EU Country Positions on Sexual and Reproductive ... - Väestöliitto

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EU Country Positions on Sexual and Reproductive ... - Väestöliitto

ong>EUong> Member States’ ong>Positionsong> on Sexual andReproductive Rights IssuesThe Family Federation of Finland – Global Development Unit2.4.2012


ContentAbout the publication .................................................................................................................................................................................................................................... 2Acronyms/glossary ......................................................................................................................................................................................................................................... 4TablesAbortion is legal ............................................................................................................................................................................................................................................. 6Availability of abortion ................................................................................................................................................................................................................................... 7Comprehensive sexuality education (CSE) ...................................................................................................................................................................................................... 8Sexual and reproductive health services ....................................................................................................................................................................................................... 10The following contraceptives are available ................................................................................................................................................................................................... 12Accessibility of contraceptives ...................................................................................................................................................................................................................... 13Condoms are available from ......................................................................................................................................................................................................................... 14Availability of contraceptives for adolescents and young people ................................................................................................................................................................... 14The following HIV services are available ....................................................................................................................................................................................................... 15HIV services ................................................................................................................................................................................................................................................. 15HIV transmission and exposure .................................................................................................................................................................................................................... 16Homosexuality ............................................................................................................................................................................................................................................. 17Schools and communities raise awareness on sexual and gender diversity.................................................................................................................................................... 18Health and law enforcement personnel are trained on LGBT rights ............................................................................................................................................................... 18Youth can participate ................................................................................................................................................................................................................................... 19The level of participation of the youth in policy dialogue .............................................................................................................................................................................. 19The government support/involvement in initiatives supporting SRHR .......................................................................................................................................................... 20The share of official development assistance to population/SRHR ................................................................................................................................................................ 21The Family Federation of Finland - Global Development Unit 1


Acronyms/glossaryARTCSEAntiretroviral drugComprehensive Sexuality EducationComprehensive sexuality education (CSE) is rights-based, age-appropriate and medically accurate. It provides people – including young people - with complete informationon sexuality and reproductive health, including information on abstinence, informed consent, partner reduction, contraception, HIV/STIs, living with HIV, sexual orientationand gender identity and human rights. CSE also builds skills for developing healthy relationships, including communication, negotiation and decision-making skills, forpromoting gender equality, and for confronting risks and challenges, including HIV/STIs, unintended and unwanted pregnancy, unsafe abortion, gender-based violence,harmful traditional practices and stigma and discrimination.CSOFMGGFTAMCivil Society OrganizationFemale Genital MutilationThe Global Fund to Fight AIDS, Tuberculosis and MalariaGillick competence/Fraser GuidelinesA term originating in England and is used in medical law to decide whether a child (16 years or younger) is able to consent to his or her own medical treatment, without theneed for parental permission or knowledge.HIVIUDIVFLGBTODAHuman Immunodeficiency VirusIntrauterine DeviceIn Vitro FertilizationLesbian, gay, bisexual, transgender peopleOfficial Development AssistanceSexual and reproductive health servicesSexual and Reproductive Health Services covers a wide range of services and rights that contribute to reproductive health and well-being by preventing and solvingreproductive and sexual health problems. These include family planning, counseling, information, education, communication and services; education and services forprenatal care; infant and women’s health care; prevention and appropriate treatment of infertility; prevention of abortion (although prevention of unwanted pregnancies isgiven the highest priority); provision of safe abortion services (where legal) and the management of the consequences of abortion; treatment of infections of thereproductive organs; sexually transmitted infections (STIs) including HIV/AIDS; breast cancer and cancers of the reproductive system; and active discouragement of harmfultraditional practices such as female genital mutilation (FGM)5 (ICPD Program of Action).SRHRSTIUNAIDSSexual and reproductive health and rightsSexually transmitted InfectionThe Joint United Nations Program on HIV/AIDSThe Family Federation of Finland - Global Development Unit 4


UNFPAUNICEFWHOUnited Nations Population FundThe United Nations Children´s FundWorld Health OrganizationYouth friendly services1. Providers are trained to work competently, sensitively and respectfully with adolescents and young people on their sexual and reproductive health needs2. Services are confidential, non-judgmental, and private3. Clinic opening hours are convenient for adolescents and young people4. Services are accessible to all adolescents and young people irrespective of their age, marital status, sexual orientation or ability to pay5. An effective referral is in place6. Opportunities are made available for adolescents and young people to be involved in designing, implementing and evaluating the programThe Family Federation of Finland - Global Development Unit 5


