019 by PresumingEb (talk | contribs) (→‎What to Get & Where to Get It: Added language info)
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OVERVIEW

In Georgia, there are quite a few options available to women, but they're not all widely used. You can purchase oral contraceptives (birth control pills) over-the-counter. No prescription is needed. It should be noted that Georgian women tend to use contraceptive methods, like birth control pills or condoms, at lower rates than many of their neighbors. This can be partially attributed to decades of scarce contraceptive supplies, the lack of affordability of contraceptives, and the conservative influences of family life and the Orthodox Church. However, Georgia is gradually experiencing an increase in contraceptive use. Meanwhile, emergency contraceptive pills (morning after pills) are available over-the-counter at pharmacies, and LNG contraceptives (such as Escapelle and Postinor) are included in the national policies for family planning and sexual violence. However, like in the case of contraceptives, Georgian women do not display a high rate of usage of ECPs.

In Georgia, there are no legal restrictions related to people with HIV/AIDS. You can find free and anonymous STI testing sites. We're not sure if PrEP or PEP are available in Georgia, but the country launched a nationwide HPV vaccination program in 2017. Regarding menstruation, you can find pads/pantyliners in Georgia, but you'll probably have difficulty finding menstrual cups (as of 2018). Finally, abortion is fully legal and available upon request during the first trimester (first twelve weeks of pregnancy). In the past, Georgia had a high abortion rate, but the rate has significantly dropped as more women have begun to use contraceptives.

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 Georgia, you can buy birth control pills over-the-counter. No prescription is needed.[1] [2] However, Georgian women use contraception at lower rates than their neighbors. According to a 2015 UN report, it was found that 51.8% of Georgian women (who are of reproductive age and married or in unions) use some form of contraception, including both modern and traditional methods. This is compared to 56.7% of Azerbaijani women, 59.2% of Armenian women, 66.5% of Ukrainian women and 74.2% of Turkish women. Furthermore, it was found that 16.8% of Georgian women have unmet family planning needs.[3]

According to 2015 data, the most common form of contraception in Georgia was found to be condoms (used by 14.4% of Georgian women who are married or in unions). This was followed by IUDs (13.2%), withdrawal/pull-out method (9%) and the rhythm method (6%). Generally speaking, birth control pills were less popular, as they were found to be used by only 4.3% of the surveyed women. There were also comparatively low rates of usage of female sterilization (3.1%), vaginal barrier methods (1.6%), contraceptive injectables (0.1%) and male sterilization (0.1%). There was found to be practically no usage of contraceptive implants (0.0%) at that time.[4]

There are many reasons why Georgian women use contraceptives at lower rates than their neighbors. For years, Georgia had insufficient contraceptive availability and family planning resources for women in the country.[5] Furthermore, contraceptives were expensive for many Georgians, and the state-funded health care system for the poor did not cover contraceptives.[6]

The low rate of adoption must also be understood from a cultural and religious standpoint. Georgia remained a relatively conservative country during the Soviet era, maintaining the belief that women should remain virgins until marriage. After they married, they lived in homes that included an extended family of potentially three or four generations,[7] where traditional sexual mores remained intact. Meanwhile, the Orthodox Church is an incredibly influential force in Georgia today. The Church does not approve of contraceptives and its priests have actively discouraged women from using them.[8] While the country continues to modernize over the decades, these cultural forces certainly play a role in women's lives.

