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AGE OF CONSENT: LEGAL REVIEW SUMMARY
i FOREWORD
There is one barrier to health access and a major impediment to national and regional development across the globe that could be removed within a few days if only the policy decisions would be made. The removal of this barrier would promote gender equality, help end child marriage, reduce teenage pregnancy and girl dropout rates from secondary school, lower HIV incidence rates, and achieve the prerequisite for the demographic dividend. Let me explain.
As the Sustainable Development Goals (SDGs) become the world’s compass towards development and a better life for all people on the planet, sub-Saharan Africa faces a potential demographic disaster that could undermine many of the SDGs.
Many sub-Saharan countries have some of the highest fertility rates in the world which, if unaltered, will see those countries’ population, rising from 17 million to 43 million by 2050. Another country’s population that is currently at 27 million will more than double to 65 million by 2050, with yet another going from 53 million to 137 million. Not one of these countries will have reached the population turnaround required as an inescapable prerequisite for achieving a demographic dividend by 2050.
With increases like these on the same available land area, with the same or less access to drinking water, potentially less arable land available due to global warming, and services and GDP increasing at a far slower rate than population, it will be impossible to achieve the SDGs and improbable to even maintain the human development index achieved thus far by 2017. These are not scenarios or ‘maybes’. This is the inevitable future of the region unless something significant, such as the fertility rates, changes. Slowing and reversing population acceleration is essential to development in sub-Saharan Africa.
And yet, the world has a dark and shameful history of ‘population control’, legislating women’s rights to decide on having children away and forcing and coercing sterilisation. These restrictions on agency and autonomy
i have no place in a democratic, sustainable development world in the 21st century and the vast majority of nations achieving the demographic dividend have not resorted to such dark methods.
Increasing gender equality, keeping girls in safe schools for longer, reducing sexual and gender based violence, and increasing the sexual and reproductive health knowledge of young people are also factors. And of course, it is the increased access to modern contraceptives and women making choices about their own reproductive health that have turned the tide.
So this research report turns its attention to this access to modern contraceptive methods, as well as all other sexual and reproductive health (SRH) services. There are many barriers for adolescents around the globe - the majority of citizens in many countries – to access SRH services. Distance from services, lack of transport, lack of available commodities, poverty, inherited beliefs, harmful practices, and hostile staff attitudes can all be barriers to access. But only one barrier is self-inflicted by countries. And this barrier could disappear tomorrow, creating massive access for adolescents. It is the barrier of legal restrictions on adolescents’ access to SRH. The majority of countries in the region have placed arbitrary legal barriers to adolescent access by creating policies or laws with a number of parental consent and other restrictions, preventing adolescents from initiating their own healthcare.
In some cases, these have been gradually added to laws or policies with well-intentioned reasons to protect adolescents. In many cases, however, they reflect an idealised view of what older people think younger people should or should not be doing. Primarily, these idealised views revolve around sex. Older people, sometimes forgetting their own youth, think that the best protection for younger people is to abstain from sex until they are, perhaps 16, or even 18. Reality is, in many cases different, and by ignoring reality and locking adolescents out of the health system when it comes to sexual and reproductive health and rights (SRHR), adults are doing irreparable damage to their children and other children, as well as directly contributing to a looming demographic disaster for their nation.
Because this seems so obvious, recent global guidelines have called on countries to examine their current policies and consider revising them to reduce age-related barriers to access and uptake of all SRH services. To assist in this process, the SRHR Africa Trust (SAT) in collaboration with the Thomson Reuters Foundation, 20 global law firms, and UNICEF, has reviewed Age of Consent laws in 22 countries: Botswana, Kenya, Ivory Coast, Malawi, Morocco, Nigeria, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Brazil, Jamaica, India, Indonesia, Thailand, Vietnam, Canada, United Kingdom, France, Sweden, and Ukraine. The range of countries was chosen to highlight a spread of geography, cultures, development status, nonachievement, in-transition and achievement of the demographic dividend, and adolescent health outcomes. Inaddition, SAT and UNICEF also undertook an Ethical, Cultural and Social review in nine countries (seven being from the 22 countries above, plus two others - Uganda and Philippines) to look at ethical cultural and social barriers impacting adolescent access to health and services including SRH services.
The data revealed some game-changing recommendations apparent to SAT:
1. Desexualise SRHR services and treat them as you would any other health system access; 2. Base both access and restriction decisions on child and adolescent development, competence and maturity to make decisions about their own health; 3. Do not make the age of sexual consent older than 16 years, and do not distinguish between young men and young women; 4. Have statutory rape provisions in place to protect adolescents from predatory adults; 5. Put ‘close in age’ exceptions to the age of sexual consent in place so that young adolescents having consensual sex with one another do not have to go to jail – a travesty affecting young men aged 13-16 years.
We offer this report and its insights to policymakers, legislators, development agencies, international cooperating partners, and activists wherever they may be. A thinking and action tool is currently being designed to accompany this report. If you wish to receive it or an electronic copy of this report, please send an e-mail to [email protected]. Please also feel free to share ways in which you may have used this report or the action tool to create positive change with us and with one another.
Our hope is that these resources will create dialogue and action that will remove all legal barriers to adolescent access to SRH services and allow attention and resources to focus on the remaining and more intractable barriers. Jonthan Gunthorp
Executive Director - SAT
ii ACKNOWLEDGEMENTS
The SRHR Africa Trust (previously known as the Southern African AIDS Trust) wishes to acknowledge the individuals, organisations and law firms that contributed to this report through their expertise, co-operation and hard work.
Special thanks go to Arnold & Porter Kaye Scholer LLP (United Kingdom), Alzinger (Ukraine), Asyla Attorneys (Tanzania), Blake, Cassels & Graydon LLP (Canada), Cloete-Henwood Associates (Swaziland), Corpus Legal Practitioners (Zambia), Independent researchers (Indonesia, Thailand), Gill, Godlonton & Gerrans (Zimbabwe), Hamilton Harrison & Mathews (Kenya), J Sagar Associates (India), John W Fooks & Co. (Cote d’Ivoire), KLA Koury - Lopes Advogados (Brazil), NERO Boutique Law Firm (Morocco), Ndadi (Botswana), Norton Rose Fulbright (South Africa), Rajah & Tann LCT Lawyers (Vietnam), Rose Law Caribbean (Jamaica), Udo Udoma & Belo-Osagie Law Firm (Nigeria), that provided pro bono legal services to undertake the review on Age of Consent Legal Review in the 22 countries, working with Arnold & Porter Kaye Scholer LLP, in particular to Catherine Young for coordinating the legal review in all the participating countries.
SAT also wishes to thank Civil Society Organisations and partners who attended the Age of Consent Validation Meeting that met to discuss and validate the draft Advocacy Toolkit. The meeting critically reviewed the draft reports, analysing the data collected for its accuracy and merits.
SAT is grateful to UNICEF for co-funding the review of the Age of Consent laws, policy frameworks, Ethical, Social and Cultural (ESC) impacts on sexual reproductive health and rights and HIV.
Last but not least, SAT thanks TrustLaw at the Thomson Reuters Foundation for their continued collaboration with SAT on health and rights and for brokering the partnerships between SAT and the law firms. TrustLaw is the Thomson Reuters Foundation’s global pro bono legal programme, connecting law firms and corporate legal teams around the world with high impact NGOs and social enterprises working to create social and environmental change.
Countries in the study
Canada United Kingdom France
Morocco
Jamaica Nigeria Kenya
Brazil Zambia Botswana
South Africa
iii DISCLAIMER
This legal review report and the information it contains is provided for general informational purposes only.
It has been prepared as a work of comparative legal review only and does not represent legal advice in respect of the laws of any country in this study. It does not purport to be complete or apply to any particular factual or legal circumstances. It does not constitute, and must not be relied or acted upon as legal advice or create an attorney-client relationship with any person or entity.
Neither the legal firms, their Attorneys, SRHR Africa Trust, nor the Thomson Reuters Foundation accept responsibility for losses that may arise from reliance upon the information contained in this review report or any inaccuracies therein, including changes in the law since the review commenced in February 2016. Legal advice should be obtained from legal counsel qualified in the relevant jurisdiction(s) when dealing with specific circumstances.