1. ABORTION IS LEGALAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenTo preserve lifex x x x x x x 1 x x x x x x x x x x xTo preserve physical healthTo preserve mental healthIn case of rape or insestIn case of fetal impairmentFor economic or social reasonsOn requestOther clarificationsAustriaBelgiumHungaryIrelandLuxembourgNetherlandsPolandSpainx x x x x x x x x x x 1 x x x x x xx x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x xx 1 x x x x x x x 1 x x x x 1 xx 1 x 1 x 11 Accorinding to the law from 1975 abortion is legal up to 3 month after nidation. That means abortion is legal up to the 16th week.In reality very few doctors will perform an abortion after the 12th week. To be very precise: abortion with the mentioned gestationallimit is not legal, but both, the women and the doctor, are exempted from punishment.1 Abortion is legal in case of an emergency situation. What counts as an emergency is not specified by law and open to theinterpretation of the woman herself.1 Information not given.1Although legal it is not accessible. Some women travel to the UK.1 A new law is in preparation it will approach abortion on request but indications still remain.1 Abortion is on request always legal and can be done until 24 weeks.1 Physical health/mental health clarification: According to the law in Poland, abortion is legal when the pregnancy is a threat to thewoman's health. However, the term 'health' is interpreted in a very narrow way which in practice mean that very popular amongdoctors is an assumption that there is no need for abotion unless the woman will become seriously disabled or is unlikely tosurvive the delivery. In Tysiac vs. Poland case, the risk for Tysiac was that she might lose her sight and this reason was not strongenough according to the doctors to let her execute her right to abortion. In this context, it is hardly possible to qualify for legalabortion when mental health is in danger - many women with already diagnosed mental illnesses experience extreme challenges inaccess to legal abortion and none of them who turned to the Federation for help was successful in exercising their right - theysought help abroad. To sum up, those options are in the law, but do hardly exist in medical practice. As far as medical abortion isconcerned, the Mifepristone is not registered in Poland and therefore it is illegal even for hospital use. Proctagladin is used instead,however medical abortion is an option only on paper as the legal procedures are conducted almost only using the surgical methodand the woman has no possibility to decide on the method of conducting abortion.1 On request until 14 weeks of pregnancy; 15 to 22 weeks a report of a specialist is needed. Upper 22 only in case of a veryimportant illness of the woman or foetus and in case of a serious malformation non compatible with the life; This requires a reportof an medical expert committee. It is free of charge but there are some women that cover the cost in order to avoid delaying theprocess.United KingdomThe Family Federation of Finland - Global Development Unit 6


2. AVAILABILITY OF ABORTIONAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainParental consent neededx x x x x x x x 1 x x x x 1 x→Until age14 18 18 18 18 16 18 16 18 16 18 15 x 1Medical abortion is availableWith gestational limit without medical reasons→ Number of weeksAbortion is free of chargeAbortion is not free of chargeOther clarificationsAustriaBulgariaEstoniaFinlandFranceHungaryLatviaNetherlandsSlovakiaSpainSwedenUnited Kingdom1 Information not given.x x x x x 1 x x x x xx x x x x x x x x x x x x x x x 1 x 212 12 12 12 22 20 12 12 12 12 24 10 12 10 14 18 28Swedenx x 1 x x 1 x x x x xx 1 x 1 x x 1 x x x 1 x x xx 11 Abortion services are not covered by the social security systems. According to the law public hospitals should offer abortions on a lower ratebut in reality only few hospitals (around the capital) do.1 Abortion is free of charge for special cases, not on request and in mainstream cases; just with social indications, under medical conditions.1 Abortion prices: 2/3 of price is covered by state. Medical abortion 34 €, surgical abortion 45 €.1 Abortion itself is almost free of charge, just a regular out-patient visit fee irrespective of what is done.1 The gestational limit of medical abortion is 5 weeks. The minor need to be accompanied by an adult of her choice.1 The price depends on private practice internal regulation. The abortion procedure is not covered by insurance or state/ municipal budgets.1 Person who wants an abortion without parental consent can turn to a general practitioner or health care provider who guide the young personin their decision.1 Abortion is quite expensive, around 250 €. The minimum wage is 283,38 € net, which makes access to abortion services very limited if notcompletely unavailable to marginalized groups or people from socially disadvantaged groups. Moreover, some doctors have a right to executean objection of conscience and refuse to provide abortion at all.1 From 16 to 17 years: Parental information is compulsory and it needs to be confirmed; they do not require parental consents (only to beinformed). At the moment, the new conservative government is reviewing the current law. They want to deny abortion on request and to demandparental signed consent for women of 16 to 17 years.1 From 18 to 22 weeks: foetal viability, abortion permitted in specific cases for strong reasons.1 Gillick competent i.e. able to weight up pros and cons and make an informed decision.2 Legal TOP and gestation varies pending reasons. Generally allowed up to 28 weeks unless severe abnormality then allowed up to term.United KingdomThe Family Federation of Finland - Global Development Unit 7