Ultimately, the low rate of contraceptive adoption may have contributed to the abortion rate in Georgia, where many women have used abortion as a late-stage family planning method. In fact, in 2005, Georgian women had an average of 3.1 abortions per lifetime.[9] However, it should be noted that the abortion rate has gradually decreased over the past decade,[10] and in 2010, the abortion rate per woman had already dropped to 1.6 abortions per lifetime. This was largely due to USAID and UNFPA campaigns in the country, which helped educate people about contraceptives and provided subsidies for contraceptives. As a result, Georgia began to see wider adoption of contraceptive methods, such as condoms and birth control pills.[11] As of 2017, there are 1.76 children born per woman, on average, in Georgia.[12]

What to Get & Where to Get It

  • In Georgia, you can obtain oral contraceptives (birth control pills) at pharmacies without a prescription. There are no age restrictions to purchase birth control pills. Some of the brands you can expect to find Ovral, Microgynon and Rigevidon.[13]
  • You can find IUDs in Georgia. At the Chachava Clinic, the cost of IUD insertion is 34 GEL an patients get the IUD themselves (as of February 2018).
  • We do not know if contraceptive implants (like Jadelle or Implanon) or contraceptive injectables (like Depo-Provera) are available in Georgia. If you do have this information, please contribute to this page.

Costs

  • The state does not include contraception in the state-funded health care system for the poor, but USAID and UNFPA have helped subsidize contraception for the poor.[14]

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

In Georgia, emergency contraceptive pills (morning after pills) are available over-the-counter at pharmacies. No prescription is required.[15] While ECPs are not stocked on shelves in pharmacies, you can access them if you ask the pharmacist for them (they are usually behind the counter).

In Georgia, LNG contraceptives (such as Escapelle and Postinor) are included in the national policies for family planning and sexual violence. However, ECPs are not widely used or understood. According to the 2010 Georgia Reproductive Health Survey, only 5% of Georgian women (ages 15-44) had awareness of ECPs and only 4% knew how to properly use them. It was especially found that adolescents, rural women and women with less education held the least general knowledge of ECPs and their usage. Furthermore, women tended to seek out information about ECPs from friends and boyfriends more than from doctors.[16]

What to Get & Where to Get It

  • In Georgia, you can obtain emergency contraceptive pills (morning after pills) over-the-counter at pharmacies. No prescription is needed. To access ECPs, you will need to request them for purchase at a pharmacy since they are not on the shelves. You can expect to see anti-progestin pills, like Dvella, and progestin-only pills, like Escapelle and Postinor. They will likely be branded in Cyrillic (Escapelle is labelled "Ескапел") but it is all the same pill. For updated instructions on how to use the pills, you can visit the Princeton EC Website.
  • If you cannot access dedicated ECPs, you can use regular birth control pills as replacement ECPs. However, if you do this, remember that in 28-day packs, only the first 21 pills can be used. Some of the pills you can use are Ovral (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Microgynon (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) and Rigevidon (take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). For updated instructions on how to use the pills, you can visit the Princeton EC Website.
  • You can also get an intrauterine device (IUD) to prevent pregnancy after unprotected sex. However, this requires a special insertion procedure, so will probably take more time to obtain than finding dedicated ECPs at a pharmacy.

Costs

In 2010, you could expect to pay around € 5.40 for LNG-type of emergency contraceptive pills, like Postinor or Escapelle. Emergency contraceptive pills (morning after pills) are not reimbursed or covered by social security.[17]

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 Georgia, there are no legal restrictions related to people with HIV/AIDS. This means that, if you're not Georgian, you can legally visit the country, regardless of your HIV status. You will not be asked for your medical records or information about your HIV status upon entry into the country. In the past, Georgia did require a health certificate for foreigners who were applying for permanent residency, but this requirement was dropped in 2010.[18]

In the last ten years, Georgia has experienced growth in number of people living with HIV/AIDS. In 2016, it was estimated that about 0.5% of the adult population (ages 15-49) was infected with HIV, and that about 12,000 adults had HIV.[19] This was a sharp increase as compared to 2006, when it was estimated that about 4600 people were living with HIV/AIDS. However, after 2012, the infection rate has stabilized and, in certain years, it has even shown minor decreases. There has also been a steady increase in people receiving ART since 2010.[20]

