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INTERNATIONAL PACT ON CIVIL AND POLITICAL RIGHTS 

WOMEN’S RIGHTS IN EL SALVADOR: AN ALTERNATIVE REPORT 

JULY 2003 

EDITORIAL STAFF

Yolanda Guirola (CEMUJER, CLADEM LIAISON)

Alma Benitez Molina (Instituto de Estudios Jurídicos de El Salvador, (IEJES) (Salvadorian Institute of Juridical Studies) 

America Romualdo (Comité 25 de Noviembre)

Latin American and Caribbean Committee for the Defense of Women’s Rights (CLADEM)  

Instituto de Estudios de la Mujer “Norma Virginia Guirola de Herrera”, CEMUJER (Institute of Women’s Studies, CEMUJER) 

Instituto de Estudios Jurídicos de El Salvador, IEJES (Salvadorian Institute of Juridical Studies) 

Organización de Mujeres por la Paz, ORMUSA (Women’s Organization for Peace) 

Comité 25 de Noviembre 

Fundación para el Desarrollo (FUNDE) (Foundation for Development)
 

TABLE OF CONTENTS 

         I.     INTRODUCTION

    II. EXECUTIVE SUMMARY OF THE MAIN POINTS OF CONCERN

III. WOMEN’S RIGHTS IN EL SALVADOR: A VIEW AS OF THE NORMS ESTABLISHED IN THE PACT ON CIVIL AND POLITICAL  RIGHTS

A.          The Right to Reproductive Health and Family Planning. The Right to Abortion (Articles 3, 6, 23 and 26 of the Pact on Civil and Political Rights [PCPR])

1.      Access to reproductive health services

2.      Family planning

3.      Reproductive health in adolescents

4.      Abortion

5.      HIV/AIDS and sexually transmitted diseases (STDs)  

B.          Violence against women (Articles 3, 6, and 7 of the PCPR)

1.      Sexual violence

2.      Domestic violence

3.      Sexual harassment 

C.          Family Relationships: Rights and Obligations of the Spouses (Articles 23, 24 and 26 of the PCPR)

1.      Marital and non-marital unions

2.      Marriages of minors

3.      Divorce and custody

4.      Equality of rights and duties 

D.          The Right to Education (Articles 2, 3, 19, 24 and 26 of the PCPR) 

E.          Economic and Social Rights

1.          The right to property and inheritance

2.          Labor laws 

    IV.     Recommendations

         I.                   INTRODUCTION

The International Pact on Civil and Political Rights establishes the commitment to:

“… respect and guarantee to all individuals in the territory and that are subject to its jurisdiction, the rights acknowledged in the present Pact, without any distinction regarding color, race, sex, language, religion, political opinion or of any other type, national or social origin, economic position, birth or any other social condition” (Article 2.1).

Bearing in mind the principle of equality referred to in the States’ commitments, we have elaborated the present document that focuses on women’s fundamental rights, such as the reproductive rights.

We have tried to develop each aspect, pointing out the legal situation, the policies and practices utilized in detriment of the rights of a substantive part of the Salvadorian society, as well as indicating the existing voids and discrimination exerted when the actions aimed at overcoming these are not implemented.

The discriminatory practices against women have not been overcome; sexual rape, family violence, sexual harassment, maternal deaths and lack of public policies aimed at eradicating patriarchal culture still persist.  In this report several recommendations are made, with the object that the State implement actions in order to provide a solution for women’s needs.

All the rights we have chosen are closely related to life (Article 6), dignity (Article 7), equality (Article 26), non-discrimination (Article 2), family protection (Article 23), social and State protection (Article 24), dignified treatment (Article 8), and equal rights (Article 3).  We expect the State, upon complying with the commitments assumed, will begin a new path of respect, protection and guarantee of women’s human rights acknowledged in the International Pact on Civil and Political Rights.

The following persons have participated in the elaboration of this Report: Yolanda Guirola, member of CEMUJER, a CLADEM liaison; Alma Benitez, IEJES; América Romualdo of the November 25 Committee; with the cooperation of Janeth Urquía, ORMUSA and Eugenia Ochoa, FUNDE.

