Safe in the knowledge: raising sexual health awareness in Bolivia

What can be done to improve the sexual health of men and women in Bolivia?  How aware are people of HIV/AIDS and other sexually transmitted diseases?  Bolivia has high sexual health related mortality rates.  In Latin America it is second only to Haiti, with seven women in every thousand dying in childbirth. Its government spends only US$ 7 or US$ 8 per capita on healthcare, compared to the rest of Latin America which spends between US$ 12 and US$ 13.  Research carried out by Marie Stopes International found that knowledge of family planning and means of protection from HIV/AIDS and other STDs was low.

The restrictions placed on abortion in Bolivia have lead to many dangerous back-street terminations.  As many as 40,000 illegal abortions may take place each year in the country although the true figure is not known.  Teenage pregnancy is high and 14 per cent of girls between the ages of 15 and 19 have been pregnant.  Only 48 per cent of women in the city of Sucre use contraception and the average number of pregnancies is 3.3 per woman.  Families often have more children than they want simply because they do not know about contraceptive methods and almost half of couples do not use any form of contraception.

324 men and women, aged between 13 and 55, were interviewed in four districts of Sucre to find out people’s attitudes and behaviour to family planning and sexual health, in order to set up a sexual health clinic in one of the city’s districts.  The interviews included questions on pregnancy, cervical and breast cancer, contraceptive methods, STDs and HIV/AIDS.  The health centre is to provide contraception, treatment for STDs and screening for breast and cervical cancer.  The study found that:

• the most popular contraceptive methods amongst couples who used them were the condom, the coil and the rhythm method
• men and women in high income groups were more likely to use contraception than those from poor families
• while half of the people interviewed knew about cervical smears, only one third knew that breast examinations were also important.  Nevertheless screening levels remained low
• around 50 per cent of people had heard of gonorrhoea and syphilis but only one in five of those knew that using condoms was an effective method of preventing infection from HIV and other diseases.

The report recommends that:

• cervical and breast screening must be provided at an affordable price in order to reduce cancer levels
• more information and better access to services are needed to help couples reduce the size of their families
• encouraging the use of condoms would help to prevent unwanted pregnancies, STDs, as well as reduce rates of cervical cancer.

Source(s):
‘Sexual and reproductive health priorities in the city of Sucre, Bolivia’, Marie Stopes International working paper 4, by R.D. Gonzales, February 2002 Full document.

Funded by: UK Department for International Development

id21 Research Highlight: 11 June 2003

Further Information:
Marie Stopes International
153-157 Cleveland Street
London 
W1T 6QW
UK

Tel: 44 (0)20 7574 7400
Fax: 44 (0)20 7574 7417
Contact the contributor: msi@stopes.org.uk

Marie Stopes International

Other related links:
'Changing behaviour, changing disease – the case of HIV in rural Uganda' >

'Friends in deed – preventing HIV through peer education in South African schools' >

'Meeting their needs? Discussing young people’s sexual health' >

See id21's collection of links relevant to sexual and reproductive health.

See id21's collection of links relevant to HIV/AIDS.