Neither the legal firms, any of the lawyers, the SRHR Africa Trust, nor the Thomson Reuters Foundation is holding itself, himself or herself out as being qualified to provide legal advice in respect of any jurisdiction as a result of his or her participation in or contributions to this legal review summary.
Sweden
Ukraine
India Thailand Vietnam Ivory Coast Indonesia Tanzania Malawi Zimbabwe Swaziland
iv ACRONYMS
AIDS...... Acquired Immune Deficiency Syndrom
ANC...... Antenatal Care
ART...... Antiretroviral therapy
HIV...... Human Immunodeficiency Virus
HPV...... Human Papillomavirus
HTC...... HIV Counselling and Testing
PEP...... Post-exposure Prophylaxis
PrEP...... Pre-exposure Prophylaxis
SAT...... SRHR Africa Trust
SRHS...... Sexual and Reproductive Health Services
SRHR...... Sexual and Reproductive Health and Rights
STI...... Sexually Transmitted Infection
UNDP...... United Nations Development Programme
UNFPA...... United Nations Population Fund
UNICEF...... United Nations International Children’s Fund
WHO...... World Health Organization
v CONTENT PAGE
FOREWARD i
ACKNOWLEDGEMENT iii
DISCLAIMER iv
ACRONYMS v
Background 1
Introduction 4
Summary of Advice 5
Age of Consent and Person Giving Consent 8
Key Message 10
Summary of Country Reports: Alphabetically 13
vi Background
The world’s attention has moved beyond HIV and AIDS, yet it remains the leading killer of adolescents in Southern Africa, presenting a major impediment to healthy communities and a significant factor in the health and status of women and girls in the region.
According to Joint United Nations Programme on HIV/AIDS (UNAIDS) on the prevention of HIV (2013), Eastern and Southern Africa is home to half the world’s population living with HIV even if the region is only 5% of the world’s population. Today the region continues to be the most infected and affected by the HIV/AIDS epidemic, with 48% of the world’s new HIV infections among adults, 55% among children, and 48% of AIDS-related deaths.
Research conducted in many parts of the world shows that several legal and human rights barriers hinder access to, and uptake of, HIV services for adolescents. Key among these barriers are Age of Consent legislation and policies. Recent global guidelines have therefore explicitly called on countries to examine their current policies and consider revising them to reduce age-related barriers to access and uptake of the overall SRH services, HIV Counselling and Testing (HCT) and to linkages to prevention, treatment and care.
HIV is the most severe in the Southern Africa sub-region which includes Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe, with each having an adult HIV prevalence of over 10%. UNAIDS reports that Swaziland have the highest HIV prevalence in the world (26.0%), followed by Botswana (23.4%).
In 2011, there was an estimated 1.2 million adolescents aged 10-19 years old living with HIV, more than half of all HIV positive adolescents globally. Eastern and Southern Africa now have 10.5 million children who have lost one or both parents to AIDS.
The risk of becoming infected with HIV is higher for girls and young women and currently, HIV prevalence among young women aged 15 - 24 years stands at 4.8%, which is two and a half times higher than among men of the same age. In Swaziland, 15% of young women are HIV positive, compared to 6.5% of young men.
The advocacy campaign ‘All In To #EndAdolescentAIDS’ was launched as a global platform for action and collaboration for social change in February 2015 by global leaders and civil society partners. This global agenda provides opportunities for ensuring that existing and new strategies and programmes on HIV prevention, treatment and care are effectively implemented to benefit young people. These include the 2012 guidance on Pre-exposure Oral Prophylaxis (PrEP) for serodiscordant couples, men and transgender women who have sex with men at high risk of HIV transmission, as well as the 2013 guidance for HCT and care for adolescents living with HIV and young key population policy briefs.
All In To #EndAdolescentAIDS works through four workstreams. As part of workstream 1, global partners have prioritised joint action to take stock of the current situation in countries with respect to Age of Consent for services including HIV prevention by carrying out a systematic desk review of Age of Consent laws and a mapping of the processes led and outcome of reforms undertaken by countries to address this barrier. Through the All In To #EndAdolescentAIDS, many agencies and global partners including the United Nations Development Programmes (UNDP), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the PACT and AIDS Alliance have already initiated actions on data collection to inform their policy advocacy efforts at globally and specifically within the 25 focus countries. This review will inform the development of a source or toolkit for learning on this theme and capacity building of experts and policymakers worldwide.
Why Age of Consent review?
Several global bodies, including UNICEF and WHO, are currently undertaking a number of initiatives to change the global guidelines with regard to adolescent access to a range of HIV prevention services, including Age of Consent and informed consent, confidentiality, availability, accessibility and acceptability. Adherence and quality must inform these services.
1 Research conducted in many parts of the world shows that several legal and human ‘‘ rights barriers hinder access to, and uptake of, HIV services for adolescents.
2 ‘‘ 3 Introduction
SAT has engaged various firms on a pro bono basis to conduct a review of the laws affecting the Age of Consent on issues relevant to HIV in 22 jurisdictions. These include countries where SAT operates: Botswana, Malawi, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe, as well as the following additional countries: Brazil, Canada, Cote d’Ivoire, United Kingdom, France, India, Indonesia, Jamaica, Kenya, Morocco, Nigeria, Sweden, Thailand, Ukraine, and Vietnam.
SAT raised various questions with regards to the ability of young persons to access services relevant to HIV prevention or treatment. Counsel in, or with expertise with respect to, each of the countries surveyed prepared individual country reports to address these questions.
The questions SAT raised are listed below:
1. At what age may sex between consenting individuals legally take place? (Age of Consent to sexual intercourse) Indicate if there are different ages for males and females? 2. Is there a definition of statutory rape? Please define. 3. Are there exceptions to question (1)? For example gay sex? 4. At what age may a young person access contraceptive services including contraceptive commodities? Please specify with and without parental consent if the answers are different. 5. May a young person access emergency contraceptives (e.g. the ‘Morning-after pill’) At what age? Please specify if there are different ages with and without parental consent. 6. Policy framework and legislation enabling or disenabling access to Antiretroviral Therapy (ART), including Age of Consent with and without parental consent. 7. Specify whether there is any prohibition on HIV Post-exposure Prophylaxis (PEP), including Age of Consent with and without parental consent. 8. If there is no prohibition in question 7, would young people be legally able to access PEP if it was it offered? At what ages? Please specify if there are different ages with and without parental consent. 9. Is there any legislation or policy specifically enabling PEP use in country? Please specify if it deals with Ages of Consent and give details. 10. Specify whether there is any prohibition on HIV Pre-exposure Prophylaxis (PrEP), including Age of Consent with and without parental consent. 11. If there is no prohibition in question 10, would young people be legally able to access PrEP was it offered? At what ages? Please specify if there are different ages with and without parental consent. 12. Is there any legislation or policy specifically enabling PrEP use in the country? Please specify if it deals with Ages of Consent and give details. 13. Please state whether there is policy framework and/or legislation enabling or disenabling access to safe abortions and/or postabortion care, including Age of Consent with and without parental consent. 14. Policy framework and legislation enabling or disenabling access to Antenatal Care (ANC), including Age of Consent with and without parental consent. 15. Policy framework and legislation enabling or disenabling access to HPV vaccines and cervical cancer screening and treatment, including Age of Consent with and without parental consent. 16. What is the Age of Consent to access HIV testing without parental consent? 17. What is the Age of Consent at which the HIV status will be reported directly to an adolescent and legal/ policy requirements to report this status to her/his parents? 18. Please explain any inconsistencies between the answers above.
4 3. Are there exceptions to answer 1. For example, gay Summary of Advice sex?
Below are high level summaries of the outcomes Gay sex is often treated differently. In Jamaica, India of the legal research in respect of each question and eight of the African countries surveyed (Botswana, included in the survey. In addition, a table Kenya, Malawi, Morocco, Swaziland, Tanzania, Zambia summarising and consolidating the responses for and Zimbabwe), gay sex is illegal. In Indonesia, the Age of Consent to gay sex is higher – 21 years, as opposed to each country. 15 years for heterosexual sex.