3. COMPREHENSIVE SEXUALITYEDUCATION (CSE)AustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenAvailable in schoolsx 1 x 1 x 1 x 1 x 1 x x 1 x x x 1 x 1 x 1 x 1 x x 1 x x 1→from ageAvailable out-of-schoolAvailable with parental consent needed for peopleunder the age ofOwn subject in schools14 4,5 10 7 11 x 1 6 13 5 7 12 10/12 11/12 6 14 6/7 7x 2 x 2 x 2 x 2 x 2 x 2 x 1 x 2 x 2 x 1 x 2 x 1 x 2x 2 x 1 x xEqually accessible to allx x x x x xNone of the above x 118United KingdomAustriaBelgiumBulgariaDenmarkEstoniaFinlandFrance1Not compulsory.2 Austria Family Planning Association (ÖGF) holds workshops in youth centres, offers email and chat counseling and runs help desks foradolescents (anonymous and free).1 CSE is part of the learning objectives of all children and youth in Belgium, however, how and at what age CSE is given to children and youthdepends upon the school itself. Possible from 4,5 years onwards. Schools decide autonomously complicating the evaluation of CSE in Belgianschools. Although all should have access, CSE is not tailored to specific groups such as people living with a handicap, immigrants or LGBT.2 Youth movements, websites, youth advice centers.1 There is a new law under elaboration - the law for shcool education. The hope is that with the new educational standard "Civil, interculturaland health education" sexed will be equally accessible for all with opportunities for own subject in school.2 Available out-of-school in NGOs such as The Bulgarian Family Planning and Sexual Health Association (BFPA) and Youth Peer EducationNetwork (Y-PEER).1CSE is by law obligatory in elementary school in Denmark but it's not an individual subject.2 e.g. clinics, danish family planning association etc.1 Sexuality education is available in schools for 4th Grade. It depends a bit of schools. Different situation is in russian speaking schools.2 Youth Counseling Centers.1 Some from 9, fully from 13.2 Part of Health Knowledge, which is a topic of its own with trained teachers.1 The obligation of the sexuality education (at least 3 sessions every year) is written into law (since 2001), but it is not applied in many schools,especially in primary schools (6 to 11 years). It depends on the head of the school. A diversity of agencies can be responsible for provision:school teachers, other types of educational staff, school nurses and doctors, and associations.The Family Federation of Finland - Global Development Unit 8


