Stockholm: Difference between revisions

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'''OVERVIEW'''

As the largest city in Stockholm, you will find many health care resources. Birth control is widely available though a prescription is required. You can purchase emergency contraception (the morning after pill) without a prescription. You can also find ellaOne, the longest lasting emergency contraception, in Sweden. You can receive an STI/STD test at many health facilities. There is a national HPV vaccination program. However, as of January 2017, there is no PrEp program yet in Sweden. Abortion is legal and available upon request for the first 18 weeks of pregnancy. From 18 to 22 weeks of pregnancy, abortion is only permitted in certain circumstances and must receive official government approval. Overall, Sweden is known as a rather progressive country with strong LGBT community. However, like all countries, there are certainly areas to improve regarding health care and general accessibility.

'''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 [https://www.plannedparenthood.org/learn/birth-control here].

In Sweden, you can only obtain contraception (birth control) with a prescription. In 2015, it was found that 70.4% of Swedish women (who were married or in-unions) used some form of contraception and 61.6% used a modern method.  

[[File:Swedishcondoms.jpg|200px | thumb|left|frame|'''Swedish condoms''']]

* For a comprehensive list of contraceptive options in Sweden, click [http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=SE here].

* If you want '''condoms''', a local says: "You can find them everywhere - supermarket, pharmacy, 7eleven etc. You can also get free condoms and prescription for birth control, std/pregnancy tests and abortion services at ungdomsmottagningen, (youth sexual center), if you're under 25 years old"

* If you want the '''contraceptive injectable/shot,''' you can find Depo-Provera SAS 150mg/ml in Sweden.<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=SE IPPF Sweden]</ref> You can the shot at Mamma Mia. It's free if you're a Swedish citizen or have a valid EU card. Otherwise, you'll need to pay 400kr for the appointment.

It costs $48 USD to register in Sweden's medical system, but three months of birth control only cost $15 USD.

'''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 [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

In Sweden, emergency contraception (the morning after pill) is available over-the-counter. This means that you don't need a prescription or to consult with a pharmacist to purchase emergency contraception. There are no age restrictions. You can find EC in the public sector clinics, pharmacies and emergency rooms. It is estimated that 59% of Swedish women of reproductive age have ever used emergency contraception.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/sweden/ EC Status and Availability: Sweden]</ref>

* You can obtain dedicated emergency contraception in Sweden at pharmacies, public sector clinics or emergency rooms. You can purchase [http://www.ellaone.se/ ellaOne], which is considered the most effective EC on the market (as of January 2017). For ellaOne, you don't need a prescription but you may need to talk to the pharmacist. To take ellaOne properly, you take 1 pill within 120 hours after unprotected sex. Other dedicated EC brands that you can find are NorLevo 1.5mg and Postinor 1.5. For these brands, they can be purchased over-the-counter and you don't need to consult with a pharmacist. You should take 1 pill within 120 hours after unprotected sex.<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref>

* You can have an IUD inserted to prevent pregnancy. Please refer to the "Contraception" section for details.

* If you can't access dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as emergency contraception. For progestin-only pills, you can take Follistrel or Microval (take 50 pills within 120 hours after unprotected sex). For combined pills (progestin-estrogen), you'll need to remember that, in 28-day packs, only the first 21 pills can be used. You can take Follinette or Nordiol (for both of these brands, take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later). You can also take Follimin, Neovletta or Nordette (for these brands, take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).<ref>[http://ec.princeton.edu/worldwide/ Princeton EC Website]</ref>

In Sweden, emergency contraception costs around €17. You can also get it for free at some public health clinics or youth centers.  

'''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 [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ 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 [http://www.whatisprep.org/ here].

In Sweden, there are no residency or travel restrictions related to HIV or STI status. You don't need any medical certificates to enter the country. Antiretroviral medications can also be imported for personal use. However, according to one source, Swedish law does state that if someone has reason to believe that they have HIV and they plan to come to Sweden, they must consult with a doctor and follow that doctor's advice (in short, HIV+ people should be following their doctor's advice).<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=170 SWEDEN - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>

Regarding HPV in Sweden, as reported by HPV Information Centre, "Current estimates indicate that every year 451 women are diagnosed with cervical cancer and 187 die from the disease. Cervical cancer ranks as the 12th most frequent cancer among women in Sweden and the 3rd most frequent cancer among women between 15 and 44 years of age. About 2.5% of women in the general population are estimated to harbour cervical HPV-16/18 infection at a given time, and 70.4% of invasive cervical cancers are attributed to HPVs 16 or 18."<ref>[http://www.hpvcentre.net/statistics/reports/SWE_FS.pdf Sweden Human Papillomavirus and Related Cancers, Fact Sheet 2016]</ref>

* Karolinska Universitetssjukhuset Huddinge: They provide HIV treatment & support. Infektionsmottagning 2, S-141 86 Huddinge, Phone: +46 8 585 800 00.