1. At what age may sex between consenting individuals In some countries, the Age of Consent is different if the legally take place? (Age of Consent to sexual couple are married. For example, in India, the Age of intercourse) Indicate if different ages for males and Consent to sex is 18 years in general, but 15 where a man females? has sex with his own wife. In Zambia and Nigeria, the position is different for couples who are married under In almost all countries, the Age of Consent to sexual customary law. intercourse is clearly prescribed by law. Ukraine is the only country in which the Age of Consent was unclear In Morocco, sex is illegal unless the couple is married, (but it is not older than 18 years and not younger than and a family court judge can authorise the marriage of 16 years). The Age of Consent varied in the countries person younger than 18 years. surveyed from 14 (in Brazil) to 21 (in Cote d’Ivoire). In the majority of countries 14 out of 22, the Age of Consent 4. At what age may a young person access was either 14, 15 or 16 years; the Age of consent was contraceptive services including contraceptive 18 years in India and in four of the African jurisdictions commodities? Please specify with and without surveyed. In Morocco, extramarital sex is illegal and the parental consent if the answers are different. Age of Consent to marry is 18 years. The position with regard to access to contraceptive Three jurisdictions surveyed (Swaziland, Tanzania and services varies widely and is often unclear or based Malawi) only specify the Age of Consent in relation to primarily on common practice rather than law or formal females. guidelines.
2. Is there a definition of statutory rape? Please define. Contraceptives that are not a form of medical treatment (e.g. condoms) are often available without parental In most countries, sex with a person under the Age of consent at any age. Consent is illegal regardless of whether both parties freely consented (i.e. amounts to statutory rape), although the The position regarding access to contraceptives that offence is often not described as “rape”. In Morocco, are a form of medical treatment is more variable, sex with a young person would be an offence on the although most countries fall into two broad categories: basis that extramarital sex is illegal. In several countries (a) countries where there is no age restriction, so (Canada, United Kingdom, Indonesia, Jamaica, parental consent is not a legal requirement, or (b) Zambia and Kenya), a defence may be available if countries where the age of access to contraceptives the accused person believed the child to be over the without parental consent is the same as the general rule age of consent. In some cases, these defences are only regarding access to medical treatment. Where an age available where the minor or the accused is relatively restriction does exist, the age at which a young person close to the Age of Consent - for example, in Jamaica can access contraceptives without parental consent the defence is only available if the accused is under varies from 10 years (in Botswana) to 21 years (in Cote 23 years, and in United Kingdom the defence is only d’Ivoire). South Africa has legislation which specifically available if the minor is over 12 years. permits the provision of contraceptives to persons aged 12 years or older, following provision of medical advice and a medical exam.
5. May a young person access emergency contraceptives (e.g. the ‘Morning day after pill’)? At In most countries, what age? Please specify if there are different ages sex with a person with and without parental consent. The position for emergency contraceptives is generally under the Age the same as for any other contraceptive, discussed in question 4 above. Some jurisdictions take the approach of Consent is that emergency contraceptives are a form of medical ‘‘ treatment and are, therefore, subject to the rules on Age illegal regardless of Consent applicable to medical treatment. of whether both However, some jurisdictions do draw a distinction between emergency contraceptives and other forms parties freely of contraceptive. For example, in Botswana, access to emergency contraceptives is more restricted - consented. although other contraceptives are available without parental consent from the age of 10 years, emergency contraceptives are only available in the event of rape, 5 ‘‘ defilement or incest. By contrast, in Canada, access Kenya, South Africa, Tanzania, Ukraine and Vietnam; to emergency contraceptives is less restricted - other in Botswana, United Kingdom, India, Indonesia, Malawi, contraceptives are subject to age restrictions, whereas Nigeria, Swaziland, Sweden and Zimbabwe, it is dealt emergency contraceptives are typically available with in policy and guidance. without age restrictions. 10. Specify whether there is any prohibition on HIV Pre- 6. Policy framework and legislation enabling or exposure Prophylaxis (PrEP), including Age of Consent disenabling access to antiretroviral therapy (ART), with and without parental consent. including Age of Consent with and without parental consent. Botswana is the only country surveyed in which there is a total prohibition on the use of PrEP. The remaining The majority of countries surveyed have implemented countries surveyed do not prohibit the use of PrEP. some form of policy, regulatory or legal framework However, in some countries where there is no prohibition governing access to ART. In United Kingdom, Canada, on PrEP, there is nevertheless restricted access to PrEP. France, India, Indonesia, Kenya, Malawi, South Africa, In Swaziland, Morocco and India PrEP is not available Sweden, Tanzania, Thailand, Ukraine, Vietnam and at all, while in Brazil non-commercialization of PrEP drugs Zimbabwe, ART is subject to policy or guidelines. Only means that access is very limited. In Sweden there are France, Indonesia, the Ivory Coast, Tanzania and practical restrictions on access to PrEP and in Kenya the Vietnam have legislation specifically relating to ART. use of PrEP is limited to research purposes. There are no specific provisions to enable access to ART in the remaining countries. 11. If there is no prohibition in question 10, would young people be legally able to access PrEP was it offered? At what ages? Please specify if there are different However, the applicable Age of Consent to access ages with and without parental consent. ART ranges from 12 to 21 years old across the countries surveyed, with 16 and 12 years old being the most A variety of approaches are taken in the countries common. No age restrictions apply in Brazil, India, that do not prohibit PrEP. Most countries apply their Tanzania, Thailand and Vietnam, so parental consent respective general principles of consent to medical is not a legal requirement. Some countries apply the treatment to determine whether young persons may general rules on Age of Consent to access medical access PrEP. In these countries, access to PrEP by young treatment to young persons accessing ART, while people is therefore not distinguished from access by Botswana and Zambia apply the Age of Consent to young people to other medicines or treatments. There access HIV testing. Cote d’Ivoire uses the legal age of are however specific rules in France, where PrEP is not majority 21 years. recommended for any person under 18 years. In Ukraine, persons 13 years or younger would require parental 7. Specify whether there is any prohibition on HIV Post- consent to the use of PrEP. In some countries (Malawi, exposure Prophylaxis (PEP), including Age of Consent Zambia and Zimbabwe) the position with respect to with and without parental consent. young peoples’ access to PrEP is currently unclear, while some countries (Thailand and Tanzania) do not have any PEP is not prohibited in any of the countries surveyed. age restrictions on access to PrEP so parental consent However, in Zimbabwe, PEP can only be administered would not be a legal requirement. in specific circumstances, including where the patient has been the victim of a sexual assault, or where a 12. Is there any legislation or policy specifically enabling healthcare professional has been exposed to HIV in the PrEP use in the country? Please specify if it deals with performance of his/her work. Ages of Consent and give detail.
