Costa Rica

Costa Rica has joined the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination. At a United Nations High-Level Meeting on AIDS side event on 7 June, the Vice President of Costa Rica, Epsy Campbell Barr, emphasized the country’s commitment to human rights by highlighting that a comprehensive and effective HIV response needs to include the human rights of people living with HIV.

Costa Rica is the third signatory to the global partnership in the Latin America and Caribbean region, joining Jamaica and Argentina.

The side event, Latin America and the Caribbean on the Road to Eliminating HIV-Related Stigma and Discrimination, was co-organized by the regional coordinator of the global partnership, RedTraSex (the Sex Workers Network for Latin America and the Caribbean), the Global Network of People Living with HIV and the Governments of Jamaica and Costa Rica, with the support of UNAIDS.

Five year ago, the 2016 United Nations Political Declaration on Ending AIDS recognized the HIV epidemic as a human rights challenge. Member States expressed concern about HIV-related stigma and discrimination around the world and about the regulatory and legal frameworks that discourage and prevent people from accessing HIV-related services.

The Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination was created in 2017. The initiative has the goal of catalysing and accelerating the implementation of commitments made to end HIV-related stigma and discrimination by United Nations Member States, United Nations agencies, bilateral and international donors, nongovernmental organizations and communities.

Countries have made commitments on ending discrimination in various international conventions, and have made further promises at the regional and national levels. The global partnership supports countries in transforming those promises into reality through policies, programmes and practices that strengthen health and HIV-related rights.

Through the regional coordination of RedTraSex, the global partnership supports an open and ongoing dialogue in the regional civil society networks with the goal of strengthening national coordination platforms and representation, with a focus on people living with, at risk of or affected by HIV.

The Vice-President of Costa Rica, Ana Helena Chacón, committed to ensuring access to inclusive HIV services and to promoting respect for human rights during a meeting with UNAIDS Deputy Executive Director Jan Beagle, held on 6 November at the Presidential Palace in San José, Costa Rica.

According to Ms Chacón, it is necessary to strengthen legal and social environments in order to promote human rights and remove barriers to accessing HIV testing, treatment and prevention services as well as social protection for the key populations most vulnerable to HIV. In Costa Rica, men who have sex with men are the most affected population, with an HIV prevalence of 10.9% compared to 0.3% among the general population. The Vice-President noted that social justice and inclusion are critical to ending the AIDS epidemic in the country by 2030.

Early last week, a bill to amend the national law on HIV was presented to the Legislative Assembly for discussion. The new bill intends to decriminalize HIV transmission and to reform the Penal Code to ensure legal protection against discrimination based on sexual orientation or gender identity.

Ms Beagle recognized the leadership that Costa Rica has shown in the AIDS response and noted its progress on the path to eradicating stigma and discrimination. She also commended the country for its efforts in scaling up HIV services to prevent new HIV infections among children and urged accelerated action in order for Costa Rica to become one of the first Latin American countries to reach zero new HIV infections among newborn children by 2015.

UNAIDS Executive Director Michel Sidibé and the Minister of Health of Costa Rica, Dr Daisy Corrales. UNAIDS HQ, Geneva. 6 November 2012. Credit: UNAIDS

The Minister of Health of Costa Rica, Dr Daisy Corrales, aims to strengthen the AIDS response among key populations at higher risk in her country, which is where the epidemic remains concentrated. During a meeting with UNAIDS Executive Director Michel Sidibé on 6 November at the UNAIDS Headquarters in Geneva, Dr Corrales highlighted the focus of her Ministry in developing HIV communications and educational strategies for organizations working with male sex workers.

“We need to develop our strategies to reach male sex workers with HIV information and education that is relevant to their needs and in agreement with their particular work schedules,” said Dr Corrales.

Costa Rica’s HIV prevalence among adults 15 to 49 years of age is 0.3%. The country’s HIV epidemic is concentrated among key populations at higher risk of infection such as the migrant indigenous population, men who have sex with men (MSM), sex workers and their clients. A study conducted in 2010 found HIV prevalence among MSM of 10.9% and 11% among female sex workers.

“It is not always easy to talk about men who have sex with men, sex workers or drug users but we have an obligation to ensure they have access to HIV services that are free from stigma and discrimination,” said Mr Sidibé.

Mr Sidibé also commended the Government of Costa Rica for its efforts in scaling up HIV treatment for people with HIV—an estimated 65% coverage—as well as their success in stopping new HIV infections among children. “Costa Rica’s transmission rate of HIV from mother-to-child is consistently under 2%, a very impressive feat and a bold example for Latin America that an HIV free generation is within our reach.”

Mr Sidibé assured the Minister of Health that UNAIDS will continue providing support to Costa Rica to design its strategy for an effective and sustainable response to AIDS.

Peer educators providing HIV prevention information during a community fair in Puntarenas.

José is a young AIDS peer educator in the Costa Rican port city of Limon and he is proud to share HIV prevention messages and tips on how to stay healthy with other young people. “It’s really great to see how at the end of a session the group knows more about HIV. We also have a better idea of how to protect ourselves and deal with our relationships more successfully,” he said. 

