Colombia

OVERVIEW

In Colombia, you will find many health care resources. However, you should remember that much of the country is Catholic and certain health care personnel hold traditional social views. Generally speaking, contraceptives are legal and widely available. Emergency contraception is also legal and, while a prescription appears to be required, it seems easily obtainable regardless of prescription status for women who appear to be adults. If you are a teenager, some pharmacists may turn you down for EC access, even though you are legally allowed to purchase EC, so you should seek out a few pharmacists if this issue arises. Regarding STI testing, Profamilia is a great resource, and there are numerous locations, including mobile clinics, throughout Colombia.

According to Colombian law, women are entitled to 14 weeks of maternity leave. Since 2006, abortion has been legal for certain cases in Colombia, but it is not yet available upon request. It is currently only available based on three criteria. Note that there are still many cases of unsafe, illegal or not recommended abortion procedures in Colombia, so it's important to research providers and the intended procedures in advance.

Contraception (Birth Control)

Laws & Social Stigmas

In Colombia, contraceptives are legal and widely available. It is estimated that 56-61% of Colombian women (ages 15-49) use some form of birth control, according to a national study. However, 80% of Colombian women who are sexually active or in relationships use contraceptives.

As reported by the Guttmacher Institute: "Despite notable gains in contraceptive use over the past two decades, 67% of all pregnancies in Colombia were unintended in 2008, an increase from 52% in 1989."Unintended Pregnancy and Induced Abortion in Colombia</ref>

In 2010, the Colombian Congress passed a law that guaranteed free access to contraceptives for all citizens, including procedures like vasectomies and sterilization. When the law first passed, the first communities to receive attention were those most in need. As reported by the LA Times in 2010, "The benefits are only now filtering down to shanty neighborhoods... where birthrates are among the nation's highest, particularly among teenagers." Furthermore, "Activists hail the legislation as a progressive measure for reproductive rights, part of a general liberalizing trend in this largely Roman Catholic nation that has included recent rulings by the constitutional court removing penalties for performing abortions." The LA Times also reported on the possible economic benefits of this legislation: "Colombia's healthcare system is on the verge of collapse because of the constitutional guarantees of universal care, as funding from tax and other government revenue falls short. Because maternity and neonatal care are among the healthcare system's fastest-growing costs, free contraceptive medicine and surgeries could end up saving the government money."

Most recently, Colombia has became the country with the second highest rate of Zika viruses. This has lead the Colombian government and the Pope to promote condom usage for the Colombian people.

Here's is a thread (from back in 2011) about public attitude toward birth control in Colombia.

What to Get & Where to Get It

It appears that you can get hormonal injectables (like Depo-Provera) at pharmacies in Colombia

Here are some oral contraceptive brands you can expect to see in Colombia: Neogynon, Noral, Nordiol, Microfemin, Microfemin CD, Microgynon, Microgynon 28 and Nordette.

Costs

Birth control should cost between 18,000-20,000 COP. In 2011, Microgynon (birth control) 21 tablets could be found for 8,374 COP, injectable birth control cost about 14,000 COP, IUD insertion was about $23 and removal was about $17.

Emergency Contraception (Morning After Pill)

Laws & Social Stigmas

You can access emergency contraception (the morning after pill) in Colombia over-the-counter. While you may technically need a prescription to obtain EC, it appears that most pharmacists sell EC without a prescription. From a legal standpoint, there are no age restrictions for purchasing EC. However, many Colombian pharmacists reportedly do not sell EC to teens due to personal or moral objections. If you are a teen and you need to buy EC, it's recommended that you seek out a few pharmacies or have an older female purchase EC for you.

Here's a personal account of talking to various Bogota pharmacies about EC.