8. If there is no prohibition in question 7, would young The only countries with specific PrEP-enabling legislation people be legally able to access PEP if it was offered? or policy in place are Canada, France, Nigeria and At what ages? Please specify if there are different South Africa. With the exception of France (where ages with and without parental consent. access to PrEP is legally restricted to persons aged 18 years or over), the enabling policies or laws in these Parental consent is required for young persons to access countries do not specify the Age of Consent to PrEP. PEP in most of the countries surveyed. However, it is not required in Brazil, India, Tanzania, Thailand and Vietnam. 13. Please state whether there is Policy framework and/ As with ART, the applicable Age of Consent for access to or legislation enabling or disenabling access to safe PEP ranges from 12 to 21 years old, with 16 and 12 years abortions and/or postabortion care, including Age of old being the most common. As a general observation, Consent with and without parental consent. it seems there is a divergence between countries that transfer decision-making powers to young people as Abortion is illegal in Nigeria and Jamaica; in most other they enter their teenage years (around 12 years), or as countries, abortion is permitted only in very limited they enter their mid or late teenage years (16 or 18 years) circumstances (for example, to save the mother’s life). although the age is 21 years in the Ivory Coast. The remaining countries are more flexible about the circumstances in which abortions are permitted. 9. Is there any legislation or policy specifically enabling PEP use in country? Please specify if it deals with ages Specific rules relating to the Age of Consent and parental of consent and give detail. consent are common. In some countries, the consent of the patient’s guardians (India) or legal representatives In most of the countries surveyed, there is some form (Brazil) is required for abortions on women under 18 of law or guidance specifically enabling the use of years of age. Similarly, France requires that women PEP. PEP use is legislated for in Brazil, Canada, France, aged under 18 years obtain either parental consent to
6 the abortion or be accompanied by an adult of their The position with regard to cervical cancer screening choosing. In Ukraine, abortions may be performed on and treatment is less clear for some countries surveyed women aged 13 years or under only with the consent as the reports do not specify whether these services are of her legal representatives. In Zimbabwe, abortions accounted for in the national policy/legal framework. may only be performed on women aged 15 years or Kenya has a policy which enables access to these under with the consent of her legal representatives. Ivory services, United Kingdom has guidelines and Ukraine Coast and Botswana apply the legal age of majority does this via Ministry Regulations. to access abortions without parental consent. Most of the remaining countries surveyed apply their general Apart from certain countries which have specific rules on rules on the Age of Consent to medical treatment to parental consent for HPV vaccines provided via schools, abortions. there are no countries which specify the Age of Consent to access the HPV vaccine generally, cervical cancer 14. Policy framework and legislation enabling or screening and treatment. Accordingly, those countries disenabling access to Antenatal Care (ANC), which do have age restrictions apply the legal age including Age of Consent with and without parental of majority or the general rule on the Age of Consent consent. to medical treatment to the provision of these three services to young persons. Countries such as Cote d’Ivoire, Jamaica, Kenya, Nigeria, Swaziland, Sweden, Zambia and Zimbabwe 16. What is the Age of Consent to access HIV testing have no policy framework or legislation in place with without parental consent? respect to ANC. However, ANC may still be available in these countries: for example, in Sweden, healthcare The Age of Consent to HIV testing varies between 12 is generally free, which enables access to ANC. In some years and 18 years, 16 years being the most common of these countries, (Kenya, Sweden and Ivory Coast) the amongst the countries surveyed. Young persons below default legal position on the Age of Consent applies also the Age of Consent usually require parental consent to to the receipt of ANC. Jamaica and Nigeria have no obtain an HIV test although the rules in some countries legal age restrictions on the receipt of ANC by young allow physicians to dispense with this requirement in persons. In Swaziland, Zambia and Zimbabwe the age of certain circumstances. There are no legal age restrictions consent to ANC is 16 years. on access to HIV testing in India, Nigeria, and Thailand. Some countries have rules on the Age of Consent which Of the remaining countries in which there exists an ANC are specific to HIV testing while other countries apply the framework, this is set out in either policy guidelines or general rules on consent to medical treatment. legislation, or a mixture of these. Many of these countries (Botswana, Brazil, India, Indonesia and Thailand) have 17. What is the Age of Consent at which the HIV status no restrictions with respect to the age at which a young will be reported directly to an adolescent and legal/ person can receive ANC and parental consent is not a policy requirements to report the status to her/his legal requirement. In Canada, France, United Kingdom parents? and South Africa, the general rules on Age of Consent to medical treatment apply to ANC. In Ukraine, the Age The age at which HIV test results will be reported directly of Consent to ANC is 14 years although younger girls to a young patient ranges between 12 years (Brazil and may receive ANC under certain circumstances and Malawi) and 21 years (Cote d’Ivoire). Sixteen years is the with parental consent. In Vietnam, the Age of Consent most common age followed by eighteen 18 years. to ANC is a matter of practice, while in Malawi and Tanzania the Age of Consent is currently unclear. In France, India, Thailand and Nigeria the HIV test results of minors enjoy the same confidentiality status as the 15. Policy framework and legislation enabling or test results of adults. In other countries young persons disenabling access to HPV vaccines, and cervical will enjoy the same right of confidentiality in respect of cancer screening and treatment, including Age of their HIV status as an adult if the young person was able Consent with and without parental consent. to consent to the test on his/her own behalf (Canada, United Kingdom, South Africa, Swaziland). In Sweden, Zimbabwe, Vietnam, Tanzania, Swaziland, Jamaica, the views of patients 12 years and older are taken into Indonesia, India, and Cote d’Ivoire are countries which account when deciding whether or not to inform the do not have a policy/legal framework in place that parents. enables access to the HPV vaccines, cervical cancer screening or treatment. 18. Please explain any inconsistencies between the answers above. The majority of the countries surveyed offer the HPV vaccine to girls aged somewhere between 9 and 15 Local or assisting counsel in Brazil, Cote d’Ivoire, India, years old, with many tending towards the younger end of Indonesia, Kenya, Malawi, Swaziland, Tanzania, Ukraine, that age-range. The vaccine is most commonly offered and Vietnam noted inconsistencies between certain in schools. Only Botswana, Zambia and Zimbabwe make answers. For example, in some jurisdictions the ages of express provision for girls who do not attend school consent vary depending on the service or treatment (although this does not necessarily mean that girls in accessed by the young person. Also, in some countries other countries could not obtain the vaccine outside of the Age of Consent to sexual intercourse differs from the school). Parental consent is often required to administer age at which contraceptives can be accessed without the HPV vaccine to girls at school although in some parental consent. However, not all counsel viewed this countries the position on consent is unclear. position as an inconsistency.
7 Age of Consent and Person Giving Consent
Age of HIV status Age of Consent Age of consent Access to HPV Age of consent Age of consent for Age of statutory rape Age for young Age for young people Age of consent Age of Consent reporting (Year) Age of Consent Antenatal and Cervical to receive ARV HIV testing without (Years) people to access to access emergency access to PEP access to PrEP for Abortions for sexual (Year) Cancer screening without parent parental consent contraception contraception (Years) (Year) (Year) (Year) Country intercourse (Year) consent (Years) (Year) (Years) (Years)
No age of No age of consent Nigeria 18 Under 18 Illegal Confidentiality consent established
Under 12 intercourse between ages Reports made South Africa 16 13-17 are illegal 12 12 to the person depending on age consented gap
Under 16 Permitted in Confidentiality Swaziland 16 Females Indecent assault 18 12 12 16 16 12 12 limited situation to all Under 18
Decision of the Sweden 15 Under 15 Parent consent No policy 12 physician
Abortions to Tanzania 18 females Under 18 preserve the No law policy 18 mother’s life
Abortions legal Thailand 15 Under 15 to preserve the woman’s life
Sexual intercourse with some who has Ukraine Not established 13 not reached puberty is illegal
10-19 access Vietnam 16 Under 16 10-19 10 16 16 16 abortion services
Abortion Zambia 16 Under 16 Unclear 16 Not clear - 16 16 permitted
Under 12 10 HPV Zimbabwe 16 (age to be raised Unclear - 15 16 16 Cervical 16 16 to 16) cancer screening
Reported to Parent Can Consent Not Applicable No Parental Consent Parental Consent No Age Restriction 8 16 12 parent disclosure to Under 18 results Age of HIV status reporting (Year) 16 18 Under 18 province Varies from province to Contradictory Age of consent for HIV testing without parental consent (Year) No Age Restriction
16 applies applpies majority] Under 18 province Access to treatment treatment Unclear 16 to medical Varies from province to [legal age of Age of consent 12 Age of consent Age of consent to receive ARV without parent consent (Years) 16 18 18 16 9-13 9-13 9-13 No Policy Provincial regulation Access to HPV and Cervical Cancer screening (Year) Parental Consent 21 13 16 No Policy ANC access Guidelines for Age of consent Antenatal (Year) Illegal Illegal Illegal mother Abortion in limited Abortions Permitted permitted permitted the life of Abortion legal circumstances Legal to preserve Age of Consent for Abortions (Year) No Parental Consent 16 18 16 21 Np PrEP Np PrEP Under 18 PrEP prohibited Age of Consent access to PrEP (Year) 21 16 applies Unclear legal age of majority Age of majority Age of consent access to PEP (Year) Not Applicable of rape Unclear medical treatment 10 only in the event 16 Age of consent to Varies from provinces Age for young people young for Age to access emergency contraception (Years) 10 Unclear provinces 21 Age of Varies from consent applies Age for young people to access contraception (Years) Can Consent Under 16 Under 16 Under 16 Under 18 Under 13 Under 16 Under 15 Under 15 Under 14 Under 18 Under 18 Under 16 Age of statutory rape (Years) 21 16 18 16 16 15 15 14 18 18 16 males 16 females nothing set for Age of Consent for sexual intercourse (Years) India Brazil United Kenya France Malawi Canada Jamiaca Kingdom Morocco Botswana Reported to Parent Indonesia Cote de Ivoire Country
9 16 12 parent Key Messages disclosure to Under 18 results Age of HIV status reporting (Year) ● The minimum age to consent to intercourse tends to range between 15 and 18 years old. ● The laws concerning homosexual intercourse can 16 18 differ for women and men. Under 18 province Varies from province to ● Statutory rape in so far as male (rather than female) Contradictory
Age of consent for HIV testing without parental consent (Year) victims are concerned is not always recognised by the law.