* Södersjukhuset: They have a gay men's health clinic that provides HIV treatment/support. Venhälsan (Gay Men's Health Clinic), S-118 83 Stockholm, Phone: +46 8 616 25 00.

* There is also a telephone counselling service - Noaks Ark Direct/Aidsjouren: Phone: 020 – 78 44 40 or from outside Sweden +46 771 78 44 40

* If you have a yeast infection, you can ask for Fluconazole at pharmacies.

* Sweden has had a national HPV vaccination program since 2012. It targets girls who ages 10-12.<ref>[http://www.hpvcentre.net/statistics/reports/SWE_FS.pdf Sweden Human Papillomavirus and Related Cancers, Fact Sheet 2016]</ref> Also, the Stockholm County Council provides all girls & women up to the age of 27 with free HPV vaccine. You can also get the HPV vaccine (Gardasil) at [http://www.mamamia.se/preventivmedel--drop-in Mamma Mia].

* There is no official Pre-exposure prophylaxis (PrEP) program in Sweden as of January 2017.<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref>

'''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 [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

In Sweden, you can find pads, tampons and menstrual cups at supermarkets, pharmacies and convenience stores. The most common brands of tampons are OB, Libresse and Lil-Lets. While you can find some brands of tampons with applicators, it's more common to find them without applicators. Some pharmacies carry 100% cotton menstrual products. You can find menstrual cups in Carrefour. If you want DivaCup, you can buy it from [http://www.jordklok.se/hygien/menskopp/divacup-menskopp.com Jordklok.se] (Strindbergsgatan 56, 115 53 Stockholm, SWEDEN, Tel: +46 8 6181213, Email: Jacob.Kamras@jordklok.se). You can get Lunette from Apoteket, Apotek Hjärtat, Kronans Apotek and Lloyds Apotek - click [https://www.lunette.com/se/kop/aterforsaljare.html here] for more details about Lunette sellers in Sweden. There appears to be no local sellers of MoonCup or LadyCup in Sweden, so those brands should be bought online.

* [http://www.mamamia.se/cellprovmottagning Mamma Mia]: They have free appointments for Swedish nationals or people with EU cards. For everyone else, they will need to pay 1.825 kr. To have a pap smear, call them in advance at the Screening Unit: Tel: 08-123138 20 .

In Sweden, parental leave (or "föräldraledighet" in Swedish) is very extensive. Overall, parents receive 480 days of leave per child, and they receive 420 days that allow them to receive 80% of their salary. The total cap is 910 SEK per day.<ref>[http://www.yourlivingcity.com/stockholm/work-money/maternity-paternity-leave-sweden/ Maternity & Paternity Leave in Sweden]</ref>

'''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 [https://www.plannedparenthood.org/learn/abortion here].

In Sweden, abortion is fully legal until the eighteenth week of pregnancy, according to the Abortion Act (1974). During the first eighteen weeks, all reasons for an abortion (including availability upon request) is legal. After eighteen weeks of pregnancy, an abortion can only be performed if the National Board of Health and Welfare grants permission. Typically, the National Health Board and Welfare only grants permission on "exceptional grounds," such as the pregnancy endangering the health of the woman.<ref>[https://en.wikipedia.org/wiki/Abortion_in_Sweden Abortion in Sweden]</ref>

In order to obtain an abortion, a woman must first receive counseling. The abortion must be performed by a licensed medical practitioner. It should also typically be performed in a general hospital or an approved health care establishment, except for in rare emergency cases. If a non-physician performs an abortion, that person may be subject to a fine or a year in prison.<ref>[http://www.un.org/esa/population/publications/abortion/profiles.htm UN Report: Abortion in Sweden]</ref>

Historically, Sweden didn't always have such open policies, yet it allowed abortions before than many other European countries. While abortion and birth control were prohibited in 1910, Swedish law began to allow abortion under many circumstances by 1938. According to the Abortion Act of 1938, abortion was technically illegal yet could still be performed on many grounds. In 1946, the grounds for abortion were further broadened and, by the Swedish Abortion Law (1974), abortion became fully legal. Today, abortions can be performed in many health care facilities in Sweden. Since the Swedish Abortion Law, the teenage abortion rate has gone down while more women in their 20s have obtained abortions.<ref>[https://en.wikipedia.org/wiki/Abortion_in_Sweden Abortion in Sweden]</ref>

In Sweden, abortion is subsidized by the government. This means that if you're a Swedish national or if you are covered by Swedish health insurance, the procedure should be free.  

* [http://fistorstockholm.se/ Feministiskt initiativ i Storstockholm (Feminist Initiative in the Greater Stockholm)]: "Feminist Initiative in the Greater Stockholm is constantly working to develop policy and want to be active in the debate. For several years, we have followed the municipal council and county council work and reflect on the issues discussed there."

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