2 Family planning centers and associations for prevention of HIV.HungaryLatvia1 Some NGOs.1 Standards of social sciences include all aspects of CSE, however, in practice as CSE is integrated, the quality is doubtful. As there is no tests toprove knowledge obtained at school, it is difficult to assess the access and quality of CSE though at schools.2 municipal NGO'sLithuaniaLuxembourg1 Available in schools on request from our organisation.1 No systematic sexual education available.2 In FPA.NetherlandsPolandSlovakiaSloveniaSpain1 Sexuality education is given in schools, however this is not always comprehensive sexuality education. It is often part of biology classes orpersonal care. Government is thinking of making education about sexual diversity compulsory in schools.1 The classes of "Preparation for family life" are non-obligatory and the programme is influenced by the Church, therefore it cannot be fullydefined as comprehensive. They start at the 5th grade if primary school, which means those children are about 11 or 12 years old. The classesconsist of only 14 hours per year and it is up to the teacher to choose the textbook - there is hardly any control over the choices of the books.Due to the lack of professional trainers, the classes are often conducted by priests or by other teachers with no training (P.E. teachers forexample). In many schools they are not conducted at all. The Ministry of Education has no data on the quality, level, content and the practice ofthe classes being conducted as Preparation for Family Life.1 CSE is not available at all, as it is not mandatory and has no approved minimum standards and no support in law, nor curricula. Provision ofany sexuality education is based on a good will of teacher which leads to a huge differences in information given to pupils, from biologicalpoint of view, scare tactics, abstitence only programmes to few exceptions, when teachers are trying to implement some parts of the CSE.1Comprehensive sexuality education not available, partial information offered by NGO's at schools and internet forums.1 In Spain there is not an educational law covering sexual education in a formal way and the process is very different depending on thedifferent regions. It is available in an informal way: chat and short courses given by Associations or primary health centres.2 Youth centres, associations, health centres.SwedenUnited Kingdom1 Youth friendly services/youth clinics.1PSHE varies from school to school and not obligatory i.e. parents can take kids out of school for the relationship and sex education part ofPSHE which starts with basics around 7 years of age. Personal, social, health and economic (PSHE) education has in various forms been part ofthe national curriculum for schools in England since 2000. Some aspects, but not all, have been compulsory. PSHE is defined by the schoolsinspectorate Ofsted as a planned programme to help children and young people develop fully as individuals and as members of families andsocial and economic communities. Its goal is to equip young people with the knowledge, understanding, attitudes and practical skills to livehealthily, safely, productively and responsibly. In July 2011, the Department for Education launched an internal review of personal, social,health and economic education to look at the content and quality of teaching of PSHE in schools. Closing date for the responses to the review isWednesday 30 November 2011.2 Via Brook (voluntary sector provider of sexual health advice and services) etc.The Family Federation of Finland - Global Development Unit 9


4. SEXUAL AND REPRODUCTIVE HEALTHSERVICESAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenServices are free of chargex 1 x x x x 1 x 1 x x x x 1 x x 1 x 1 x x xAccessible with parental consent needed for peopleunder the age of14 16 18 2 16Access to youth-friendly servicesServices are equally accessible to allServices are not equally accessible to allOther clarificationsx x 1 x x x x 1 x x 1 x x 1 x xx x x x x x x x 1 x xx 1x 1 x 1 x 1United KingdomAustriaBelgiumBulgariaEstoniaFinlandFranceIrelandLatviaLuxembourgNetherlands1 Cancer screening (cervix and mama) are covered by the social security system - counselling is free. Infant´s and women´s health care iscovered by the social security system.1 We lack youth-friendly services. We do have student doctors, but they only reach out to the student community and not to all young people.Some doctors provide youth friendly services but there is no promotion of this so young people can not easily find out who to turn to.1 SRH services are accessible to all under 18 - they are all health insured by government. After the age of 18, there are strata of society out of thehealth insurance system, thus with difficult access to health services including SRH. Youth-friendly services are available only in special unitssuch as BFPA (Family Planning) centres, municipality and private hospital are far form this.1 All services and visits in Youth Counselling Centres (until the age of 24) are free of charge to all young people (including uninsured youngpeople). In hospitals and medical centres is fixed visit-fee (3,20 €).1 Most sexual and reproductive health services are free of charge, such as those related to family planning, STI, pre- and postnatal care andinfant care. But not infertility and some others.1 For youth services services, there are differences between rural/urban areas. Differences also depending on the political will and priorities ofauthorities (departmental and regional).1 Services are free of charge to people on low incomes.1 The sexual and reproductive health services are part of GP services. A small patient fee should be paid except the poorest population.1 3 Family Planning Associations in the whole country.1 Health services for youth are often free of charge.The Family Federation of Finland - Global Development Unit 10