San Salvador, July 2003

    II.                   EXECUTIVE SUMMARY OF THE MAIN POINTS OF CONCERN

+  Access to sexual and reproductive health services

Women’s health is still being viewed from the maternal/child standpoint, not recognizing them as individual subjects of rights beyond their reproductive capabilities.  There are difficulties in accessing first-level services and even more so specialized medicine services.  The resources are concentrated in the urban area, leaving unattended vast rural zones.

Since 1999 there is a project in the Legislative Assembly regarding a Health Code that encompasses norms related to the sexual and reproductive rights.  It is necessary that the Salvadorian Institute for Women’s Development, ISDEMU, through its Inter-Institutional Commission, in charge of reviewing the legislation, boost the updating process of said project.

The rendering of family planning services must be backed up by an adequate advisory service that includes a process of information and consultation with the persons requesting the service and the supplier.

There are no policies directed at teachers, health staff, or public officers, aimed at their self-knowledge and self-study, which is indispensable in order to grasp and comprehend their own sexuality, which will allow them to isolate their myths and the false concepts of human sexuality, in such a way that they may better understand the attitudes and conducts of the other persons.

+    Reproductive Health in Adolescents

In El Salvador, the increase of adolescents’ pregnancies is alarming.  In the first five months of 2002, the National Maternity Hospital reported 194 births in the 10-14 years old range and 3,985 in the 15-19 years old range.  The implementation of a ongoing dissemination policy on a national scale on the norms established by the Ministry of Health, involving the educational, health, and judicial systems as well as the mass media, since the beliefs based on taboos, prejudices and religious concepts still persist, and these do not contribute to preventing pregnancies, sexually transmitted diseases (STDs) or HIV/AIDS.

+    Abortion

Penalization of abortion leads to clandestine practices, with the result of thousands of deaths due to the unhealthy conditions, malpractice, deficient post-abortion attention, among others, since women tend to avoid the national hospitals for fear of being denounced by the healthcare providers, who are forced to inform the authorities about the cases of induced abortion, ignoring the right to professional reserve, contravening on the one hand the right to intimacy referred to in Article 17 of the PCPR and on the other, Article 7, by not going to timely treatment, for fear of punishment, interrogations and maltreatment.

The State must approve sexual and reproductive health preventive policies, revise the norms contemplated in the Penal Code, perform serious studies on maternal mortality caused by unsafe abortions, and perform consultations to the health professionals, which will allow it to obtain technical diagnosis on the consequences of penalization of abortion in the lives of women.

+    HIV/AIDS

The gradual increase of infections due to the human immunodeficiency virus is alarming in the country.  The annual incidence has been increasing, especially during the last five years.  The AIDS cases in the 12 to 18 age range reflect a real danger for the adolescent population, highlighting the low efficacy of the prevention measures that are being performed to maintain the population informed about the risks of exercising sexuality under unsafe conditions.

AIDS deaths constitute the tenth cause of hospital death in the general total, and the second one among men and women in the 20 to 59 age range, estimating that for 2005 the number of persons with HIV shall be 62,906 and for 2010, 81,904.

There are several factors that influence the increase in the epidemic: the lack of permanent State policies that translate into nationwide actions, with the participation of different actors, such as the mass media through which messages are sent to the population; local activities in which the municipal authorities, the National Police, the Justice Tribunals, the Attorney General and the community participate; maintenance of ongoing campaigns for the distribution of birth control material to vulnerable groups, preceded by information lectures; revision of the contents of educational programs at all levels so that these issues are included as mandatory matters.  The absence of these and other measures only contributes to the expansion of the epidemic and the increase of the mortality rates in the country.

+    Sexual Harassment

In the last few years, sexual harassment has constituted one of the offenses that go unpunished, due to the fact that it involves persons with a high level of authority, who use their power to lessen the merit of the denouncements interposed by the victims in court.

The procedures imposed at the justice tribunals for this type of offenses put the blame on the object of the offense, and she has to prove her morality, exposing her private life to investigation and being subject to all sorts of interrogations.

The consequences of sexual harassment in the lives of women are so serious that they not only affect their homes, but the education, work, justice and health systems, etc. as well.

It is necessary to perform a review of the labor legislation to introduce the figure of sexual harassment within the prohibitions.  Also, develop ongoing campaigns through the mass media; revise the study programs to incorporate in all educational levels, modules on the causes and consequences of harassment, instruct the justice administrators on the magnitude of a sexual harassment deed, so that they may change their point of view.  Incorporate into the ISDEMU actions, the prevention against sexual harassment.