● In some countries the rules concerning access to medical care by minors are the same regardless of 16
applies the type of treatment sought while in others the rules applpies majority] Under 18 province Access to treatment treatment Unclear 16 to medical Varies from province to [legal age of differ depending on the treatment. Age of consent 12 Age of consent Age of consent to receive ARV without parent consent (Years) ● In some countries the decision to treat minors without parental consent is left to the discretion of the attending healthcare practitioner subject to certain 16 18 18 16 guidelines. 9-13 9-13 9-13 No Policy Provincial ● Marital status, rather than age, is the key determinant regulation in some countries- for example, in Morocco, sexual Access to HPV and Cervical Cancer screening (Year) relations outside marriage are illegal at any age and access to contraceptives is more difficult for unmarried women. 21 13 16 ● While ART and PEP are usually accounted for in No Policy
ANC access local rules/policy there are usually fewer or no rules Guidelines for
Age of consent Antenatal (Year) concerning PrEP. ● Although there are no age restrictions to access treatments and/or contraceptives in certain jurisdictions, some local counsel have noted that this Illegal Illegal Illegal mother Abortion in limited Abortions Permitted permitted permitted would not prevent institutions from requiring parental the life of Abortion legal circumstances Legal to preserve Age of Consent for Abortions (Year) consent as a matter of policy or practice. ● PrEP in some countries is prohibited as a result of the fact that no drug has been authorised for use in PrEP. ● A number of jurisdictions have noted discrepancies 16 18 16 21
Np PrEP Np PrEP between the Age of Consent to sexual Under 18
PrEP prohibited intercourse and the Age of Consent to access Age of Consent access to PrEP (Year) contraceptives, treatments, ANC and abortion. ● Many African jurisdictions prohibit gay sex. ● Many countries either prohibit abortion or only allow 21 abortions to be performed in limited circumstances. 16 applies Unclear legal age of majority Age of majority Age of consent access to PEP (Year) A number of of rape Unclear jurisdictions medical treatment 10 only in the event 16 Age of consent to Varies from provinces Age for young people young for Age to access emergency contraception (Years) have noted discrepancies
10 ‘‘ Unclear provinces 21 Age of
Varies from between the Age consent applies Age for young people to access contraception (Years) of Consent to sexual intercourse Under 16 Under 16 Under 16 Under 18 Under 13 Under 16 Under 15 Under 15 Under 14 Under 18 Under 18 Under 16 and the Age of Age of statutory rape (Years) Consent to access contraceptives, 21 16 18 16 16 15 15 14 18 18 16 males 16 females nothing set for
Age of Consent for sexual intercourse (Years) treatments, ANC and abortion. India Brazil United Kenya France Malawi Canada Jamiaca Kingdom Morocco Botswana Indonesia Cote de Ivoire Country 10‘‘ The risk of becoming infected with HIV is higher for girls and ‘‘ young women and currently, HIV prevalence among young women
aged 15 - 24 years stands at 4.8%, which is two and a half times higher than among men of the same age. In Swaziland, 15% of young women are HIV positive, compared to 6.5% of young men. ‘‘
11 12 Summary of Country Reports: Alphabetically
i i v i i
1 1 14 1 1 1 15 18 i i i i i i i i i i i i i
2 e ual intercourse e ual intercourse e ual intercourse e ual intercourse e with a person e ual intercourse e ual intercourse i i i with a young person with an individual with persons under with a person under who is under 13 years with a person under with a person under under the age of 1 is younger than fourteen the age of 1 is the age of 1 years is of age amounts to the age of 15 years is the age of 18 years is i illegal, whether they 14 years old is illegal. ista e of age illegal. statutory rape . illegal. illegal. have ostensibly illegal. is not a defence e with a minor consented unless the accused aged 13 15 is illegal if defilement or not too all reasonable the defendant new rape . steps to ascertain the or should have nown age of the the victim was under complainant. 1 .
3 ay se is prohibited o. es, there are close o. In practice, minors of o. e ual intercourse or i and criminalised. in age or peer the same or similar se ual acts by a man 1 group e ceptions. age who engage in with his own wife, the consensual se are wife not being under unli ely to be 15 years of age. prosecuted. ay se is illegal.
4 ontraceptive here are no age he age of consent to In the absence of here are no age ersons under 18 here are no age services are restrictions on access access contraceptives specific rules the age restrictions to access years of age can restrictions on access accessible by to contraceptives so varies from province of consent is 1 years contraceptives that access contraceptive to contraceptives so iv adolescents and parental consent is to province. old. are a form of barrier services without parental consent is vi i i youths , who may be not a legal method. ee the parental consent. not a legal iv as young as 10. hey requirement. response to question requirement. i i do not require 5 for contraceptives i i parental consent. that are a form of i medical treatment. i i
5 es, from the age of here are no age In most provinces in In the absence of he general rule on ersons under 18 here are no age 10, but only in the restrictions on access anada e cept in specific rules the age age of consent to years of age can restrictions on access event of rape, to emergency uebec , the of consent is 1 years medical treatment access emergency to emergency iv defilement or incest. contraceptives so emergency old. applies to doctors contraceptives contraceptives so i hey do not require parental consent is contraceptive pill see question 8 . without parental parental consent is parental consent. not a legal lan B harmacists have consent. not a legal i i i requirement. orning fter ill is similar rules and are requirement. i available without age discouraged from i restrictions. supplying persons under 13.
6 i ational policy he policy framewor he policy framewor egislation refers to linical use of in ecree permits uidelines refer to i i enables access to does not provide and legislation I treatment. young persons is set adolescents 1 years eligibility for . i . restrictions or legal enabling or out in uidelines and older to receive i i requirements to disenabling access to In the absence of which are referred to . here are no age i vi he age of consent is obtain parental varies from specific rules the age by a government restrictions on access the legal age of consent in order to province to province. of consent is 1 years body. he general rule he general rule on to so parental i i ma ority 18 but in administer to a old. on age of consent to age of consent to consent is not a legal i practice, health child or adolescent. medical treatment medical treatment requirement. i authorities would not applies see question applies see question refuse treatment to 8 . 8 . persons under 18 who need it.
13 i i v i i
7 i here is no here is no here is no legal here is no here is no here is no here is no i prohibition on prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . i i i but it can only be administered in i certain i i circumstances. i i
8 i he age of consent is ny individual, at any es, young people In the absence of he age of consent to arental consent is In the absence of an i i i i the legal age of age, is legally entitled can legally access specific rules the age medical treatment is required to medically e press prohibition, i 7 ma ority 18 but in to access . but the position of ma ority applies 1 . owever, parental treat persons under young persons can practice, health concerning access 1 unless the consent is not 18 years of age access facilities authorities would not and parental consent patient is a girl of required to medically unless the health of even in the absence i refuse treatment to varies from province childbearing age. treat persons under the patient is in of parental consent. persons under 18 to province. 1 years of age if the danger. who need it. patient has capacity i i i to consent on his her i own behalf. i
9 uidelines enable n ordinance he drugs underlying o. here are various he law addresses uidelines address i i i access to . contains are on the policy guidelines the ris of . hey do not i i i recommendations on federal rescription enabling access to transmission. It does deal with the age of i hey do not deal with . It does not deal rug ist which in the . not deal with the age consent. i i i the age of consent. with the age of means that can of consent. i consent.. be legally prescribed. iv
10 i here is no here is no re drug here is no legal here is no here is no here is no here is no specific i prohibition on r . approved for prohibition on r . prohibition on r . prohibition on r . prohibition on r . prohibition but the i i i commerciali ation by approval of r by r will be available the Bra ilian heath the rug ontroller i free of charge from authorities. eneral is awaited. i i 01 . herefore, access to i r is very limited. i
11 i he age of consent is ere it offered oung people can In the absence of oung people can o. r is not t the moment it is i i i i the legal age of access to r by legally access r specific rules the age access r sub ect recommended for illegal to provide r i 10 ma ority 18 but in young people would but the rules on age of ma ority applies to the rules persons under 18 to anyone of any age. practice, health li ely be handled of access and 1 unless the mentioned in question years of age. authorities would not similarly as other parental consent vary patient is a girl of 8. owever, r is i refuse treatment to services offered by from province to childbearing age in currently only persons under 18 the to I province. which case she will available via a private who need it. patients e.g. . not require parental prescription. i i i consent. i i
12 es. o. he ingredients used o. o. es, a temporary o. i i i to ma e ruvada are recommendation is in i i i uidelines allow on the federal place until 01 . nly i r to be provided rescription rug ist, persons aged 18 or to high ris which means this older can access i i i populations. form of r can be r . i legally prescribed. iv i