PolandSlovakiaSloveniaSpain1 The Ministry of Health decides which reproductive health services are covered fully by the public health insurance and which are not. Most ofthem are free of charge, however it is challenging to have access to them. Some services (such as In Vitro Fertilization) are not covered at all.Others, such as antenatal screening, are funded only for selected groups (free of charge for high-risk pregnancies and for women over 35), otherscan access them if they cover the costs. Worth mentioning is the fact that often the waiting lists are so long that women are forced to use theprivate health services - especially in pregnancy time is vital and the tests have to be conducted in certain weeks of pregnancy. This results inexclusion of many women from the SRHR services.2 Due to the necessity of parental consent even for a regular visit at any of the doctors, young people are 100% dependent on their parents whenit comes to their access to SRHR services. There are no youth-friendly SRHR services.1 Service providing differ from region to region, in some, they are free of charge at a gynaecologist, but it also depend on his/hers beliefs whatkind of information or services are provided. Services described above are more likely to be received at private clinics, which makes them lessaccessible for certain groups of people.1 Services offered at outpatient clinics as for all other women, free of charge for those insured.1 There are a lot of differences depending on the regions (17 Autonomous Communities). In some regions there are Sexual and ReproductiveHealth Centres or Family Planning centres (public centres and free of charge). In others the contraceptive methods prescription is offered in theprimary health centres (General Practitioners). In Spain only 8 or 9 youth-friendly services are working. In the theory these services are equallyaccessible to all but in the practice is not true. The law establishes that an adolescent older than 15 does not need the parental consent. In thefamily planning and the youth-friendly services the adolescents 13-15 can be attended without parental permission when the doctor trust in thematurity of them.The Family Federation of Finland - Global Development Unit 11


5. THE FOLLOWING CONTRACEPTIVES AREAVAILABLEAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainOral pillx x x x x x x x x x x x x x x x x x xIUDx x x x x x x x x x x x x x x x x x xMale Condomx x x x x x x x x x x x x x x x x x xFemale condomInjectablesContraceptive patchSpermicidesVaginal ringsImplantsEmergency contraceptives (with prescription)Emergency contraceptives (without prescription)Female sterilizationVasectomyOtherClarificatonsx x x x x x x x x x x 1 xx x x x x x x x x x x x x xx x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x x x xx x x x x x x x x x x xx x x x x x x x xx x x x x x x x x x x x x x 1 x xx x x x x x x x x x x x x x x 1 xx x x x x x x x x x x x x x x x 1 xx 1 x 1 x 1x 1 x 2SwedenUnited KingdomAustriaFranceLuxemburgPolandSpainSweden1Emergency contraception: Vikela is sold over the country, for Ella one a prescription is obligatory.1 Diaphragm.1 No information given.1Chemical contraception.2Female sterilization is illegal and can be conducted only if woman's life is at risk.1Emergency contraception based in Ullipristal Acetate needs prescription.1 Yes, but limited.The Family Federation of Finland - Global Development Unit 12


6. ACCESSIBILITY OF CONTRACEPTIVESAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainAll contraceptives free of charge for allx 1x 1 x 1 x 1 x 1 xx 1 x 1 x x 1 x 2 x 1 x 1 x x 2 x 2Some contraceptives free of charge for allSome contraceptives free of charge for youthContraceptive methods covered by healthinsuranceAustriaBelgiumEstoniaFinlandFranceLuxembourgNetherlandsPolandPortugalSloveniaSpainSwedenUnited Kingdomx 2 x 2 x 2 x 1 x 2 x 1 x 2 x 11 Contraceptives are not covered by the social security system in Austria. At NGOs (like ÖGF) adolescents get contraceptives for free.1Oral pill, IUD, injectables, contraceptive patch, emergency contraceptives for youth under age 21.2 Depending on health insurance.1 Male condoms, for example from Youth Counselling Centres and from sexual-health lectures.2 Contraceptive methods with prescription (oral pill, contraceptive patch, vaginal rings) are 50% covered by Estonian Health Insurance Fund.1 First IUD in some municipalities.2 Only 3 month starting package.1 All for minors and women without health Insurance.2 Some pills, implant, IUD, diaphragm (little), female sterilization, vasectomy.1 Oral contraceptives 80% covered till 25 years.1 Morning after pill with anonymous prescription.2 Oral pill covered for youth, other contraceptives (like vaginal ring) partly covered.1 One type of oral contraceptives (from the old generation range) is partially covered by health insurance. The IUD placement and exchangeis free of charge if the woman buys the IUD herself.1 It depends of the Health Center, but the majority are Pills and Male Condoms; but in Hospitals and HIV Services also Female Condom.2 All.1 All above except male condoms.1 The patients pay 40% of the cost of some trademarks. For example, approximate there are a total of 30 marks of pills and 10 of them can becovered in this way. Also could be covered.2 The condoms can be free of charge in the Family Planning and Y-F centres.1 In most parts of Sweden contraceptives are subsidized for women up to around 20 to 25 years.2 Oral pills, IUD, vaginal rings or condoms are free of charge for youth in some parts of Sweden.1 Contraceptives can also be purchased in chemist, petrol stations etc.SwedenUnited KingdomThe Family Federation of Finland - Global Development Unit 13