III.                       WOMEN’S RIGHTS IN EL SALVADOR: A VIEW AS OF THE NORMS ESTABLISHED IN THE PACT ON CIVIL AND POLITICAL RIGHTS

A.         The Right to Reproductive Health and Family Planning. The Right to Abortion.

(Articles 3, 6, 23 y 26 of the PCPR)

1.         Access to reproductive health services and family planning.

Laws and Public Policies

The Constitution of El Salvador contemplates in its Article 65 that health is a public good, assigning to the State and to all persons the obligation of seeing to its conservation and reestablishment.  Likewise, it establishes that it shall be the State who shall determine the national health policy, controlling and overseeing its application. [1]

The Health Code contemplates, as basic action of the Ministry of Health, the education for health, which will have as purpose to develop the habits, customs and attitudes of the community in the health field.  It must also promote the social well-being of the community without distinction of creeds or ideology.  It acknowledges as the State’s unavoidable obligation: promote, protect and recover the mother’s and child’s health, by all means available to it, for which the corresponding health organisms shall render preventive and curative attention to the mother during pregnancy, childbirth or puerperium, the same to the child since conception until the end of schooling.  It points out that the Ministry must promote and perform in the establishments or facilities, programs of immunization and control of transmittable diseases, hygiene education, and treatment and prevention of venereal diseases.  The health authorities may order or perform directly, with a mandatory nature, the periodic practice of collective health examinations, regarding certain groups, classes, sectors of the population or individuals in case of epidemics or in populations under special risk.

The Ministry shall give preventive treatment to the population to prevent dissemination of transmittable diseases and everybody is obliged to undergo such treatment.[2]

The National Reproductive Health Plan 1999-2003, defines Reproductive Health as: “the complete state of physical, mental, and social well-being of the Salvadorian population and not only the absence of illnesses related to the reproductive system, its functions and processes” including “the capability of enjoying a satisfactory and without risks sexual life; and of procreating with the freedom of doing it or not, when and how frequently”.[3]

In 1999 the “Reproductive Health Technical Manual” is published, elaborated by the Ministry of Health’s Integral Health Bureau, with the expectations that the health services offered to the women and newborns of the present and future generations are to be integral, with an enhanced quality and warmth, with the purpose of contributing to the well-being of the Salvadorian people, facilitating the efforts towards productive transformation with equality.[4]

Reference is made to breast and cervical/uterine cancer, which constitute major causes of maternal deaths, therefore it is believed that information and service-rendering actions are necessary, with a view to prevent these cancers, as well as early diagnosis and timely referrals.  These actions tend to decrease women’s morbid mortality.

The Manual focuses on reproductive health as an option of the persons to have a responsible and satisfactory sex life, to be capable of reproducing themselves and the freedom to decide when and how often to do it. Implicit is the right of men and women to be informed and to have access to safe, effective, affordable, acceptable and of their choice family planning methods.

Family Planning is considered in the Manual as a human right that all persons can demand, constituting a duty of the State to provide same.  Likewise, it is the means that enables a country to adapt the growth of its population to the resources it possesses, in order to provide it with an adequate quality of life.

In that same year of 1999, the Norms Manual of Family Planning was made official, with the purpose of developing integrated actions aimed at the entire population, with the object of contributing to enhance their health and living standards, by means of a inter-institutional, inter-sector and inter-agency effort, which would ensure quality attention to the population in matters of reproductive health.[5]

In the year 2001, the First National Forum for the Promotion of Health was held, consisting in a “Consultation for the Construction of the Health Policy’s Promotion”, with the purpose of obtaining the point of view that the different actors of the Salvadorian society have regarding the promotion of health.  The policy must be based on the agreements assumed at the Fifth Health Promotion World Conference, held in Mexico in June 2000: to promote social responsibility in Health; enhance the capabilities of the community and empower the individual; increase investment in development and Health; ensure the infrastructure for the promotion of Health; strengthen the base of evidence in the promotion of Health; and reorient the Health systems and services.[6]