Testing Facilities

  • AIDS Centre Georgia: Free and anonymous/confidential counseling and testing for HIV infection / AIDS - Contact us on the hotline: 2398018
  • National Center of Dermatology and Venerology (NCDV): From the website: "Up-to date equipment for Clinical and Biochemical investigations of skin and STD for clinical laboratory diagnosis; Diagnosing of STD is carried out by specific Diagnosticums." They provide diagnosis and treatment of syphilis, Gonorrhea, Chlamydiosis, Trichomoniasis, Urogenital Candidosis, Ureaplasmosis, Micoplasmosis, etc. They also deal with viral infections, such a Human Papilloma Virus (HPV), Herpes Simple virus, Cytomegalovirus, etc. Address: დ. აღმაშენებლის 147. Phone: +995 577610261. Email: info@vipmed.ge
  • Chachava Clinic: You can get tested for HIV - 16, RPR- 11, Gonorrhea- 51, Chlamydia - 21.

Support

  • AIDS Centre Georgia: Free and anonymous/confidential counseling and testing for HIV infection / AIDS - Contact us on the hotline: 2398018
  • UNAIDS Georgia: "The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths." Contact: Vinay Saldanha, Director, Regional Support Team for Eastern Europe and Central Asia. Phone: +74956636784. Email: saldanhavp@unaids.org
  • World Vision: This organization may potentially do HIV/AIDS work in Georgia. "In 1996 World Vision opened an office in Georgia’s capital, Tbilisi, in response to the country’s dire need for economic assistance and intervention in the lives of Georgia’s poor and vulnerable. Today, all of World Vision Georgia’s projects are built around three strategic goals: Strengthen child welfare, Enhance youth participation, and community development. They build local capacity, contribute to the development of local and national policies, and are community-based and sustainable." Address: World Vision Georgia Main Office, 61, D. Agmashenebeli Ave, 0102 Tbilisi, Georgia. e-mail: ana_chkhaidze@wvi.org. Tel: (+995 32 ) 215-75-15

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • Regarding pre-exposure prophylaxis (PrEP), there is no general nationwide program, as of January 2018.[21] However, Georgia began exploring a pilot program in 2016, which was expected to become a full-fledged pilot program in 2017. The program organizers were especially interested in finding ways to provide PrEP to members of the LGBTQ community.[22] [23] The PrEP in Europe Initiative has also written about PrEP access being explored in Georgia.[24]
  • Regarding post-exposure prophylaxis (PEP), it is explicitly mentioned in Georgian law (see Law of Georgia - On HIV Infection/AIDS, and it's available in the country, as evidenced in its recorded usage on mothers and babies.[25]
  • While Georgia does not have a nationwide HPV vaccination program, they have launched a pilot program, as of July 2017.[26] You can also get vaccinated at many clinics. For example, at Chachava Clinic, you can get the Gardasil vaccine for 384 GEL (as of February 2018).

Costs

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.

Laws & Social Stigmas

What to Get & Where to Get It

  • Regarding menstrual cups, the majority of the major international brands (DivaCup, LadyCup, MoonCup, Lunette, OrganiCup) do not appear to have official retailers in Georgia, as of January 2018. However, you may be able to find menstrual cups sold among local or boutique retailers. You may also be able to order menstrual cups online and have them delivered to your address in Georgia.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

