(QCOSTARICA) The risk for sex social workers (prostitutes) and their clients of contracting a sexually transmitted infecion (STI) has increased over the past several months, due to changes in the Costa Rica Social Security or Caja (Caja Costarricense de Seguro Social – CCSS) – in shutting down the specialized services.
Nubia Ordonez Ugalde, head of the La Sala, an association that groups female sex workers and Fundacion Transvida, grouping some 200 “chicas trans” (trans girls), working the streets of San Jose, say the Caja has stopped providing them medical attention to diseases “from the waist down”.
Dayana Hernández, leader of Transvida, that if it were not for a non-governmental organization (NGO) that donates 5,000 condoms monthly, the (trans) girls who work the streets would have no protection and be exposed to a greater risk of contracting an STI and passing it on.
Both Hernández and Ordonez say STIs are a public health problem.
Worldwide, according to the World Health Organization (WHO), every day, over a million people contract an STI, including syphilis, gonorrhea or herpes.STIs are infections that are spread primarily through person-to-person sexual contact. There are more than 30 different sexually transmissible bacteria, viruses and parasites.
Before the reforms in the Health sector, in the early nineties, venereal disease controls were administered by the Ministry of Health (Ministerio de Salud).
After the changes, the controls were taken over by the CCSS. That modification, the groups argue, crippled them.
Health minister, Fernando Llorca Castro, acknowledged a problem exists. “We have analyzed the issue. The Caja told me they need to know the number of people affected, to consider the possibility of insuring them by the State (…).”
Meanwhile, the medical director of the CCSS, Maria Eugenia Bonilla Villalta, said that all health centres in the institution are obliged to serve those who come with any symptoms of an STI.
In fact, Villalta promised to send a circular to remind officials at state clinics to serve them (sex workers) and bill it to the State.
Villalta added that the focus is on preventing the spread of STIs.
According to Ordonez, the girls have been unprotected since last November, when the Caja removed the STI service at the Clinica Moreno Cañas, in the case of San Jose.
“We want to tell the CCSS that as sex workers, our needs have to be addressed. If we have to pay for a doctor and we don’t have a way to pay, it is a public health problem,” said Ordonez.
Gloria Terwes, in charge of the issue at the CCSS, told La Nacion the CCSS wants as many of “these people” to be self insured (that is to pay for being insured by the Caja).