7. CONDOMS ARE AVAILABLE FROMAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSupermarketsx x x x x x x x x x x x x x x x x x x xClinicsx x x x x x x x x x x x x xPharmaciesx x x x x x x x x x x x x x x x x x xNight clubsx x x x x x x x x x xWeb storesx x x x x x x x x x x x x x xSchoolsx x xSwedenUnited Kingdom8. AVAILABILITY OF CONTRACEPTIVES FORADOLESCENTS AND YOUNG PEOPLEAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenAny restrictionsx 1 x 1 x x 1 x x x x 1 x 1 x x x x 1Parental consent needed for people under the age of 14 16 18 15 16 1United KingdomAustriaBelgiumIrelandNetherlandsPolandSpainUnited Kingdom1 Condoms can be bought at the above mentioned locations, hormonal contracpetives are only available with prescription.1 Prescription of doctor needed. A visit to a doctor can be a hindrance for youth. Above the age of 21 it differs from health insurance to healthinsurance if and which contraceptive methods are being covered.1 Irish Doctors usually use the Fraser Guidelines (maturity/evoling capacity guidelines) as in the UK however these have no standing in Irish law.1 Restrictions only related to their own health and the fact that their body is still developing.1 In order to obtain prescription, parental consent is needed. Only contraceptives available without prescription (male and female condoms andchemical contraceptives only) can be bought without parental consent.1 The parental consent under 16 is not clear and depend on de doctor or health centre´s criteria.1 If Gillick competent, GP will prescribe.The Family Federation of Finland - Global Development Unit 14


9. THE FOLLOWING HIV SERVICES AREAVAILABLEAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainVoluntary testingx x x x x x x x x x x x x x x x x 1 x xAnonymous testingPre- and post testing counsellingPrevention counsellingAnti-retroviral treatment (ART)Prevention of mother-to-child transmissionNeedle exchange programsNone of the abovex x x x x x x x x x x x x x x x x x x 1 xx x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x xx x x x x x x x x x x x x x x x 2 xSwedenUnited KingdomSpainSweden1 The quick test of HIV and counselling is available in some Family Planning, youth-friendly centres and centres specialized in STI/HIV. Also in 4youth-friendly centres of the Spanish Family Planning Federation.1 Yes, but not if tested positive.2 Available, but very limited and not implemented in several parts of the country.10. HIV SERVICES AREAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenAvailable free of chargex x x x x x x 1 x x x x 1 x x x x xIntegrated to public healthx x x x x x x x x x x x x x x x x x xNone of the aboveUnited KingdomFranceNetherlands1ART is not free of charge but it is reimbursed by health insurance.1 HIV services are in some places free of charge/and or covered by insurance.The Family Federation of Finland - Global Development Unit 15


11. HIV TRANSMISSION AND EXPOSURE ISAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenCriminalizedx 1 x 1 x 1 x x→In casex 1 x 1Not criminalizedx x 1 x x x x x x 1 x x x 1United KingdomBelgiumDenmarkFinlandFranceNetherlandsPolandSpainUnited Kingdom1 HIV transmission and exposure is not criminal by law, however, there have been cases wherein a person has been prosecuted for manslaughter because he/she did not inform her partner about his/her status, when it was known by the person him/herself and thus did not takeany precaution to protect his/her partner from getting infected.1 It's criminal if the partner is not informed that the other is HIV-positive.1 Intentional transmission has been considered a criminal act as causing harm to another person in some cases, but there are no specific lawsabout it.1 Recent convictions for HIV transmission have created a jurisprudence.1 HIV services are in some places free of charge and/or covered by insurance.1HIV transmission and exposure is not criminalised only in cases of being unaware of carrying HIV.1 It is criminalized in case of infection through a hospital or facility care.1 It is criminal if the person transmitting HIV is doing it with intent i.e. having unprotected sex to transmit the virus.The Family Federation of Finland - Global Development Unit 16