As one of more than 80 peer educators, between the ages of 18 and 24, José is taking part in an ambitious HIV prevention project in the cities of Limon and Puntarenas, which are among the most affected by the virus in Costa Rica. The educators have gone through extensive training and can provide educational and communication materials and tools to their counterparts in a lively and informative way.

The three-year programme which began at the end of 2008 is called Friendly education and health services to promote healthy lifestyles and prevent HIV and AIDS—or Giro 180 for short. Supported by UNAIDS, the programme is managed by its cosponsors the UN Development Programme (UNDP), the UN Children’s Fund (UNICEF), and the UN Population Fund (UNFPA). The UN bodies work alongside the country’s Vice-Ministry of Youth and the National Council on Public Policy for Youth.

The peer educators themselves have developed a number of the interventions, including using online games that feature questionnaires on HIV risk and a Facebook page. Youth carnivals and community fairs, board game evenings and artistic, musical and recreational activities are also being used.

“We did a fair in Villa Plata, a very poor place,” said Deiker, a youth promoter in Limon. “We gave out information, played and had fun. We were there, sharing experiences with the boys from morning till evening. And in the end the guys didn’t want to leave.”

 As well as providing young people with HIV information and life skills to make informed choices, the project also seeks to build the capacity of healthcare and educational institutions to attain these goals in a protective environment.

Some 73 000 adolescents in the two cities aged between 13 and 18 are the main beneficiaries and young people from around the country are also indirectly benefiting from the political and institutional advocacy and information campaigns launched by the project.

Such information campaigns are vital in a country where a 2008 study carried out by UNFPA and UNICEF, with support from UNAIDS, found that the majority of young people in Costa Rica were sexually active by the age of 16. The same study showed that fewer than 30% of young people in Limon and 17% in Puntarenas knew how to use a condom correctly.

However, things are changing. The programme has led to an increase in commitment from government authorities and decision makers. A number of local and regional institutions, such as the Department of Health in Limon, have committed themselves to broadening youth-friendly HIV services. In Puntarenas, schools have adopted the ‘Giro Junior’ intervention, dedicated to the development of specific strategies to challenge HIV, with guidance and support centers. The regional Ministry of Public Education has also prepared a set of guidelines for HIV prevention in schools, which will be binding throughout the region.

The team spearheading the programme hopes that it will become a flagship model. For at least one of the peer educators, Bizmark from Limon, they are enjoying making waves, “Older people might be a bit scared of us talking so openly, widely and directly. We are changing lives in perhaps the only way people can change, which is having fun while learning.”

The President of the Republic of Costa Rica, Mr Óscar Arias signing the HIV prevention and education agreement.

Young people in Costa Rica will be receiving information on HIV prevention and healthy lifestyles from their peers thanks to a new agreement signed in San Jose by the Government of Costa Rica and the United Nations.

The agreement establishes that young people, aged 15 – 25 years, will lead in sharing sexual health information among their peers in two provinces: Limón and Puntarenas. The young leaders will provide education on a wide range of issues such as modes of HIV transmission and how to use a condom.

UNAIDS Regional Director Dr César Núñez emphasized that only timely information and HIV prevention can stop the spread of HIV. “It is urgent to provide young people with HIV information and to include sexual education in the school curriculum, as well as to develop specific strategies for the population outside schools,” he said.

The agreement was signed on 24 February 2009 by the President of the Republic Mr Óscar Arias and the Deputy Minister of Youth Karina Bolaños together with Dr César Núñez, UNAIDS Regional Director, Nils Kastberg, UNICEF Regional Director for Latin America and the Caribbean, Luis Mora, UNFPA Regional Adviser in Gender and Masculinities, and young people from the Limón and Puntarenas provinces.

A 2008 study carried out by UNFPA and UNICEF with support from UNAIDS showed that the majority of young people in Costa Rica were sexually active at the age of 16. The study also highlighted that there was lack of HIV information and knowledge among Costa Rican youth.

For that reason, President Arias, who received a Nobel Peace prize in 1987, emphasized on the occasion of the signing the need to speak about sexual education openly and without prejudices. “Talking about sex cannot continue to be taboo in Costa Rica,” he said.

The President of the Republic of Costa Rica, Mr Óscar Arias (centre) talking with the United Nations representatives that signed the agreement.

The study shows that in Limón only about 28% of the young people interviewed know how to use a condom correctly whereas in Puntarenas the percentage drops to about 17%. Furthermore, in both provinces, more than 50% of the adolescents find that asking a partner to use a condom could be interpreted as a sign of mistrust. Finally, 43% in both provinces think that a young girl carrying condoms in her purse is a woman with a “doubtful reputation.”

The agreement signed will look at strengthening the capacity of the health and education institutions as well as youth and adolescents in the country to promote HIV prevention. UNICEF, UNFPA and UNAIDS will provide technical and financial assistance to the programme which plans to directly benefit 73,000 adolescents.

This agreement is a direct result of the Meeting of Ministers of Education and Health to prevent HIV in Latin America and the Caribbean, that took place in Mexico in August 2008 ahead of the International AIDS Conference, when Ministers signed an historic declaration pledging to provide comprehensive sex education as part of the school curriculum in Latin America and the Caribbean.