What to Get & Where to Get It

• In Colombia, locals report that you can purchase emergency contraception (birth control) without a prescription at pharmacies. For progestin-only EC, you'll find Escinor 1.5, NorLevo 1.5mg, PostDay 1 or Postinor 1 (for these brands, take 1 pill within 120 hours after unprotected sex). You can also find Emergyn, PostDay, Postinor-2, Pregnon or Tace (for these brands, 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. For progestin-only pills, you can take Microlut (take 50 pills within 120 hours after unprotected sex). You can also take progestin-estrogen combined pills but remember that, in 28-day packs, only the first 21 pills can be used. You can take Neogynon, Noral, Nordiol (take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Microfemin, Microfemin CD, Microgynon, Microgynon 28 or Nordette (for these take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later). You can also take Microgynon Suave (take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later).

Costs

In 2012, EC was about 400,000 - 500,000 COP.

Sexually Transmitted Infections (STIs/STDs)

Laws & Social Stigmas

Regarding HIV, 9% of all Latin American HIV infections occur in Colombia.

There appears to be no travel restrictions related to people with HIV. According to HIVTravel: "The Colombian Embassy in Brazil informs us that the Colombian authorities have never requested HIV-specific information from people entering the country. Proof of Yellow Fever vaccination is required from people who have visited endemic areas. The Embassy refers to the Public Health General Director in Bogotá."

What to Get & Where to Get It

In Spanish, this is how you say STDs: "Enfermedades de transmisión sexual."

Testing Facilities

• Profamilia: This is basically the Planned Parenthood-like organization of Colombia. Provides STI tests and other sexual/reproductive health services. Has 66 facilities, including mobile clinics, throughout Colombia. Calle 34 #14-52, Bogotá, D.C. Colombia, P: (57-1) 339-0900. Bogota Helpline: 489-1664. Rest of the country helpline (toll free): 01-8000-110-900.

Support

• Fundación Santa Fé de Bogotà: Calle 119 (#) 9-33
• SIDA - Fundación Apoyemonos: CRA. 15 (#) 59 - 57 Ap. 503
• Revista Indectable: An online magazine for people living with HIV. Has a special section for women.
• Fundación Apoyarte: Address: Carrera 15 N°124-29 Of 416 – Edificio las Arcadas, Bogotá - Colombia, Telephone: +57 1 320 4919605, Email: comunicaciones@fundapoyarte.org
• Instituto Nacional de Salud: Vigilancia y Análisis del Riesgo en Salud Pública, Address: Avenida calle 26 No. 51-60, Zona 6 CAN Bogotá, Telephone: +57 1 2207700, Fax: +57 1 2200901, Email: contactenos@ins.gov.co
• Liga Colombiana de Lucha Contra el SIDA: Address: Cl 32 carrera 15, Bogotá, Telephone: +57 1 2454757, Fax: +57 1 2454757, Email: jpacheco@ligasida.org.co
• Red Colombiana de PVVS - RECOLVIH: Address: Calle 9 # 2 - 73, Barrio La Candelaria, Bogotá, Telephone: +57 314 3399985, Email: recolvihbogota@gmail.com
• Red Latinoamericana de Personas con VIH/SIDA - REDLA+: Secretario Regional, Address: Calidonia, Peru Avenue and 35 East Street, Masnou Building, 2-D, Panamá, Telephone: +507 396 5161, Fax: +507 396 5160, Email: repo_pa@yahoo.com

Medication & Vaccines

What to Get & Where to Get It

If you have a yeast infection, ask a pharmacist for a local version of Fluconazole. If you have a urinary tract infection, you can say that you have a "infección en las vías urinarias."

Menstruation

What to Get & Where to Get It

In Colombia, you'll be able to find pads, tampons and menstrual cups in larger cities. In smaller towns, you may only find pads and pantyliners. For pads, one of the most common brands is "Nosotras," which are maxipads that vary in absorbency. For tampons, you can expect to find tampons without applicators, particularly OB. Check out the OB Colombia website for details. For DivaCup, it's sold at Proveestetica (Contact: María Sanchez, E-mail: s.maryh24@hotmail.com; andresfgalvis@hotmail.com, Tel. 1-3037451, Cel. 3122547900). For Ladycup, check out Ladycup Colombia. There are no known sellers of MoonCup or Lunette in Colombia, so if you're interested in those brands, they should be purchased online. For menstrual underwear, you'll also probably need to buy them online.