In that same year, the Ministry of Health made official the document “National Technical Directive for the attention of Women during pregnancy, birth, puerperium and of the new born”.  This Technical Directive shall guide the rendering of services by the healthcare providers in the different limits and levels, as well as by the institutions responsible for the formation of human resources and by those organizations or institutions committed to women’s and the newborn’s health.  It is intended to unify the promotion and education criteria in Health with the rendering of integral services, taking as base the primary attention in Health in order to favor safe motherhood and the newborn.[7]

In the year 2000 the Ministry of Health enacted the document “Technical Normative for the Prevention and Control of Cervical/Uterine Cancer”, as a technical tool that prioritizes the prevention and timely handling process of the pre-invasive injuries of the cervix.[8]

Reality of the Country

The political, economic and social situation that the country is undergoing, in which an economic model that proposes cutting social expenditures prevails, generates a situation that hits hard the precarious existing economy and negatively impacts in health, especially of girls and women.

Women’s health continues to be conceptualized from the maternal/child binomial, not acknowledging them as individual subjects, beyond their reproductive capabilities, constituting the population group with higher risks, together with the rural population and that in situation of poverty.  There is difficulty in accessing first-level attention services and more so the services of specialized medicine of the second and third levels.  The resources are concentrated in the urban area, leaving unattended vast rural zones.

The National Women’s Policy, approved in 1997, highlights in Strategic Objective 3.3, the State’s commitment to “promote the attention of women’s sexual and reproductive health, her sexual and reproductive rights and the risk practices that affect her health, applying the gender approach”.  The Ministry of Health is the State entity in charge of the application of the health norms.[9]  Since 1999 there is a project in the Legislative Assembly regarding a new Health Code, which contemplates norms related to sexual and reproductive rights.  It would be RECOMMENDABLE that ISDEMU, together with the Ministry of Health, boosted a process of revision and updating of the proposal, presenting the results to the Health Commission of the Legislative Assembly, for its study and subsequent judgment, prior to the discussion in the Legislative Assembly.

The rendering of family planning services must be based on an adequate advisory service that includes a process of information and consultation with the partner and the provider of family planning services.  However, there are no policies directed at educators, health staff, male and female public officers, aimed at their own self-knowledge and self-study, which is indispensable to acknowledge and comprehend their own sexuality, which will allow them to isolate their myths and false concepts of the human sexuality, so as to enable them to better understand the attitudes and conducts of the other persons.

The use of birth control methods varies: the last Family Health National Survey, FESAL 1998, indicates that of the total of fertile women aged 15 to 44, 38% uses a birth control method, being 59.7% married; 33.9% are separated, in non-marital unions and under 25 years of age.  Nevertheless, in women aged 40 to 44, sterilization is the most widely used method.[10]

The Ministry of Health provides birth control methods to 68.0% of the population with no formal education and to 62.6% of women from the low social/economic stratus. On the other hand, the Salvadorian Demographic Association provides the services to 18% of women with less than 7 years of schooling and to 19% of low social/economic stratus.  This indicates that the utilization rate of birth control methods in the rural area is minimal, therefore the implementation of a widely-disseminated policy on reproductive health and the ongoing and free distribution of birth control methods are RECOMMENDED.

Regarding the maternal mortality rate, great differences have been found in the statistical data, stating the profound inequalities that are showing up: the FNUAP points out 300 out of 100,000 girls and boys born alive; Ministry of Health, 62 for every 100,000; National Health Survey, FESAL 98, 120 out of 100,000.  The institutional maternal mortality for the year 2000 was reflected in relation to the social/economic level: in the Department of San Salvador, where the capital of the country is, it was 33.6% with a rate of 31.3% of the total population and a public investment of 32.6%; in the Department of Cuscatlán, it was 123.0% counting with a population rate of 3.3% and with 0.4% of the public investment.[11]

The mortality due to cancer in women, in San Salvador’s metropolitan area, between 1997 and 2000 was focused in the uterus neck in 2,002 women, of which in 1998, 524 died of mammary cancer, that figure increasing to 616 in the year 2000.[12]

One of the most effective methods for the early detection of cervical/uterine cancer is the Papanicolau test.  However, social/economic factors influence the treatment for dysplasias, making access to the service difficult, especially for women of the rural zones.[13]