  • American Medical Centers (Tbilisi, Georgia): This international medical center was recommended by multiple locals. They say that the bedside manner is very good, but AMC can be expensive. You can expect to pay around $50-$70 USD per appointment. From the website: "American Medical Centers is a health services provider that owns and manages ambulatory and outpatient care facilities in Georgia, Ukraine, Eastern Europe.Address: 11 Arakishvili street, Tbilisi, Georgia. Phone: +995 322 50 00 20
  • MediClub Georgia: This has mixed reviews. They seem to be well-equipped but not everybody has had a great experience with them. If you have more insights to add about MediClub, please contribute to this page. Address: 22 A Tashkenti St, Tbilisi 0160, Georgia. Hours: Closed ⋅ Opens 9AM
  • Innova Invitro/ინოვა ინვიტრო: This was recommended by multiple locals. You should be able to find Georgian and English speakers on staff. One local said: "A first appointment is 50 GEL, the others will be 40 GEL, an ultrasound exam 50-60 lari, lab exams start from 15 lari, depending on the tests they perform." From Google Translate of main website: "Reproductive Health and Inventory Clinic Innova Invitro was opened in 2016-in partnership with the world's leading clinics network IVI... The directions of the clinic are: Inquiry fertilization, Inspiration, Donation-surrogacy programs, Gynecological endocrinology, Neuroendocrine, Conservative gynecology, Determine the cause of self-abortion abortions and appropriate treatment, Contraception." Address: Sandro Euli street 7A, Tbilisi, Georgia. Phone: +995 596 23 22 32

Costs

Pregnancy

Laws & Social Stigmas

In Georgia, women are entitled to 730 days of maternity leave with 183 days of paid leave. If the pregnancy has any complications, or if the woman is pregnant with more than one child (such as twins or triplets), she may take 200 days of paid maternity leave.[27] [28]

What to Get & Where to Get It

  • Chachava Clinic: This is a fertility clinic. Address: Merab Kostava Street 38, Tbilisi 0179, Georgia. Hours: Open 24 hours. Phone: +995 322 95 33 11
  • Mariposa Counselling Provides private prenatal classes, childbirth education, birth doula services and postpartum support, including lactation consultations. Owned and run by a professional counsellor and doula. English, Russian, Spanish, Georgian (with translator). +995 595 343 789.

Costs

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 Georgia, abortion is fully legal and available upon request during the first trimester (first twelve weeks of pregnancy). This means that all general reasons for an abortion are permitted in the first trimester, including when the abortion will save the life of the woman, when an abortion will preserve the mental or physical health of the woman, when the pregnancy was the result of rape or incest, when there's risk of fetal impairment, when the pregnant woman has economic or social reasons for wanting an abortion, or when the woman simply requests that she wants an abortion. After the first trimester, abortion is legal in special circumstances.[29] [30] However, parental authorization/notification is required for minors who are seeking out abortions.[31]

As a former member of the Soviet Union, Georgian abortion policy shares a similar history to other former Soviet nations. According to the Soviet Decree of 1936, abortion was prohibited except for specific cases, such as when the pregnancy endangered the life of the woman. However, in 1955, the USSR repealed the ban on abortion and decreed that abortions could be freely performed during the first twelve weeks of pregnant. The decree still detailed specifications under which abortions were legal, such as the fact that the abortions needed to be performed in hospitals and by physicians. Following the decree, the clandestine abortion industry in Georgia still remained in place, which concerned the government. This lead the government to allow abortions for health reasons for up to the twenty-eighth week of pregnancy in 1982. These changes lead to a dramatic increase in the number of reported abortions. The high rates were also due to the short supplies of high-quality contraception in the country. By the 1990s, however, contraceptive access had improved and the abortion rate dropped.[32]

What to Get & Where to Get It

  • Association HERA XXI (HERA XXI): Address: Vajha Pshavela Ave 16 (5th Floor), Room 510, Tbilisi 0160, Georgia. Tel: +995(32) 253 471. Fax: +995995(32) 253 471. Email: hera@caucacus.net

Costs

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

  • 112 Georgia Emergency and Operative Response Center: Dial 112 for 24-hour emergency help
  • Fire emergency: Dial 011
  • Police: Dial 022
  • Ambulance: Dial 033
  • Ambulance: Dial (+995 32) 009
  • Ambulance: Dial (+995 32) 2 910 910
  • Information about medicines in pharmacies: Dial (+995 32) 0-007
  • Information about medicines in pharmacies: Dial (+995 32) 225 22 33

