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France

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INTRODUCTION

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En France, vous trouverez une grande diversité de ressources de soins. La contraception est très facilement accessible. Vous n'avez pas besoin d'ordonnance pour obtenir une contraception hormonale, et certaines pharmacies n'acceptent pas les ordonnances étrangeres, mais vous n'aurez en général pas de problème pour vous procurer des contraceptifs. La contraception d'urgence (pilule du lendemain) est disponible en pharmacie sans ordonnance. Il n'y a pas de restrictions d'âge et de nombreuses marques sont disponibles, y compris ellaOne

A propos des besoins menstruels, vous trouverez serviettes hygiéniques, tampons (y compris 100% coton) et des cups menstruelles en France, comme DivaCup et Lunette. Notez que les tampons sont souvent sans applicateur, et s'ils en ont, ils peuvent être en carton.

Pour les femmes enceintes, la France offre 16 semaines de congé maternité avec 100% de couverture. Ces 16 semaines sont divisées: 6 semaines avant l'accouchement et 10 après la date présumée d'accouchement, quand vous déclarez votre grossesse. Vous pouvez également bénéficier de 2 semaines avant le congé maternité si vous avez des problèmes. Quant aux services d'avortement, l'IVG est pleinement légale à 14semaines de grossesse/12 semaines de gestation. Il y a beaucoup de cliniques qui proposent l'avortement, et il est possible de faire couvrir votre IVG par l'état.

Contraception

 
Pilule contraceptive achetée en France (€8 pour 3mois)

Note générale : il existe de nombreux moyens de contraception, comme les DIU (dispositifs intra-utérins ou stérilets), les contraceptions orales, les patchs, les injections, les préservatifs, etc. Pour une liste complète, cliquez ici.

Lois et stigmatisation sociale

En France, vous aurez besoin d'une ordonnance pour obtenir une contraception hormonale. Selon certains, les pharmacies Françaises acceptent les ordonnances étrangères. D'autres disent qu'elles n'acceptent pas les ordonnances étrangères, donc il faudra voir au cas par cas. Vous aurez plus de chance si vous parlez un peu le Français... Cependant, les préservatifs sont largement disponibles et très couramment utilisés; il est estimé que la France est le troisième pays utilisateur de préservatifs dans le monde. .[1]

Voici un témoignage personnel sur l'acquisition d'une contraception en France.

Que prendre et où le trouver

  • Pour une liste des contraceptifs disponibles en France, cliquez here.
  • Si vous n'avez pas encore d'ordonnance pour votre contraception, vous pourrez facilement l'obtenir en consultant un obstétricien/gynécologuqe ou un médecin sage femme, qui vous délivreront une ordonnance. Si vous avez une ordonnance étrangère, enmenez la, ainsi qu'une plaquette/ emballage vide, afin que la pharmacie puisse vous donner ce dont vous avez besoin. Vous pouvez dire “Pourriez-vous me dépanner avant que j’obtienne une nouvelle ordonnance?”. Ils vous vendront probablement 1-3mois de contraception, surtout si vous promettez d'aller chez un médecin rapidemment.
  • En France, vous pourrez trouver de nombreuses sortes de pilules contraceptives, incluant des pilules phasiques, progestérone uniquement et pilules combinées. Les marques disponibles viennent de nombreux pays, comme la France, l'Allemagne, les USA, le Royaume-Uni et le Chili. Vous trouverez des marques comme Adépal, Cerazette, Cilest, Cycleane 30, Cycleane-20, Diane, Diane-35, Effiprev, Exluton, Harmonet, Jasmine, Jasminelle, Jasminellecontinu, Levonorgestrel, Ludeal Gé, Meliane, Melodia, Mercilon, Microval, Milli-Anovlar, Milligynon, Minesse, Minidril, Miniphase, Minulet, Moneva, Nordette, Ogyline, Ortho Novum 1/35, Phaeva, Planor, Qlaira, Tetragynon, Tri-Minulet, Triella, Trinordiol, Trinordiol 21, Varnoline, Yasmine et Yaz.
  • Vous pourrez avoir l'implant contraceptif. Nous savons qu'Implanon est disponible en France, mais ne sommes pas sûrs des autres marques d'implant.
  • Vous pourrez avoir des injections contraceptives, comme Depo-Prodasone, Depo-Provera SAS 150mg/ml et Noristerat.
  • Vous pourrez aussi obtenir la pose d'un stérilet. Nous savons que la marque Mirena ets disponibles, mais ne sommes pas sûrs des autres marques disponibles en France.