Costs

For a box of tampons, you can expect to pay around 15,883 COP.

Gynecological Exams

Pregnancy

Laws & Social Stigmas

In Colombia, women are entitled to 14 weeks of maternity leave. They can leave up to 2 weeks before their expected date of delivery. By one week before expected delivery, it is mandatory that the woman takes maternity leave. As detailed in AngloInfo: "After the 37th week of pregnancy, the mother should ask her doctor to prepare a Licencia de maternidad pre parto, entitling her to maternity leave one or two weeks prior to the birth of the baby. In the event of a premature birth the mother should contact the health service provider to follow the procedure with the employer."

Abortion

Laws & Social Stigmas

In Colombia, abortion is legal under three circumstances: to save the life of the woman, risk of fatal fetal malformations and cases of rape, incest or non-consensual insemination. For cases dealing with maternal health, this decision was left to medical authorities (there is no official court finding on what is included). For fetal malformations, there are no specific provisions for what qualifies at the court level, so this is left to medical opinion. For cases of rape, incest or non-consensual insemination, a report must be made to authorities. In all other cases, such as to preserve physical health, to preserve mental health, economic or social reasons, or available on request, are not legal reasons, according to the 2006 Colombian Constitutional Court ruling.

During the 2006 court rulings, the court also considered conscientious objectors. It was decided that health care centers (clinics, hospitals, etc) cannot refuse to perform an abortion. However, doctors can refuse to perform abortions in religious grounds. If this is the case, they must refer women to providers who can perform abortions.

In 2008, it was estimated that 400,400 abortions were performed in Colombia, and only 322 of the abortions were legal. Yet it should be noted that, for decades, the abortion rate in Colombia has remained pretty consistent. For example, the rate was 36 abortions per 1000 women (of reproductive age) in 1989, and it was 39 women out of 1000 women in 2008. Some of the highest rates of abortion are in Bogota. As reported by the Center for Reproductive Rights: "While the government continues to demonstrate its commitment to the promotion and protection of reproductive rights, women in Colombia still face barriers to accessing safe abortion services, such as onerous medical requirements to prove they qualify for a legal abortion, as well as refusals to provide safe abortion services by doctors, medical institutions —and even judges—based on their personal or moral objections."

What to Get & Where to Get It

Medical Abortion - You can access Misoprostol (the abortion pill) in Colombia. It's estimated that half of all abortions are performed this way. Warning - Go to a clinic/doctor that knows what they're doing because "... despite the drug´s safety and efficacy when used correctly, inadequate knowledge of its use among women and providers results in a high rate of complications (32%), primarily heavy bleeding and incomplete abortion."

Surgical Abortion - If you're interested in surgical abortions, you should know that 8 out of 10 facilities use the dilation and curettage (D&C) method. This is considered invasive and expensive. It's recommended to find a facility that performs surgical abortions with the manual vacuum aspiration (MVA), which is also recommended by WHO for first trimester abortions.

• Fundación Oriéntame: One of the two main nonprofit clinics in Bogotá that provide legal abortion services. You can read an account by someone who worked at Fundacion Orientame.

Costs

For surgical abortion, you can expect to pay between $45 (at lower-end facilities) to $200 (at higher end facilities).

Advocacy & Counseling

What to Get & Where to Get It

• Casa de la Mujer, Apartado 36151, Bogota, Colombia. Tel. 248 2469.
• FANA: "Located in Suba, the 11th locality of the Capital District of the Colombian capital city, Bogotá, FANA (the Spanish acronym for the Foundation for the Assistance of Abandoned Children) is a modern facility with up-to-date medical care, staff and equipment capable of caring for 150 children. FANA is also able to offer prenatal and delivery services to any birth mother in need. Any child who is placed for adoption is cared for in a new born intensive care facility under the supervision of full-time physicians and medical personnel."

List of Additional Resources

• Centros Comunitarios LGBT de Bogota
• LGBT Bogota Facebook Page
• Corporación Sisma Mujer: Colombian feminist organization focused on women's citizenship and human rights