MENUMENU
  • EDITORIAL COMMITTEE
    • Alaka BasuAlaka Basu
      Alaka M. Basu is Professor, Development Sociology, Cornell University, and a member of the Guttmacher-Lancet Commission on Sexual and Reproductive Rights and Health
      Alessandro RosinaAlessandro Rosina
      Professor of Demography and Director, Center for Applied Statistics in Business and Economics, Università Cattolica del Sacro Cuore
      Andrea BrandoliniAndrea Brandolini
      Head of Statistical Analysis Directorate, Bank of Italy
      Bruno MasquelierBruno Masquelier
      Professor of Demography, University of Louvain, Belgium
      Cheikh MbackéCheikh Mbacké
      Associate Professor, Sociology department, Laval University
      Cinzia ContiCinzia Conti
      Researcher at Istat, Head of Unit on Foreign Presence and Social Dynamics
      Corrado BonifaziCorrado Bonifazi
      Director of the Institute for Research on Population and Social Policies, National Research Council, Rome Italy
      Ernestina CoastErnestina Coast
      Associate Professor of Population Studies, London School of Economics
      Wang FengFeng Wang
      Professor of Sociology at the University of California, Irvine, USA, and Professor at Fudan University, Shanghai, China fwang(at)uci.edu
      Francesco BillariFrancesco Billari
      Professor of Sociology and Demography, University of Oxford
      Gilles PisonGilles Pison
      Professor at Museum National d'Histoire Naturelle and Director of Research at the French National Institute for Demographic Studies (INED) (Paris)
      Gustavo De SantisGustavo De Santis
      Professor of Demography, University of Florence, Italy
      Jacques VallinJacques Vallin
      Emeritus Research Director at INED, Paris; Honorary President of IUSSP
      John KnodelJohn Knodel
      Research Professor Emeritus, Population Studies Center, Institute for Social Research, University of Michigan (USA) and International staff, College of Populations Studies, Chulalongkorn University (Thailand)
      Letizia MencariniLetizia Mencarini
      Associate professor of Demography, Bocconi University - Dondena Centre for Research on Social Dynamics and Public Policy & Collegio Carlo Alberto; P.I. ERC P.I. ERC project n. 313617 (2013-2018) SWELLFER http://swellfer.wordpress.com
      Letizia TanturriLetizia Tanturri
      Associate Professor of Demography, University of Padova, Italy
      Massimo livi BacciMassimo livi Bacci
      Emeritus Professor of Demography, University of Florence, Italy
      Monica Das GuptaMonica Das Gupta
      Research Professor of Sociology, University of Maryland, USA
      OUR AUTHORS
      Paula Miranda-RibeiroPaula Miranda-Ribeiro
      Professor, Demography Department and Cedeplar, Universidade Federal de Minas Gerais, Brazil.
      Peter McDonaldPeter McDonald
      Professor of Demography in the Australian National University. Honorary President of IUSSP and winner of the Irene B. Taeuber Award
      Roberto ImpicciatoreRoberto Impicciatore
      Assistant Professor of Demography, University of Milan, Italy
      Salvatore StrozzaSalvatore Strozza
      Professor of Demography, University Federico II, Naples (Italy)
      Stefano MolinaStefano Molina
      Senior Program Officer, Giovanni Agnelli Foundation, Italy
      our authors
  • N-IUSSP
    • N-IUSSP is a new IUSSP news magazine, which will disseminate scientific findings from demographic research carried out all over the world. The practical implications of current trends, the risks and potentialities of emerging situations, the pros and cons of specific laws are discussed in rigorous but plain language.

      Everybody is free to reproduce our articles, for free, provided the original source is cited.

      You are invited to contribute to this new publication: please check our guidelines and submit your 1000 word contribution to contact@niussp.org

Sexual and reproductive health in Argentina: a right for everyone?
La santé sexuelle et reproductive en Argentine: un droit pour tous?

Eleonora Rojas Cabrera
reproductive health

Mortality from sexually transmitted diseases has been declining too slowly and unevenly in Argentina, compromising the right to sexual and reproductive health with equal opportunities. This is confirmed by Eleonora Rojas Cabrera’s analysis: the considerable advances observed among younger people contrast with a stagnation, if not a worsening of the situation at higher ages.

People who contract sexually transmitted diseases (STDs) may suffer dire consequences: their right to enjoy sexuality or their ability to reproduce is impaired, they are frequently exposed to stigmatization and social discrimination, and their health is affected, sometimes seriously.

Given the high and growing incidence of STDs in the world (principally related to HIV/AIDS), since the 1990s, the international community has been urging governments to act. This issue is reflected in objectives and goals included in several action plans, starting with the 1994 International Conference on Population and Development Programme (paragraphs 7.29-7.33, 8.29) and extending to the recent Sustainable Development Goals (Objective 3).