12. HOMOSEXUALITY ISAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenLegalx 1 x 1 x 1 x x 1 x 1 x 1 x x 1 x 1 x 1 x 1 x 1 x 1 x 1 x 1 x x 1 x 1 x 1IllegalIf legal, are there any restrictive laws regard to LGBT?United KingdomAustriaBelgiumBulgariaEstoniaFinlandFranceIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSpainSwedenUnited Kingdom1 Marriage Law: in Austria the civil union gives homosexual couples less rights than married heterosexual couples. For example: Neitheradoption nor In Vitro Fertilization are legal for homosexual couples.1 No restrictive laws.1Marriages nor adoptions are not allowed (not treated by a particular law, but not happening at all).1 It`s generally regulated by Family Law act. Restrictive laws are under a discussions in Estonia.1 Outside adoption right limited. Civil union allowed.1 Marriage and adoption are not legal. The PACS (Civil Solidarity Pact) is available for LGBT and give them some rights (in matters ofinheritance, insurance and taxes).1 Civil partnership is legal. Gay marriage is not nor are there adoption rights for LGBT.1 There are no laws specifically to LGBT couples- marriage law, adoption rights are not regulated.1Marriage and adoption are not legal.1 Marriage and adoption are not legal.1 No restrictive laws.1LGBT couples are not recognised as similarly informal opposite sex couples. LGBT persons are not legally allowed to marry and have noadoption rights in Poland. Even if they decide to marry abroad, their documents will not be recognised in Poland. Polish law treats them asstrangers to each other therefore they do not have any of the opposite-sex couples' privileges.1 Adoption rights and medical assisted reproduction.1 Same-sex relationships are not legally recognized, and they are not allowed an adoption.1 The marriage between people of the same sex and adoption is permitted by law. The support and treatment of transgender people is limited tosome hospitals of 3-4 big regions (Autonomous Communities).1 Yes, forced sterilization for legal recognition of self-identified gender.1 Civil partnership allowed.The Family Federation of Finland - Global Development Unit 17


13. SCHOOLS AND COMMUNITIES RAISEAWARENESS ON SEXUAL AND GENDERDIVERSITYAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenYesx x x x x 1 x 1 x 1 x 1 x 1 x x x 1 x xNox 1 x x xUnited Kingdom14. HEALTH AND LAW ENFORCEMENTPERSONNEL ARE TRAINED ON LGBT RIGHTSAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenYesx x 1 x 1 x 1 x 1 x 1 xNox x 1 x 1 x 1 x x 1 x x xUnited KingdomAustriaBelgiumBulgariaFinlandFranceIrelandLatviaNetherlandsPolandSpainSweden1 Awareness raising campaigns are very rare.1 Trainings are only provided on demand of certain organizations and thus not standard nor obliged.1Sexual and gender diversity is raised mainly by NGO programmes, not by government.1 To some extent.1 There are differences depending on the political will and priorities of school directors and departmental and regional authorities.1 Yes, but inconsistent.1 Questions are difficult to answer with YES or NO as there are specific activities to raise awareness and also the issues of LGBT rights are in theschool curricula, however, there is no evidence how wildly these issues are discussed.1 Some schools and communities do.1 A few short one-off trainings for police were conducted by LGBT NGOs in Warsaw, but this is a drop in the ocean and there is littleunderstanding of the need for systematic and comprehensive training for public administration staff, health care providers and lawenforcement personnel.1 Answers have to be understood in a partial way. As always, depending on the different political ideologies of the regional governments.1 Yes on law enforcement, no/very limited on health personnel.The Family Federation of Finland - Global Development Unit 18


15. YOUTH CAN PARTICIPATE IN THE…AustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenDesign of youth-friendly SRHR servicesx x x 1 x 1 xDesign of sexual education materialsNone of the abovex 1 x x x 1 x x 1 x 2 xx x x x x x x x xUnited Kingdom16. THE LEVEL OF PARTICIPATION OF THEYOUTH IN POLICY DIALOGUE ISNationalRegionalGlobalNone of the aboveAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenx 1 x x x x x x 1 x 1 x x 3 xx x x x 1 x x x 1 x 3 xx 1 x x x xx x x x x x 1United KingdomBelgiumBulgariaFinlandFranceLatviaNetherlandsSpainSweden1 When materials are developed they are pre-tested among youth who can provide feedback.2 Youth take part in disucssion on SRHR through different youth advisory councils that discuss all kinds of topics concerning youth.1Mainly due to NGO and international organizations efforts (such as UNFPA, IPPF, WHO, ong>EUong>).1 The level of participation of the youth about this is rather limited.1 There are youth councils in some municipalities and departmental councils.1 young people are involved in NGO's when their SRHR are discussed, however when country education materials, curricula is developed, youngpeople lack participation.1 This is however not happening on a structural base.1 There are some interesting experiences of participation but only in limited spaces and places (municipalities, Associations, schools, etc.).1 To certain extent through dialogue.2 Partly in collaboration with CSOs.3 Sometimes/occasionally.The Family Federation of Finland - Global Development Unit 19


