A sharp devaluation has hiked the cost of imported birth control supplies including condoms, raising fears of a wave of sexually transmitted infections and unplanned pregnancies
- Lebanon's crisis hinders access to contraception
- High cost of condoms seen fuelling STIs, abortion
- Refugees, rural residents at highest risk, say doctors
By Tala Ramadan
BEIRUT, March 1 (Thomson Reuters Foundation) - Lina, a 27-year-old Lebanese woman, started skipping her contraceptive pills a year ago as their price soared beyond her reach. Today, she is five months into an unplanned pregnancy and anxious about the future.
As Lebanon's economic crisis makes birth control, condoms and screening tests too expensive for many young adults, doctors have warned about a wave of unwanted pregnancies, sexually transmitted infections (STIs) and possibly unsafe abortions.
"I don't have a career, I don't have anything stable, I don't have a home where (the baby) can be safe," said Lina, who is married and asked to use a pseudonym to protect her identity.
Lebanon's economic meltdown has plunged more than 82% of the population into poverty, with the lira currency's sharp devaluation hiking the cost of imported birth control supplies - from contraceptive pills to condoms.
Before the lira crashed in late 2019, a year's supply of birth control pills cost about 21,000 lira. Today, it costs nearly 10-times as much.
A packet of six condoms now costs at least 300,000 lira – nearly half the monthly minimum wage.
This has effectively made contraceptives unaffordable for many young adults – with possibly life-threatening consequences, said Faysal El Kak, an obstetrician-gynecologist at the American University of Beirut.
"The potential rise in unintended pregnancies could result in further economic consequences, increase in maternal morbidity and mortality, and of course a rise in unsafe abortions," El Kak told the Thomson Reuters Foundation.
Abortion is illegal in Lebanon – even in the case of rape or incest – and anyone who facilitates, promotes or has an abortion could face a fine and imprisonment.
The ban - and conservative attitudes about having a child outside marriage - mean women with unwanted pregnancies often seek out illegal abortions, said El Kak, estimating that unsafe terminations cause 25% of maternal mortality.
Nearly 12 million women in poorer countries lost access to contraception in the COVID-19 pandemic, leading to 1.4 million unplanned pregnancies, the United Nations said last year.
In Lebanon, the problem has been compounded by the country's financial woes, with refugees and rural residents in particular facing a dearth of adequate and approachable sexual health services, El Kak said.
Even people seeking screening for STIs including HIV are struggling to afford the cost of an STI test, which can cost up to 200,000 Lebanese Lira in private clinics.
STI services have long been neglected and underfunded in Lebanon, leading to a lack of screening, shortages of trained personnel and laboratory capacity and scant pharmaceutical supplies for follow-up treatment, El Kak said.
There were 2,885 people diagnosed with HIV in Lebanon as of November 2021 of whom only 1,941 people were receiving antiretroviral treatment - far below the global average, according to estimates given by the National AIDS Program.
Stigma, discrimination and a ban on gay sex stop many LGBTQ+ Lebanese from getting tested or seeking treatment for HIV and other STIs, El Kak said.
Tough laws on sex work and drug use are also cited by health professionals and HIV campaigners as barriers to the delivery of screening and treatment services among high-risk groups.
Many local initiatives, often funded with charity donations, have been providing free STI tests in a bid to plug the gap.
According to data collected by SIDC, a nonprofit that provides the free testing, 70% of people who tested in their labs in 2021 were having unprotected sex.
But just as demand for affordable sexual health services grows, the crisis is depleting nonprofits' funds as donors redirect their support to programmes focused on providing food and shelter, said Nadia Badran, SIDC's president.
"(They) prioritise funding people who are dying from hunger, rather than from STIs," Badran said.
(Reporting by Tala Ramadan @talaramadan; Editing by Helen Popper. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)
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