Coûts

Sans assurance Française (sécurité sociale dite 'sécu'), la plupart des marques de pilule vous coûteront de 2 à 15euro pour un mois. Si vous avez la Sécu, certaines marques sont partielement couvertes, ainsi que Depo-Provera et les diaphragmes. Le patch, l'anneau (comme Nuvaring), les spermicides et les capsules cervicales ne sont pas couverts par la Sécu, vous devrez donc les payer à 100%. .[2]

Contraception d'urgence (pilule du lendemain)

Note importante": La contraception d'urgence peut prévenir la grossesse pendant trois jours (72heures) et parfois cinq jours (120heures) après le rapport non protegé. Prenez la pilule du lendemain aussi rapidemment que possible après le rapprot à risque. Si vous n'avez pas accès à la contraception d'urgence, les contraceptifs oraux peuvent être utilisés en guise de pilule du lendemain, mais n'oubliez pas ces indications: 1/ Seuls certains contraceptifs peuvent être utilisés en remplacement de la pilule du lendemain. 2/ Les différents contraceptifs oraux nécéssitent des dosages et temps de prise différents pour fonctionner comme contraception d'urgence. 3/ Vous ne devez utiliser que les 21 premières pilules dans ue plaquette de 28. 4/ Cette solution peut être moins efficace que les contraceptions d'urgence prévues à cette effet. Pour des informations générales sur la contraception d'urgence, cliquez ici et ici.

Lois et stigmatisation sociale

En France, vous pourrez obtenir la 'pilule du lendemain' sans ordonnance ni restriction d 'âge.

Que prendre et où le trouver

Vous pouvez obtenir de la contraception d'urgence dans les pharmacies et plannings familiaux. Il y a également des sites Français où vous pourrez acheter de la contraception d'urgence en ligne.

  • Si vous voulez de la contraception d'urgence (pilule du lendemain en France), vous pouvez acheter ellaOne (prenez 1 pilule 120h maximum après le rapport non protegé) [3] . C'est actuellement la pilule du lendemain la plus efficace.
  • Vous trouverez également en France les marques Levonorgestrel Biogaran 1500 (Disponible en pharmacie sans ordonnance; prenez 1 pilule dans les 120h maximum après le rapport non protegé) et NorLevo 1.5mg (Disponible en pharmacie sans ordonnance; prenez 1 pilule dans les 120h maximum après le rapport non protegé). Vous pouvez aussi prendre Anthia ((Disponible en pharmacie sans ordonnance; prenez 2 pilules dans les 120h maximum après le rapport non protegé)).[4]
  • Si vous n'avez pas accès à la pilule du lendemain, vous pouvez utiliser une pilule contraceptive normale en guise de substitut à la contraception d'urgence. Pour une pilule progestine seule, vous pouvez prendre Microval (prenez 50 pilules 120h après le rapport non protegé). Vous pouvez aussi utiliser des pilules combinées progestine- oestrogène en remplacement de la pilule du lendemain, mais souvenez vous que dans une plaquette de 28 comprimés, vous ne pouvez utiliser que les 21 premiers. Pour se faire, vous pourrez prendre Ovral (prnez 2 comprimés 120h après le rapport à risque et encore 2 120h plus tard).Vous pouvez aussi prendre Minidril or Nordette (pour chacune de ces marques, prenez 4 comprimés dans les 120 h après le rapport à risque puis 4 comprimés de plus 12 h plus tard). [5]
  • Si vous prenez un stérilet, il peut également prevenir la grossesse après un rapport non protegé. Vous pouvez la section 'contraception (pilule du lendemain)'.

Costs

LNG: € 6,75 (as of 2013); UPA: € 18,88 (as of 2015). If you have a prescription, 65% of EC costs are reimbursed. You can typically get EC for free at family planning clinics or if you're under 18.

