Cáceres C, Cueto M, Palomino N
Cayetano Heredia University, School of Public Health, Lima, Peru.
Glob Public Health. 2008;3 Suppl 2:39-57. doi: 10.1080/17441690801981159.
This study is aimed at examining how subsequent Peruvian governments, since 1990, have addressed reproductive rights, HIV/AIDS prevention and treatment, and sexual diversity rights, as well as the drastic policy shifts and its many contradictions. Abortion and contraception consistently generated the deepest public controversies and debates, which made progress in reproductive rights difficult. HIV/AIDS was often portrayed as having the potential to affect everyone, which allowed advocates and activists to achieve some success in advancing HIV/AIDS-related rights. Sexual diversity rights, perceived as a demand made by "others", were generally trivialised and disdained by politicians, officials, and the general population. Positive changes occurred as long as the issue was given a low political and institutional profile. The analysis of policy-making and programme implementation in these three areas reveals that: (1) Weaknesses in national institutional frameworks concerning reproductive health made it possible for governments to adopt two very different (even contradictory) approaches to the issue within the past 15 years; (2) Policies were presented as rights-based in order to garner political legitimacy when, in fact, they evidenced a clear disregard for the rights of individual citizens; and (3) By favouring low-profile "public health" discourses, and marginalising "the sexual" in official policies related to sexuality, advocacy groups sometimes created opportunities for legal changes but failed to challenge conservative powers opposing the recognition of sexual and reproductive rights and the full citizenship of women and sexual minorities.
本研究旨在考察自1990年以来秘鲁历届政府如何处理生殖权利、艾滋病毒/艾滋病防治以及性取向多元化权利问题，以及政策的急剧转变及其诸多矛盾之处。堕胎和避孕问题始终引发最激烈的公众争议和辩论，这使得生殖权利方面难以取得进展。艾滋病毒/艾滋病常被描绘成有可能影响到每个人，这使得倡导者和活动人士在推进与艾滋病毒/艾滋病相关的权利方面取得了一些成功。性取向多元化权利被视为“他人”提出的要求，通常遭到政客、官员和普通民众的轻视和不屑。只要该问题在政治和制度层面上不那么突出，就会出现积极的变化。对这三个领域的政策制定和项目实施情况进行分析后发现：（1）国家生殖健康制度框架存在的缺陷使得政府在过去15年里有可能对该问题采取两种截然不同（甚至相互矛盾）的方法；（2）政策被表述为基于权利，以便获得政治合法性，而实际上这些政策明显无视公民个人权利；（3）通过支持低调的“公共卫生”话语，并在与性相关的官方政策中边缘化“性”的内容，倡导团体有时为法律变革创造了机会，但未能挑战反对承认性权利和生殖权利以及妇女和性少数群体完全公民身份的保守势力。