Mortality from STDs in Argentina

The Argentine Republic has adhered to these agreements and to others that reinforce their intentions at regional level (among them, the Montevideo Consensus on Population and Development celebrated in 2013), and has taken action to reduce morbidity and mortality attributable to STDs. However, a critical analysis of official information on mortality (from the National Office of Health Statistics and Information, DEIS for its acronym in Spanish) indicates that these efforts have been insufficient and that they have not reached the whole population, or at least not equally.

Indeed, although the mortality rate due to STDs decreased between 1997-2001 and 2009-2013 (from 7.6 to 6.0 per 100,000 men and from 8.2 to 7.9 per 100,000 women), the greatest advances were registered in the population between 0 and 44 years of age. These advances were especially marked in the first year of life, when mortality from STDs is high because of vertical transmission (from mother to child), and for males aged 25-44 years, among whom prevalence was initially very high (Figure 1).

Schermata 2018-04-28 alle 18.07.38

In contrast, the mortality rate for men aged 45 years or over increased (especially between 45 and 64 years) while the rates for women rose slightly at ages 45-64 and decreased only marginally for those older than 64 years (Figure 1).

An analysis by cause reveals a predominance of male deaths from HIV/AIDS followed by deaths from tumors associated with the Human Papilloma Virus (HPV), that is, oropharyngeal, anal, penile, vulvar, vaginal and cervical cancer. The order of causes is reversed in women, mainly due to the high incidence of cervical cancer (Figure 2).

Schermata 2018-04-28 alle 18.08.23

The variation in mortality rates from HIV/AIDS reflects the efforts made by the country to reduce them: as figure 2 shows, these efforts were successful for the (relatively) young population, thanks to the decline in new infections (more pronounced among young men), the growing number of persons receiving antiretroviral treatment (which is free in Argentina; National Law N° 23,798) and the measures taken to reduce vertical transmission.

However, death rates have increased after age 45 (Figure 2). Why? Firstly, the greater use of antiretrovirals has prolonged the life expectancy of affected people, who now die at older ages. Secondly, there has been a gradual improvement in the registration of HIV cases: this helps to reveal the true magnitude of the problem, but distorts comparisons over time. Finally, some of these older adults have developed habits that affect the spread of these diseases, such as visiting their doctors rarely and not talking to them about their sexual life, or having sexual activity with multiple partners, sometimes without protection, under the mistaken belief that it is no longer necessary beyond a certain age.

The female mortality rate due to tumors attributed to HPV (Figure 2) has declined. This drop is due mainly to a reduction in mortality from cervical cancer, thanks to the increase in access to the Pap test as a means for early diagnosis and timely treatment. In contrast, mortality rates from vaginal and oropharyngeal cancers have increased, especially in women aged 45 or over.

Both hepatitis B and syphilis have decreased markedly (Figure 2), the former because the specific vaccine has been incorporated into the official immunization schedule, the latter (still high at age zero) thanks to the growing number of pregnant women who access antenatal care.

Some challenges to overcome

The results reveal the challenges of ensuring a continued reduction in STD mortality in some contexts, and of reversing its upward tendency in others. One such challenge concerns access to information for preventing STDs. Although Argentina has made efforts to provide this information as widely as possible, knowledge about certain specific STDs (HPV, for instance) is still very limited in the general population. Worse still, it is decreasing in the most disadvantaged socio-economic sectors.

Another challenge concerns the use of prevention methods. In this regard, several studies show that condom use decreases with age because it is considered more as a means of contraception than as a method to prevent the spread of STDs, a fact which, incidentally, explains the increase in mortality from STDs at older ages.

In addition, special mention should be made of actions aimed at timely diagnosis. Thus far the focus has been on certain sectors of the population (for example, pregnant women to prevent vertical transmission of STDs and women in general, to promote Pap tests), but empirical data show that the rest of the population must not be left behind.

References

Economic Commission for Latin America and the Caribbean (2013). Montevideo consensus on population and development. First session of the Regional Conference on Population and Development in Latin America and the Caribbean (LC/L.3697), Montevideo, 12-15 August 2013.

Rojas Cabrera, Eleonora (2017). “El derecho a la salud sexual y reproductiva en la Argentina: un análisis a partir de la variación de la mortalidad por enfermedades de transmisión sexual entre los quinquenios 1997-2001 y 2009-2013”, Notas de Población, 104(44): 145-160.

United Nations (2015). Transforming our world: the 2030 Agenda for Sustainable Development. (A/RES/70/1).

United Nations (1995). Report of the International Conference on Population and Development (A/CONF.171/13/Add.1), Cairo, 5-13 September 1994.

image_pdfimage_print

By continuing to use the site, you agree to the use of cookies. more information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close