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.

Note about PEP: in France, PEP is given at most within 48 hours. If you've been exposed, go to the Emergency service of the nearest public hospital to get it. It is fully covered but the social security. In case of problems, call Sida Info Service (0800 840 800, free call from landline).

Laws & Social Stigmas

In France, there are no travel restrictions related to HIV status. You can enter the country without presenting medical certificates. If you take a test ad learn that you're HIV positive, and if you're a foreigner, you will not be deported. French hospitals are required to treat anyone in need, and high-quality specialized treatment centers can be found at university hospitals. [6] Furthermore, in Paris, there appears to be very little social stigma attached to STI testing. It is seen as a normal and healthy choice made by responsible adults.

Regarding HPV, according to the HPV Information Centre, it's estimated that 4.7% of French women are infected with HPV-16/18. Furthermore, 75.6% of invasive cervical cancer cases in France are attributed to HPV 16 or HPV 18. Fortunately, the country has a nationwide vaccination program.[7]

In French, AIDS is "SIDA" (Syndrome d'immunodéficience acquise), HIV is "VIH" (Virus de l'immunodéficience humaine) and HIV-positive person is "séropositif" (male) or "séropositive" (female).

Testing Facilities

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

Support

  • SOS Hepatites: This is a hepatitis group that is a member of the World Hepatitis Alliance. T: +33 143 672 640. Address: 190 Bd de Charonne. 75020, Paris, France.
  • AIDES National: This is a national AIDS organization that provides social support, legal support, needle exchange, etc. Address: Tour Essor, 14, rue Scandicci, 93508 Pantin, Phone: +33 1 4183 4646.
  • Sida Info Service : Counselling hotline, Phone: +33 1 4183 4277
  • Act Up-Paris: This is the Paris branch of the HIV/AIDS activist group. Address: B. P. 287, 75525 Paris cedex 11, Phone: +33 1 4806 1389
  • Positifs: This is a website for people with HIV/AIDS and an association formed in 1989. Website is in French and English.
  • Sidaction: A French group of businesses, researchers, and doctors who raise funds for HIV research, prevention programs and organizations
  • Site du C.R.I.P.S.: This French-language site has a list of worldwide events related to HIV/AIDS, hepatitis, etc.

Costs

Free and anonymous testing places are available in big enough cities. In other areas, or for quicker results, any doctor can fill up a prescription for a test that can be taken at a local lab. In this latter case, both the visit to the doctor and the tests are 65% covered by the social security.

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • If you have a yeast infection, you can ask the pharmacist for Fluconazole.
  • The word for "(UTI) urinary traction infection" in French is: "IVU (Infection des voies urinaires)." For a female urine sample, you can say "Prélèvement ďurine chez la femme."
  • In France, there is a PrEP program in place. According to PrEPWatch, "In January 2016, full reimbursement by France’s health system became available for Truvada as PrEP, along with counselling and follow-up. Daily PrEP can now be prescribed for anyone assessed as needing it or intermittent PrEP is available for MSM, as studied in the IPERGAY trial."[8] For more information on PrEP access in France, click here.
  • In France, there has been a national HPV vaccination program since 2007. It targets young people, ages 11-14.[9]

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

You can buy pads, tampons and menstrual cups in France. For pads and tampons, you'll find them in grocery stores, chain store markets and in some pharmacies. You can find 100% cotton tampons in health food stores, but they're more expensive. If you're looking for menstrual cups, they are available in many pharmacies and stores in Paris and other French cities. You can also buy DivaCups at Boutique Bio, Raniana or Vivre-Mieux.com. For LadyCups, check out LadyTeen, LadyCup.fr, and CTOOBIO. For Lunette, check out Lunacopine.

Usage

Note that it's much more common to see tampons without applicators, like OB, than tampons with applicators. If you do find tampons with applicators, there will be a good chance that they are cardboard applicators. If you use cups, there is a crowd-sourced database of cupsafe places: Clean Your Cup. Cupsafe places are places like pubs, restaurants, museums, libraries, universities, whose toilets are equiped with a tap on the inside to rinse the cup freely.