17. HAS THE GOVERNMENTSUPPORTED/BEEN INVOLVED ININITIATIVES SUPPORTING SRHR?YesNoAustriaBelgiumBulgariaDenmarkEstoniaFinlandFranceHungaryIrelandLatviaLithuaniaLuxembourgNetherlandsPolandPortugalSlovakiaSloveniaSpainSwedenx 1 x 1 x x x 1 x 1 x 1 x x 1 x 1 x 1 x 1 x 1 x 1x 1 x x xUnited KingdomIf yes, explanationAustriaBelgiumBulgariaEstoniaFinlandFranceHungaryLuxembourgNetherlandsPortugalSpainSwedenUnited Kingdom1 Austria supported UNFPA until 2011 and have supported the Maternal Health Trust Fund.1 Belgium has been investing most of its budget for SRHR on HIV/AIDS, making signficant contributions to the Global Fund.1 Bulgaria is still doing its first steps in ODA - SRH is present as a priority in the ODA platform.Government have supported / have been involved in different SRHR conferences and events, but support and involving could be more active.1 Women Deliver conferences. Side events in CSW and CPD. Support to GFTAM. Among the biggest donors of UNFPA. Supports IPPF.1 Financial support is not systematic, still to negotiate. Participation especially for international conferences (e.g. following conferences inCairo or Beijing, CSW) or Global Summit of Parliamentarians ahead of the G8 and G20 "girls and population: the forgotten drivers ofdevelopment" or Conference "Population, Development and Family Planning in French West Africa: the urgency to act " in Ouagadougou.1 Few events and projects.1 The government supports the FPA with a essential contribution.1 Yes, they used to fund UNFPA heavily. Still funding but less. they are supporting the Dutch SRHR alliance (consisting of 5 organisations workingon international SRHR is one of the 4 core themes of the government.1 With UNFPA and some NGO Programmes.1 All the initiatives undertaken by Red ACTIVAS have had strong support from the past Government.1 SRHR is included and prioritized in the Swedish Official Development Assistance both in terms of a specific SRHR policy for internationaldevelopment cooperation, and financial support/initiatives both through bilateral support (mainly health sector support) and multilateralSRHR support for instance to UNFPA, UNICEF, World Bank , UNAIDS , WHO and GFTAM, as well as financial support to CSO focusing on SRHR.1 Numerous including Abortion conferences.The Family Federation of Finland - Global Development Unit 20


18. THE SHARE OF OFFICIAL DEVELOPMENT ASSISTANCE TO POPULATION/SRHRAustria 0,89 % of ODA (2010).Belgium 2,37% of ODA=31.227.582 € (2010).BulgariaBulgaria is still doing its first steps in ODA - SRH is present as a priority in the ODA platform.Denmark 5,78 % 1EstoniaInformation not available.Finland 6 %France the part of ODA is 0.43 % of gross national income. It is multilateral and bilateral assistance. At the G8 Summit in Muskoka in June 2010,France has committed to an additional contribution for the maternal and child health between 2011-2015. In September 2010 at the UNSummit on millennium development goals, France announced 20 % increase of the contribution to the Global Fund to Fight against AIDS.Hungary 0 %Ireland 7,91 % 1LatviaInformation not available.Lithuania 0.33 %Luxembourg 6,94 % 1Netherlands 2.5 %PolandNone. Polish ODA is focused on technical assistance, infrastructure, education and humanitarian assistance.PortugalLow.SlovakiaInformation not given.SloveniaInformation not given.Spain The highest contribution has been close to 6 %, now it is around 2,5 %.Sweden 6,7 % in 2009 and 6,2 % in 2010.United Kingdom 6.35 % according to Euro mapping 2009.1 Financial Resource Flows for population activities in 2009, UNFPA 2009The Family Federation of Finland - Global Development Unit 21

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