2.         Family Planning

Laws and Public Policy

Family planning as a program is initiated in El Salvador in 1962, year in which the Salvadorian Demographic Association (SDA) was founded.  In 1970 the Ministry of Public Health and Social Assistance (MPHSA), starts the family planning program and establishes the corresponding norms.  Furthermore, the Salvadorian Social Security Institute (SSSI), incorporates the attention centers, starting the sterilization programs.  In 1974, the norms of the surgical feminine sterilization were reviewed and uniformed, acknowledging the right of women to decide upon them, without the need for the consent of the husband or partner.  The last review and updating was done in 1999 “with the purpose of granting a quality attention and facilitating access in the utilization of the different methods of family planning.”[14]

In that year the Manual “NORMS OF FAMILY PLANNING”, which includes the legal framework that supports the norm, the necessary advice for the use of the methods, the description of each one of the available methods most used in the country, natural methods, emergency birth control and the use of birth control methods in adolescence.

It is established that the norms must be applied in all the health services of the country, that depend both of the government institutions as well as the non-government ones, and in the private exercise, indicating the need to disseminate it broadly, train appropriately the staff that uses them and the updating and standardization of the institutions’ and suppliers’ practices.

Reality of the Country

In spite of having acknowledged that health, justice and equality for women are goals per se, and that it is necessary to promote equality between the sexes and the rights of women, as well as ensuring that it is she who controls her own fecundity,[15] the high rate of births in the country continues being the main cause of the population’s accelerated growth, affecting the social development and economic planning and therefore the individual, family and social well-being.

The Salvadorian Institute for Women’s Development, ISDEMU, which sets women’s national policy’s guidelines, acknowledges that “it is a basic right of all couples and individuals to decide freely and responsibly on the number of children and the spacing of the births, as well as to have available the information and the means for this, plus the right to reach the highest possible level of sexual and reproductive health”[16]

However, in the publication “Logros 2002” (Achievements 2002), no mention is made about Area Nº 3, HEALTH, which Specific Objective is: “To foster access and improve women’s integral health conditions, based on the promotion, prevention, cure, recovery and rehabilitation, according to the needs established by the different stages of their vital cycle, with the purpose of enhancing their quality of life”.[17]

In El Salvador, the institutions responsible for the Family Planning Program are: the Ministry of Public Health and Social Assistance, which comprises 47.1% of the services nationwide; the Salvadorian Institute of Social Security, with an 18.2% in the urban area and the Salvadorian Demographic Association, with a 15.5% in the rural area.

The Ministry of Health provides birth control methods to 68.0% of the population with no formal education and to 62.6% of women from the low social/economic stratus. On the other hand, the Salvadorian Demographic Association provides the services to 18% of women with less than 7 years of schooling and to 19% of low social/economic stratus.  This indicates that the utilization rate of birth control methods in the rural area is minimal, something that can be attributed to the lack of a dissemination policy on reproductive health and to the lack of resources to access such methods.

The last Family Health National Survey, FESAL 1998, indicates that of the total of fertile women aged 15 to 44, 38% uses a birth control method, being 59.7% married; 33.9% are separated, and in non-marital unions or divorced and 12.9% are single.  As of 1998, the prevalence towards the temporary methods was greater among married women, in non-marital unions and under 25 years old.  Nevertheless, in women aged 40 to 44, sterilization is the most widely used method.

The persons in charge of the family planning services do not relate the aspects linked to sexual behavior for pleasure with the teaching and offer of birth control methods to control reproduction.  The latter are provided without the required orientation on enjoyment and sexual responsibility.

3.         Reproductive Health in adolescents

Reality of the Country

In El Salvador, the increase of adolescents’ pregnancies is alarming. The Ministry of Health reported that in 1999, 26,240 hospital births were reported in the range of 10-19; in the year 2000 there was a decrease to 23,217 and in the year 2001 22,090 were reported. It is in the 10-14 years old range that the frequency varies, since out of 945 births registered in 1999, these increased in 2001 to 1,088. In the first five months of 2002, the National Maternity Hospital reported 194 births in the 10-14 age range and 3,985 in the 15-19 age range.[19]

The Family Health National Survey, FESAL 98, indicates that the adolescent fecundity rate is 87 x 100,000 for the urban zone and 150 x 100,000 for the rural zone, informing that 75.8% of said population has access to sexual education.  However, from the official data we can gather that it is RECOMMENDABLE to implement a nationwide dissemination policy on the norms established by the Ministry of Health, since the beliefs based on taboos, prejudices and religious concepts that do not contribute to the prevention of pregnancies, sexually transmitted diseases (STDs) or HIV/AIDS, persist.