14 Summary of Country Reports: Alphabetically (cont.)
i i v i i
13 bortion is permitted bortions are illegal, bortion is legal. bortion is permitted bortion is permitted bortion is permitted bortion is permitted i by law in limited e cept in very limited by law in very limited by law. by law. by law under certain i circumstances. circumstances. ven he rules on access circumstances. prescribed i i owever, in such limited to abortions with or he rules on consent woman under 18 circumstances. i post abortion care is circumstances, if the without parental In the absence of are the same as years of age must i i provided for in policy mother is under 18 consent vary from specific rules on the those described in the either obtain parental omen under the i guidelines. the consent of her province to province. age of consent the response to question consent or be age of 18 require i legal representatives age of ma ority 1 8. accompanied by an parental consent. i i he legal age of must be obtained. applies. adult of her choice. i ma ority 18 applies i and parental consent is required.
14 i olicy guidelines ccess to is ealthcare is here is no policy or uidelines enable aws e ist enabling here are guidelines state that pregnant assured by law. generally free in law on . access to . access to . governing the i i i adolescents youths anada, which provision of . i i are eligible for o parental consent enables access to he default legal he rules on consent he general rule on ante natal care. is necessary for . position on the age of are the same as the age of consent to here are no age young persons to be consent 1 applies. those described in the medical treatment restrictions to access i i arental consent is assisted with at he rules on the age In practice, however, response to question applies to see so parental i not required to access the Bra ilian nified of consent vary by girls receive 8. question 8 . consent is not a legal i such youth services. ealth ystem. province. without parental requirement. consent. d
15 i ational policy and he vaccine is ederal funding was here is no law or uidelines govern he rench igh o laws or policy are guidelines enable part of the public provided to provinces policy on these topics. the availability of ouncil for ublic in place. i i i access to these 3 immunisation and territories in 00 these services. ealth support the i i services. he program. to support an irls under 15 years use of the here are no age vaccine is offered to vaccination program. old can be given the he rules on consent vaccination. restrictions on access v i girls aged appro irls ages to 15 vaccine at are the same as to these 3 services so vi 13. only require parental he rules on access schools or with the those described in the he general rule on parental consent is i consent when the and parental consent consent of their response to question the age of consent to not a legal i i he legal age of vaccine is provided are determined by parents. 8. medical treatment requirement. i ma ority 18 applies via a school each rovince. applies to see i and parental consent campaign. question 8 . is required.
16 1 . here is contradictory he age of consent to 1 1 18 here are no legal guidance regarding access I testing age restrictions but i i ersons under 1 the age of access to varies from province ersons under 1 he general rule on he general rule on guidelines require parental I testing without to province. require parental age of consent to access to medical recommend obtaining consent to access parental consent. consent to access medical treatment treatment applies to parental consent for I testing. In I testing. applies to persons I testing see persons under 18 practice, persons under 1 years of age question 8 . years of age. under 1 will be see question 8 . tested if they are mature enough.
17 i 1 1 , unless the If a young person can he law allows est results are I test results are I test results are i physician determines consent to medical doctors to report the reported to the confidential for both confidential for both i that i the patient decisions, he or she I status of patients parents of patients minors persons persons under 18 does not understand will be able to obtain who are under 1 under 1 years of age under 1 and adults. years of age and i the severity of his her the test results years to his her if the parents I test results may adults. i situation or ii without the parents parents. consented to the not be disclosed to non disclosure may being made aware of testing on the parents without the i place the patient at the results. patient s behalf. minor s consent. ris .
18 i o inconsistencies he answers to o inconsistencies ee full report. o inconsistencies o inconsistencies ee full report. i i i were noted. question 1 and were noted. were noted. were noted. questions 4 5 are v inconsistent. In regard to questions 1 1 , there is contradictory guidance. ee full report for details.
15 i i i i i i i i
1 15 1 18 1 for females. o e outside of 18 1 1 for females. i age specified for marriage is illegal at i males. any age the legal age o age of consent is i i of marriage is 18. not established for i males. i i i i i i i i
2 e ual intercourse It is illegal for e ual intercourse e ual intercourse ape is the act by e ual intercourse e ual intercourse e ual intercourse i i i with a person under someone aged 1 with a person under with a female under which a man has se with a person under with a person under with a female under the age of 15 years is years or over to have the age of 18 years is the age of 1 years is with a woman against the age of 18 years is the age of 1 years is the age of 1 is i illegal unless the se ual intercourse illegal. defence is illegal. the will of the woman illegal. illegal. e ual illegal. perpetrator did not with a person under available if the minor or with a minor under intercourse between reasonably now that the age of 1 . deceived the accused the age of eighteen persons aged 13 1 Indecent assault the woman was defence is available as to his her age and years, an incapable years may be illegal against someone of underage. to persons under 3 the accused person, a disabled depending on the age any gender under 18 years of age where reasonably believed person, a person gap between the years is illegal. he or she believed the he she was of age. nown to be mentally partners. other person to be wea such over 1 . individuals are considered as incapable of giving consent
3 he main e ceptions ay se between ay se is prohibited ay se is prohibited ay se is prohibited rosecutors may here are rules which ay se is illegal. i are men is prohibited and and criminalised. and criminalised. and criminalised. decline to charge allow persons aged 1 criminalised.. individuals with 1 1 years to he age of consent udge may statutory rape if engage in consensual for gay se is 1 authorise the customary practices se ual intercourse years. marriage of a person provide for an depending on the age under 18. e ception to the gap between the he pair are offence of rape, e.g. partners. married. where adult males marry female children.
4 ncertain. In practice, I here are no age In the absence of any dolescents do not arental consent is here are no age ersons 1 years or ontraceptive contraceptive restrictions on access age restrictions young require parental legally required for restrictions so older can access services devices may services and to contraceptives persons of any age consent but it is persons aged under parental consent is contraceptives be provided to iv commodities become which are not a form may access unclear at what age 18 to access medical not a legal without parental persons under 18 vi i i accessible under of medical treatment contraceptives this applies. treatment, including requirement. consent. ee also without parental iv tate programs to see response to without parental contraceptives. the response to consent. i i young people who are question 5 so consent. ondoms are freely question 5. i i married. parental consent is available in practice i not a legal without parental i i requirement. consent.
5 here are no nown ontraceptives which here are no age nclear. here are no age here are no age ontraceptives that ontraceptive age restrictions so are a form of medical restrictions on access restrictions so restrictions so are not condoms can services devices may parental consent to treatment are sub ect to emergency parental consent is parental consent is be provided to young be provided to iv access emergency to the general rule contraceptives so not a legal not a legal persons 1 years or persons under the i contraceptives i.e., persons aged parental consent is requirement, but in requirement. older without parental age of 18 without appears not to be a under 1 years not a legal practice unmarried consent following parental consent. i i i legal requirement. require parental requirement. women may not be provision of medical i consent to access able to obtain advice and a medical i medical treatment. emergency e am. contraceptives without parental consent.