Costs

List of Additional Resources

  • Click here to learn about LGBTQ rights and laws in Georgia.
  • Click here to read a 2018 UNFPA article about sexual and reproductive health taboos in rural Georgia.
  • IDP Women Association “Consent”: 41, Leselidze Street. Tbilisi 380005. Georgia. Tel: 8-832-98-89-06
  • International Centre of Women's Education and Information: Baratashvili 10, 380005 Tbilisi, Georgia. Tel:+995 32 989 217 or +995 32 999 253. Fax: +995 32 001 077 or +995 32 001 127 or +995 32 989 217. E-mail: tamar@caucasus.net
  • International Women's Association Georgia: "International Women’s Association, Georgia (IWAG) is a non-profit, non-governmental organization with a CHARITABLE Status, and it is part of the International Women’s Association worldwide network" Address: ProCredit Bank, Tbilisi, Georgia.
  • International Society of Women in Georgia for Peace: 20 Ateni St., Apt 29380079, Tbilisi, Republic of Georgia. Tel: 007 8832 22 20 66
  • Network Of East-West Women: 41, Leselidze Street, Tbilisi 380005, Georgia, Tel: 8-832-98-89-06
  • Women of Georgia for Peace: 20 Ateni St. Apt. 29, Tbilisi 380079, Georgia
  • Women's Center: Address: Av Chavchavadze 15, Tbilisi 380079, Georgia. Telephone (99532) 233299 ;536940;314656. FAX number(995 32) 23 32 99; e-mail address. grc@access.sanet.ge or grc@ip.osgf.ge
  • Women's Education and Information Center - Georgia: e-mail: Tamar@iberiapac.ge
  • Women's Information Center: Address: Tsinamdsgvrishvili St.40, Georgia, Tbilisi, 0102. Tel: (995 32) 942699. Mob: (995 99) 561733. Fax: (995 32) 969905. E-mail: wicmika@caucasus.net

References

  1. ↑ Global Oral Contraception Availability
  2. ↑ [Free the Pill: Where on Earth?]
  3. ↑ Trends in Contraceptive Use Worldwide 2015
  4. ↑ Trends in Contraceptive Use Worldwide 2015
  5. ↑ Abortion and Contraception in Georgia and Kazakhstan
  6. ↑ From Abortion to Contraception
  7. ↑ Central and Eastern Europe in Central Europe
  8. ↑ Georgians Wrestle With Abortion Issue As Gender Imbalance Grows
  9. ↑ From Abortion to Contraception
  10. ↑ [http://agenda.ge/news/62872/eng Abortion rate drops in Georgia[
  11. ↑ From Abortion to Contraception
  12. ↑ CIA World Factbook - FIELD LISTING :: TOTAL FERTILITY RATE
  13. ↑ Princeton EC Website
  14. ↑ From Abortion to Contraception
  15. ↑ ECEC: Georgia
  16. ↑ ECEC: Georgia
  17. ↑ ECEC: Georgia
  18. ↑ GEORGIA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  19. ↑ UNAIDS: Georgia 2016: HIV and AIDS Estimates
  20. ↑ UNAIDS: Georgia 2016: HIV and AIDS Estimates
  21. ↑ PrEPWatch World Map
  22. ↑ Eurasian Coalition on Male Health - PrEP Updates
  23. ↑ PREP: EFFECTIVE AND EMPOWERING
  24. ↑ PREP ACCESS IN EUROPE
  25. ↑ Global AIDS Response Progress Report: GEORGIA - Country Progress Report
  26. ↑ Georgia Human Papillomavirus and Related Cancers, Fact Sheet 2017
  27. ↑ LABOR CODE of GEORGIA
  28. ↑ Georgian women face discrimination in the workforce
  29. ↑ Women on Waves: Abortion law Georgia
  30. ↑ UN Report - Abortion Policy: Georgia
  31. ↑ World Abortion Laws
  32. ↑ UN Report: Abortion Policy: Georgia


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