Indicators of the Adolescent Women’s Attention Program of the Ministry of Health registered for the period comprised between January and March 1999, 1,830 induced abortions, having attended institutionally 2,701 abortions in 2001.

One of the main problems in determining the number of maternal deaths in the abortion cases is due to sub-reporting, since the causes of death are reported, in many cases, on the basis of diagnoses that do not reflect the reality of the situation, hence the need to RECOMMEND to the Ministry of Health, the design and implementation of mechanical and/or electronic instruments that make it possible to keep a more effective registry.

4.         Abortion

Reality of the Country

Abortion is added to the reality of fecundity, maternal mortality and contraception.  In the Salvadorian society there are very few spaces where one can openly approach its causes and consequences, with the purpose of seeking viable alternatives from the reproductive rights standpoint.

Penalization of abortion impedes knowing the accurate, real figures, and we only have the registers kept by the hospitals.  In the first semester of 1999, 3,766 hospitalizations due to induced abortions had been registered, something that can only be taken as an indication of the prevalence of abortion, since the figures are not precise and do not contribute to give an accurate idea of the magnitude of the problem.[22]

The most objective source of information on abortion is the Ministry of Health, which for the year 2000 registered 7,423 cases and for 2001, 6,858 abortion cases.  This data does not specify the induced abortions, yet it does establish the number of abortions registered by the national system.  The Integral Attention to Women Bureau of the Ministry of Health refers that the proportion of abortion vis-à-vis institutional births is 10% nationwide.

In the year 2000, the Offenses against Women and Minors Unit of the Attorney General’s Office received 2,512 denouncements of rape, as a consequence of which 1.39% of these were abortions, 25.46% of the victims were under 15 years of age, and 94.5% took place in the rural zones.

Due to the complications that arise from a badly-done abortion, and taking into consideration penalization, women tend to avoid going to hospitals for fear of being denounced, since the providers of health services are obligated to inform the authorities about the cases in which alleged induced abortions have occurred, thus violating professional confidentiality, contravening, on the one hand, the right to intimacy, set forth in Article 17 of the Pact on Civil and Political Rights (PCPR), by intervening in women’s decision and on the other hand, Article 7 of the PCPR, by not seeking timely treatment, due to fear of punishment, interrogations and maltreatment.

It is difficult to establish an approximate index of the real magnitude of the problem: if it is provoked, it will be in clandestine conditions; therefore it will only be acknowledged by the health system if complications develop.

The data provided confirms the need to RECOMMEND the State institutions in charge of women’s health to review the dispositions that penalize abortion.

5.         HIV/AIDS and Sexually Transmitted Diseases (STDs)

Reality of the Country

The first case of infection caused by the human immunodeficiency virus was notified in 1984, having observed a progressive increase in the epidemic.  Up until December 2002, 5,487 cases had been officially registered, with a ratio of 19.1 x 100,000 inhabitants; the annual incidence has been increasing, especially during the last five years.[24]

Out of a total of 222 cases of HIV (+) in adolescents aged 12 to 18; the female sex represented 62% and the male sex 38%.  Regarding the AIDS cases in the same age ranges, out of a total of 120 cases, the female sex represented 46% and the male sex 54%,[25] thus constituting a real hazard for the adolescent population, pointing out the reduced efficacy of the State’s preventive action to keep it informed about the risks of exercising sexuality under unsafe conditions.

The National STDs/HIV/AIDS Program reported, for the year 2002, 251 deaths by AIDS in public hospitals, constituting the 10^th cause of hospital death out of the general total and the second cause of death in women and men in the 20 – 59 age group, estimating that by 2005 the number of persons with HIV shall be 62,906 and by the year 2010, 81,904.