6 i here is a inistry here are no specific uidelines e ist but uidelines on arental consent is here is no policy e ists to here are no laws or i i egulation provisions concerning they do not specify e ist but they do not legally required for established age of enable access to policies enabling i concerning I access to . the age of consent. specify the age of persons aged under consent. In practice . access to . i i treatment. ccess is sub ect to consent. 18 to access medical healthcare i vi the general rule on arental consent is treatment, including professionals will ccess is determined he age of consent is enerally, persons access to medical required for persons he age of consent to , but this usually as to spea according to the rules 1 unless the young i i under 18 years of age treatment see under 18 years to is unclear but requirement is to the parent of a described in the person does not have i may require parental response to question access medical the legal age of unli ely to be strictly patient who has not response to question sufficient maturity in i consent to access 5 . treatment including ma ority is 1 . applied in practice. reached adolescence. 8. which case it is 18. medical treatment. .
16 Summary of Country Reports: Alphabetically (cont.)
i i i i i i i i
7 i ssisting counsel are here is no here is no here is no here is no here is no here is no here is no i not aware of any law prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . i i i prohibiting in Indonesia. i i i i i
8 i es, sub ect to the es, sub ect to the here is no statutory nclear but the legal arental consent is ee answer to oung persons aged he age of consent is i i i i general rule on general rule on age limit on access to age of ma ority is 1 . legally required for question . 1 1 years can 1 unless the young i 7 access to medical access to medical . he general persons aged under consent to medical person does not have treatment described treatment described policy of requiring 18 to access medical treatment on their sufficient maturity in in relation to question in relation to question parental consent for treatment, including own behalf if they which case it is 18. i . 5. medical treatment of , but this have sufficient persons under 18 requirement is maturity and mental may be applied. unli ely to be strictly capacity. i i i applied in practice. i i
9 here is a o. he law requires the uidelines address he inistry of ealth he ational lan he e ual ffences uidelines enable i i i government decree ministry of health to but they do not authorised in encourages access to ct enables access to access to . hey i i i covering use of issue guidelines on specify the age of 01 , but the . It does not deal . It does not deal do not deal with the i in wor places. It does . he law does consent. authorisation does not with age of consent. with age of consent. age of consent. i i i not deal with the age not deal with age of deal with age of i of consent. consent. consent. iv
10 i ssisting counsel are here is no here is no e press here is no r treatment is not here is no here is no r is not currently i not aware of any law prohibition on r . prohibition on r . prohibition on r . currently authorised prohibition on r . prohibition on r . available in i i i prohibiting I r se is currently being for sale in orocco wa iland. in Indonesia. limited to research but r is i purposes. undergoing clinical i i trials . i i
11 i es, sub ect to the es, sub ect to the ccess to r would nclear but the legal arental consent is ee answer to es. oung persons he age of consent is i i i i general rule on general rule on be determined by the age of ma ority is 1 . legally required for question . aged 1 1 years can 1 unless the young i 10 access to medical access to medical general policy that persons aged under consent to medical personminor does not treatment described treatment described parental consent is 18 to access medical treatment on their have sufficient in relation to question in relation to question required for patients treatment, and this is own behalf if they maturity in which case i . 5. under 18 years of li ely to apply to have sufficient it is 18. age. r , but this maturity and mental requirement is capacity. i i i unli ely to be strictly i applied in practice. i
12 r appears to be o. o, there is no o. ot yet, although a es, it does not deal es, it does not deal o. i i i permitted under a legislation or policy trial of r is with the age of with the age of i i i ealth inistry specifically enabling planned for 01 . consent. consent. i egulation. It does r use. not deal with the age i i i of consent. i iv i
17 i i i i i i i i
13 bortions are bortion is illegal. bortion is illegal bortion is legal if it bortion is illegal bortion is illegal. bortion is permitted bortion is permitted i permitted by law in e cept in limited is performed in order e cept in limited by law. by law in very limited i very limited circumstances. to save the mother s circumstances. circumstances. i i circumstances. he general rule on life. omen under 18 i the age of consent to here the patient is years of age are he age of consent i i here are no nown medical treatment he age of consent to under 18, the advised to consult for lawful abortions is i age restrictions on applies to lawful lawful abortion is physician must their parents but do 18 years. i access to abortions abortions and unclear but the legal attempt to obtain not require parental i i but the patient s persons under 18 age of ma ority is 1 . spousal or parental consent in order to i husband must years require parental consent. obtain an abortion. i consent. consent.
14 i egulations enable here is no policy here is no policy is part of the olicy enables access here is no policy egislation and here is no policy or access to . framewor or framewor or ssential ealthcare to . he general framewor or policy enable access legislation dealing i i i legislation enabling legislation enabling ac age. rule on age of legislation enabling to . with . i i here are no nown access to . access to . consent to medical access to . here restrictions on the he age of consent is treatment applies are no legal age lease see the he age of consent is provision of to In practice, is he general rule on unclear but the legal see question 4 . restrictions but in response to question 1 years. i i unmarried women, or provided regardless the age of consent to age of ma ority is 1 . practice healthcare 8 for the rules on i to women of a certain of the mother s age medical treatment provides may request access to medical i age. and without parental applies to . parental consent. treatment by persons consent. under 18 years.
15 i here are no nown o laws or policy are policy framewor for n vaccination olicy enables access he ational lan o laws or policies o laws or policies laws or policy in in place. the vaccine and programme was to vaccination encourages access to e ist apart from a e ist. i i i place. cancer screening is in introduced in 013 for and cervical cancer vaccines. It does government i i he general rule on place for girls 13 13 year olds. screening. he not deal with the age vaccination program he age of consent is he general rule on consent to medical years of age but it is vaccine is available to of consent. for girls in schools. 1 years. v i consent to medical treatment described unclear as to whether he position on girls aged and over. vi treatment described in relation to question parental consent is consent is unclear. he general rule on here are no age he general rule on i in relation to question 5 applies. required. age of consent to restrictions so access to medical i i applies. medical treatment parental consent is treatment applies i applies see question not a legal see response to i 4 . requirement. question 8 .
16 18 1 18 years unless arental consent is egally, parental here are no age 1 1 years old provided certain e ceptions not required for consent is required restrictions so oung persons 1 the young person can i i ersons under 18 ersons under 1 apply in which case persons aged 13 for unmarried persons parental consent is years or older can demonstrate may require parental require parental the patient can years or older and aged under 18. not a legal consent on their own competence. consent to access consent as per the consent him herself. those younger than owever, I testing requirement. In behalf. ounger I testing. general rule on the 13 years who have is available without practice the attending children can be tested age of consent to sufficient maturity. proof of age. professional may without parental medical treatment require parental consent if they have see question 5 . consent. sufficient maturity.
17 i he test results of he test results of est results are he test results of he test results of hildren and I test results are person under 18 i persons under 18 persons under 1 are released to the persons aged 1 persons nown to be adolescents are reported to the person years of age who has i years of age may be reported to his her parents unless the years or younger will under 18 will be entitled to the same who consented to the capacity to consent disclosed to his her parents. young person directly be disclosed to the reported to their legal level of confidentiality testing. has the same rights to i parents. consented to the parents. representative. as adults. confidentiality as an i testing. adult. i
18 i ee full report. o inconsistencies ee full report. ee full report. o inconsistencies o inconsistencies o inconsistencies here are i i i were noted. were noted. were noted. were noted. discrepancies in the age of consent for v different activities. ee full report for details.
18 Summary of Country Reports: Alphabetically (cont.)
i i i i i i i
1 15 18 for females 15 he age of consent is 1 1 1 i not clearly i no age specified for established. It is not i i males younger than 1 and i not older than 18. i i i i i i i i
2 e ual intercourse e ual intercourse e ual intercourse e ual intercourse e ual intercourse e ual intercourse e ual intercourse i i i with a person under with a woman under with a person under with a person who with a person under with a person under with a person under the age of 15 years is the age of 18 years is the age of 15 years is has not attained the age of 1 years is the age of 1 years is the age of 1 years is i illegal. illegal. illegal. puberty is illegal. illegal. illegal. defence is illegal the age will be ggravated available if the raised to 1 . punishments e ist for accused had urrently those aged rape of minors aged reasonable cause to 1 14 years can 14 1 and infants believe, and did in consent to se if aged 13 or under . fact believe, that the capable of doing so. child was aged 1 or over.