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

You can either do a gynecological exam (and pap test) with a "gynécologue"(gynecologist), with a "médecin généraliste" (physician), or with a "sage-femme" (midwife). And you can consult a "centre de planning familial", a family planning and advisory centre for advice and support.

Costs

The consultation cost is 28 € with a gynecologist and 23 € with a midwife. Both are partially covered if you have the french Sécu. The Planning familial is free if you are a minor (under 18).

You have to pay for extra. For exemple, if you need a pap test, you have to pay 15,40 €.

Pregnancy

Laws & Social Stigmas

In France, women receive 16 weeks of maternity leave with 100% wage coverage.

What to Get & Where to Get It

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 France, abortion, or "“Interruption Volontaire de Grossesse” (IVG), is legal for up to 14 weeks after pregnancy (i.e. week 12 of gestation, week 14 after first day of last menstrual period). During this period, all reasons for an abortion are accepted, including to save the life of the woman, to preserve physical health, to preserve mental health, rape or incest, risk of fetal impairment, economic or social reasons, or available on request. However, there are certain protocols to follow. Before a voluntary abortion, women are advised to seek counseling. If they are non-emancipated minors, they are required to seek counseling. During this consultation, women will meet with a person who "has satisfied qualified training as a marriage counselor or any other qualified person in a facility for information, consultation, or family counseling, a center for planning or family education, a social service, or another approved organization." Once the consultation is complete, women will receive a certificate of counseling. If minors wish to keep this consultation confidential or not share this information with their parents, they may choose any adult to serve as a referral.[10]

As stated in the law, "If, after the consultations provided for in articles L. 2212-3 and L. 2212-4, the woman renews her request for a termination of pregnancy, the physician must request a written confirmation from her; he may only accept this confirmation after the expiration of a week following the first request of the woman, except when the term of twelve weeks risks being passed. This confirmation can only occur after the expiration of a delay of two days following the discussion provided for in article L. 2212-4; this delay may be included in that of the week provided for above."[11]

In terms of facilities and physicians, physicians are not required to perform voluntary abortions. However, if they refuse to offer services, they must inform prospective patients of facilities/physicians that will perform abortions. Note that abortions may only take place in health facilities, public hospitals or private hospitals. The only exception is if an agreement has been made between the practitioner or a center for family education, family planning or a health center, and legal facilities will be determined by the State Council.[12]

French abortion laws were significantly liberalized in 2014. In the past, abortions were only permitted when continuing the pregnancy would put “her in a situation of distress.” With the changes, signed by French President François Hollande, women could access abortions on request.[13]

As detailed in a UN Report, "The most recent development in French abortion law was occasioned by the activities of a small number of anti-abortion protesters. In the early 1990s, they began a campaign of harassment of clinics where abortions were performed and of persons performing abortions. They blockaded and invaded a number of hospitals and tried to discourage individual physicians from performing abortions. To respond to such attacks, the Government in late 1992 enacted legislation establishing new criminal penalties in the Penal Code to combat disruptive activities. Under these provisions, persons who prevent or attempt to prevent a voluntary termination of pregnancy by disrupting access to or the free movement of persons into and out of clinics or hospitals by threatening or engaging in any act of intimidation against medical and non-medical personnel are subject to fines and imprisonment. The provisions also apply to acts directed towards abortion counselling and requests for abortion and allow organizations established to protect the right to contraception and abortion to join as a party in suits brought against such obstruction."[14]

What to Get & Where to Get It

If you are seeking an abortion in France, you should first visit a physician, a gynecologist or a midwife. They will give you a counseling session (which is optional if you're an adult) and a medical certificate and order an ultrasound scan (to date the pregnancy). Then, you'll need to renew your request on a second appointment. They can usually speed up the process if you're close to the 12 week gestation deadline.

Costs

Under France's social security, abortions (medical or surgical) are 100% covered, if the practitioner's prices are Secteur 1 “tarif conventionné.” The recommended follow-up visits, which typically happen 3 weeks after the abortion, are also covered.[15]

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

Costs

List of Additional Resources

References