Studies Performed in the Sexual Workers Population

A multi-center study performed in the year 2001, in which the women’s organization “Flor de Piedra” (Stone Flower), which works with women commercial sex workers (CSW), participated, included 491 women, with the object of determining the prevalence of HIV, STDs and the degree of knowledge about those infections.  Of the total sample, 26.8% were women aged 20 - 24, 48.6% initiated their sexual commercial activity before their 19^th birthday with an average schooling of 5.5 years.  Out of the total of CSW women, only 64% have taken the HIV test.  The weighted prevalence of HIV is 3.6%, being ostensibly higher among the women that work the streets.  The infection rate is 7.2%. [26]

In conclusion, on average 50% of the CSW population studied has hazardous behavior and false concepts about HIV.  Therefore, it is necessary to RECOMMEND the State to perform actions oriented to change the hazardous practices and behaviors, as well as to decrease the marginal state in which these groups live, extending their access to the basic health services, to information, reviewing the prevention and control strategies, since their condition turns them into bridge populations for the transmission of HIV.

B.         Violence against Women (Articles 3, 6 and 7 of the PCPR)

1.         Sexual Rape

Reality of the Country

In El Salvador it is difficult to objectively establish the number of denouncements from persons sexually assaulted, since each institution handles its register individually and its own classification of the denouncement. In view of this difficulty, in 1999, work was started around the proposal of a Sole Protocol for taking down the denouncements, as well as a system of unified information that would allow getting to know and doing a more realistic analysis of the different cases.  In this aspect, the Salvadorian Institute for the Development of Women (ISDEMU), guide of Women’s National Policy, has performed inter-institutional coordination efforts, collecting information from instances such as hospitals, Health Units, district attorney, Attorney General of the Republic, and the Institute of Legal Medicine; nevertheless, there have been no substantial advances in this system.

The Offenses against Women and Minors in the Family Relationship Unit, attached to the Attorney General of the Republic, reported for the year 2000 2,512 denouncements of rape, of which 25.46% of the victims were under the age of 15 and 94.5% occurred in the rural zones.  In 2001 it received 2,775 denouncements, of which 684 were from raped women; 158 sexual assaults; 179, intent to rape.  There is no information about the number of sentences in relation to the denouncements filed.  However, there is a virtual impunity since many of the cases come to an end for lack of proofs, especially when adult women are involved.

The existence of discriminatory norms that subsist in the performance of the different agents of the justice system are reflected in treatment imparted to the victims of these offenses, since they are exposed to investigations that re-victimize them one more time when they have to declare details about the occurrences, such as the way in which they were dressed, the apparent motive for the assault, the relationship with the aggressor, the degree of resistance opposed, the eye-witnesses, among others.

The law contemplates that the authors of offenses such as rape shall be also condemned by way of indemnification.[31]  The right to abortion on account of rape is not recognized, since it is penalized.

It is RECOMMENDABLE to put in practice policies and programs oriented towards the prevention of this type of conduct, since the lack of these contributes to reinforcing impunity, which adds to the inoperativeness of the norm, evidencing that the State is not too interested in these deeds, which violate women’s right to sexual freedom, dignity and integrity.

2.         Domestic Violence

Reality of the Country

The advances in the legislative field must be acknowledged; however, we cannot avoid observing that the law is not being applied as much as it should.  In this respect, the concepts and attitudes with which some justice operators work imply serious obstacles for the exercise of the rights of women victims of violence.

In the last 10 years, the prevalence of intra-family violence has increased, and we find ourselves with serious problems to provide effective measures for the prevention, sanction and eradication of violence.  Studies performed on the application of the law reflect a number of difficulties that hamper their application, such as the interpretation of it based on gender prejudices.[34]

The Action against Violence Network has performed a diagnosis on the application of the law, having concluded that it is necessary to elaborate an inter-institutional Procedures Manual.  Since the mid-90s, various efforts have been undertaken to organize locally structures that can contribute to the prevention and attention to violence.  In this sense, UNICEF is backing an initiative called Inter-institutional Committees against Intra-family Violence, based on the organizational effort of the National Civil Police with other local organizations.  The Pan­-American Health Organization (PHO) has supported a detection and attention system of intra-family violence from the primary health system, prioritizing training in attention techniques and inter-institutional coordination.

In spite of the fact that ISDEMU has acquired the responsibility of ruling entity of the policies related to violence, it maintains a deficient profile in different spaces of inter-institutional coordination, such as the Action against Gender Violence Network, continuing with the training activities and with the Preventive Fairs to Eradicate Violence in different locations around the country.

In El Salvador, according to the data provided by the Attorney General of the Republic, in the year 2000, each day 3.7 offe