3 n e ception e ists if man may have Illegal but not o. o. o e press ay se between i the circumstances in se ual intercourse punishable if the girl e ception e ists. men is illegal. nly 1 which the se ual act with a female aged is aged 13 14, owever, an men aged over 14 too place indicate 15 1 years if she is provides her consent, e ception would e ist can be charged with that the minor was not his wife. and the court allows if the couple are the offence. abused e.g., only a the couple to marry. married under slight age difference. ale gay se is customary law. criminalised. ay se is criminalised.
4 here are no age here are no age here are no age here are no age ersons aged 10 to here are no age ontraceptives that restrictions so restrictions so restrictions so restrictions on 1 years are entitled restrictions so are a form of barrier parental consent is parental consent is parental consent is contraceptives apart to access parental consent is method are available iv not a legal not a legal not a legal from those which contraceptive not a legal to persons of any age vi i i requirement. requirement. requirement. involve receipt of services, including requirement, although without parental iv medical treatment for contraceptive in practice parental consent. ee also i i which persons aged commodities and are consent may be the response to i i 13 years or younger li ely to be able to do required for persons question 5. i require parental so without parental under 1 . i i consent. consent.
5 here are no age here are no age here are no age ersons under 14 ersons 10 years of here are no age ontraceptives that restrictions so restrictions so restrictions so years of age require age or older are li ely restrictions but are a form of parental consent is parental consent is parental consent is parental consent. to be able to access parental consent may medication such as iv not a legal not a legal not a legal emergency be required for those emergency i requirement. requirement. requirement. contraceptives under 1 years. contraceptives can without parental only be provided to i i i consent. persons under 1 i years of age with i parental consent.
6 i here is a olicy and legislation guidelines enable is provided egislation facilitates he age of consent is uidelines provide for i i ecommendation on provides for the access to . according to the access to . unclear but is li ely to the treatment of i access to . provision of . clinical protocols be the same as for children but they do i i here are no age approved by the here are no age I testing i.e. 1 not mention the age i vi he decision to treat here are no age restrictions on access inistry of ealth restrictions on access years see response of consent. herefore, a young person restrictions so to so parental to so parental to question 1 . the age of 1 applies. i i without parental parental consent is consent is not a legal oung persons 13 consent is not a legal i consent is a udgment not a legal requirement. years old or younger requirement.. i call for the attending requirement. require parental physician. consent.
19 i i i i i i i
7 i here is no here is no here is no here is no here is no here is no can only be i prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . prohibition on . administered in i i i specific circumstances. i i i i i
8 i he decision to treat here are no age oung persons of any ersons 13 years or here are no age he age of consent is Individuals below 1 i i i i a person under the restrictions so age can receive younger would restrictions so unclear but is li ely to years of age would i 7 age of 18 without parental consent is without parental require parental parental consent is be the same as for require parental parental consent is a not a legal consent. consent. not a legal I testing i.e. 1 consent to access udgment call for the requirement. requirement. years see response . i attending physician. to question 1 . i i i i i
9 reatment policies egislation e ists o. he law and egislation enables o. here are guidelines i i i enable access to which enables access regulations specify access to . It but they do not i i i . hey do not to by healthcare eligibility to receive does not specify the specify the age of i deal with the age of practitioners. . hey do not age of consent. consent to access i i i consent. deal with the age of . i consent. iv
10 i lthough there is no here is no here is no here is no here is no here is no here is no i legal instrument prohibition on r . prohibition on r . prohibition on r . prohibition on r . prohibition on r . prohibition on r . i i i prohibiting r , access to r is i effectively limited. i i i i
11 i he decision to treat here are no legal here is no age es. ersons 13 here are no age nclear. nclear. elevant i i i i a person under 18 age restrictions so restriction on years or younger restrictions so discussions suggest i 10 years of age without parental consent is accessing r so would require parental consent is that r would be parental consent is a not a legal parental consent is parental consent. not a legal offered to women as udgment call for the requirement. not a legal requirement. young as 15 but there i attending physician. requirement. is no mention of parental consent. i i i i i
12 o. o. o. o. o. o. o. i i i i i i i i i i i iv i
20 Summary of Country Reports: Alphabetically (cont.)
i i i i i i i
13 egislation enables nly abortions which nly abortions which bortions are bortions are bortion is permitted bortion is only i access to abortions are performed to are performed to permitted by law. permitted by law. by law in certain permitted by law in i with no age preserve the mother s preserve the mother s bortions can be ersons aged 10 to circumstances. very limited i i restrictions. life are legal. life are legal. performed on women 1 year have the right circumstances. i 13 years or younger to access he age of consent to i i he decision to treat he applicable age of here is no age of only with the consent reproductive health a lawful abortion is ersons under 1 i a person under 18 consent to a lawful consent specified in of her legal services and ta e not specified but is years of age would i years of age without abortion is unclear. law. representatives. responsibility for their li ely to be 1 years. require parental i i parental consent is own decisions in this consent to obtain a i the decision of the regard. lawful abortion. i attending physician.
14 i ealthcare is is accounted for is covered by ccess to is ecision provides here is no here is no generally free in in the policy to reduce the national scheme. regulated by law. guidelines on access legislation or policy legislation or policy i i i weden, which maternal deaths. It to . enabling access to enabling access to i i enables access to does not deal with the here are no age irls 14 years or older . . . age of consent. restrictions on access can receive . he age of consent is to so parental irls 13 years or a matter of practice. he age of consent is he age of consent is i i he decision to treat he applicable age of consent is not a legal younger can receive li ely to be 1 years. 1 . i a person under 18 consent is unclear. requirement. if there are i years of age without medical indications parental consent is and their parents the decision of the have consented. attending physician.
15 i he vaccine is o laws or policies ecommendations inistry of ealth o laws or policies here are guidelines o codified policy is offered to girls aged e ist. set out in policy egulations enable regulate these on the vaccine. in place. i i i 11 1 through the encourage the use of access to these activities specifically. irls aged 10 are i i school health system. he applicable age of immunisation. treatments. offered vaccines via he age of consent arental consent is consent is unclear. he age of consent school. utside for the vaccine is v i required to receive here are no age or the vaccination of would be a matter of school girls aged 10 10 years policy . vi the vaccine at school. restrictions to access adolescents under 18 practice. years can access the i ee question 14 for the vaccine so parental consent is vaccines. arental he age of consent i i the rules on the age parental consent is required. consent is li ely for cervical screening i of consent applicable not a legal needed. is 1 . i outside the school requirement. setting.
16 18 1 person at any age 14 1 1 1 can access I i i he decision to treat ersons under 1 testing without I testing is ersons under 1 ersons under 1 n individual younger a person under 18 require parental parental consent. available for require parental require parental than 1 does not years of age without consent to access individuals aged 14 consent to access consent to access require parental parental consent is I testing. years or above I testing. I testing, e cept in consent if he she is the decision of the without parental the case of married, considered to be a attending physician. consent. pregnant or mature minor . parent children.
17 i he views of young 18 If a person under 18 In the event that a 1 nclear but li ely to est results will be i persons 1 years and years of age does not person aged 13 or be the same as the reported directly to i older are ta en into understand the under is found to be age of consent for the patient from the account as to whether process of testing, the I positive, the testing 1 years . age of 1 , or on i the parents are test results will be medical staff who assessment of i informed. he more reported to the parent tested the young maturity by the health mature the young or guardian. person must inform service provider if the i person the more his or her parents. individual is below the influence it should age of 1 . have over the decision.
18 i o inconsistencies ee full report. o inconsistencies here is an he law is silent on o inconsistencies o inconsistencies i i i were noted. were noted. inconsistency the age of consent for were noted. were noted. between the age of some matters e.g. v consent to an , , r , and vaccination and the , but not for I age of consent for testing. ee full report access to medical for details. treatment in general.
21 22 Several global bodies, are currently undertaking a number of initiatives ‘‘ to change the global guidelines with regard to adolescent access to a range of HIV prevention services, including Age of Consent and informed consent, confidentiality, availability, accessibility and acceptability. Adherence and quality must inform these services. ‘‘
23 24 www.satregional.org
@SATregional
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To download reports visit www.satregional.org/age-of-consent
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