because they advocate the maximization of procreation. one of the oldest ways to reduce unwanted pregnancy is coitus interruptus - still widely used in the developing world. there are many types of contraceptives. one type of contraceptive includes barrier methods. one barrier method includes condoms for males and females. both types stop sperm from entering the woman's uterus, thereby preventing pregnancy from occurring. another type of contraception is the birth control pill, which stops ovulation from occurring by combining the chemicals progestin and estrogen. many women use this method of contraception, however, they discontinue using it equally as much as they use it. one reason for this is because of the side effects that may occur from using the pill, and because some health care providers do not take women's concerns about negative side effects seriously. the use of the birth control pill is common in western countries, and two forms of combined oral contraceptives are on the world health organization's list of essential medicines, the most important medications needed in a basic health system. margaret sanger, birth control advocate, and her sister ethyl byrne, on the courthouse steps in brooklyn, new york city, january 8, 1917, during their trial for opening a birth control clinic. contraception has been and still remains in some cultures a controversial issue. there are many objections to the use of birth control, both historically and in the present day. one argument against birth control usage states that there is no need for birth control, to begin with. this argument was levied in 1968 when richard nixon was elected president, and the argument stated that since birth rates were at their lowest point since world war ii ended, birth control was not necessary. demographic planning arguments were also the basis of the population policy of nicolae ceaușescu in communist romania, who adopted a very aggressive natalist policy which included outlawing abortion and contraception, routine pregnancy tests for women, taxes on childlessness, and legal discrimination against childless people. such policies consider that coercion is an acceptable means of reaching demographic targets. religious objections are based on the view that premarital sex should not happen, while married couples should have as many children as possible. as such, the catholic church encourages premarital abstinence from sex. this argument was written out in humanae vitae, a papal encyclical released in 1968. the catholic church bases its argument against birth control pills on the basis that birth control pills undermine the natural law of god. the catholic church also argues against birth control on the basis of family size, with cardinal mercier of belgium arguing, "...the duties of conscience are above worldly considerations, and besides, it is the large families who are the best" (reiterman, 216). another argument states that women should use natural methods of contraception in place of artificial ones, such as having sexual intercourse when one is infertile. support for contraception is based on views such as reproductive rights, women's rights, and the necessity to prevent child abandonment and child poverty. the world health organization states that "by preventing unintended pregnancy, family planning /contraception prevents deaths of mothers and children". sexually transmitted infection main article: sexually transmitted infection a page from de morbo gallico (on the french disease), gabriele falloppio's treatise on syphilis. published in 1564, it describes early use of condoms. a sexually transmitted infection (sti) --previously known as a sexually transmitted disease (std) or venereal disease (vd)-- is an infection that has a significant likelihood of transmission between humans by means of sexual activity. the cdc analyses the eight most common stis: chlamydia, gonorrhea, hepatitis b virus (hbv), herpes simplex virus type 2 (hsv-2), human immunodeficiency virus (hiv), human papillomavirus (hpv), syphilis, and trichomoniasis. estimated prevalence in % of hiv among young adults (15–49) per country as of 2011. no data <0.10 0.10–0.5 0.5–1 1–5 5–15 15–50 deaths from syphilis in 2012, per million persons disability-adjusted life year for gonorrhea per 100,000 inhabitants there are more than 600 million cases of stis worldwide and more than 20 million new cases within the united states. numbers of such high magnitude weigh a heavy burden on the local and global economy. a study conducted at oxford university in 2015 concluded that despite giving participants early antiviral medications (art), they still cost an estimated $256 billion over 2 decades. hiv testing done at modest rates could reduce hiv infections by 21%, hiv retention by 54%, and hiv mortality rates by 64%, with a cost-effectiveness ratio of $45,300 per quality-adjusted life year. however, the study concluded that the united states has led to an excess in infections, treatment costs, and deaths, even when interventions do not improve overall survival rates. there is a profound reduction in sti rates once those who are sexually active are educated about transmissions, condom promotion, interventions targeted at key and vulnerable populations through comprehensive sex education courses or programs. south africa's policy addresses the needs of women at risk for hiv and who are hiv positive as well as their partners and children. the policy also promotes screening activities related to sexual health such as hiv counseling and testing as well as testing for other stis, tuberculosis, cervical cancer, and breast cancer. the cdc stated that the rate of sexually transmitted infections is higher among minorities compared to white people. these minorities are currently being affected by different factors including health literacy, socioeconomic status, access to health services, and fear of discrimination by health providers. the rates of infection are five to eight times higher in the black community compared to non-hispanic white people. young african american women are at a higher risk for stis, including hiv. a recent study published outside of atlanta, georgia collected data (demographic, psychological, and behavioral measures) with a vaginal swab to confirm the presence of stis. they found a profound difference that those women who had graduated from college were far less likely to have stis, potentially be benefiting from a reduction in vulnerability to acquiring stis/hiv as they gain in education status and potentially move up in demographic areas and/or status. abortion globally, an estimated 25 million unsafe abortions occur each year. the vast majority of such unsafe abortions occur in developing countries in africa, asia and latin america. the abortion debate is the ongoing controversy surrounding the moral, legal, and religious status of induced abortion. the sides involved in the debate are the self-described "pro-choice" and "pro-life" movements. "pro-choice" emphasizes the right of women to decide whether to terminate a pregnancy. "pro-life" emphasizes the right of the embryo or fetus to gestate to term and be born. both terms are considered loaded in mainstream media, where terms such as "abortion rights" or "anti-abortion" are generally preferred. each movement has, with varying results, sought to influence public opinion and to attain legal support for its position, with small numbers of radical activists using violence, such as murder and arson. articles from the world health organization call legal abortion a fundamental right of women regardless of where they live, and argue that unsafe abortion is a silent pandemic. in 2005, it was estimated that 19-20 million abortions had complications, some complications are permanent, while another estimated 68,000 women died from unsafe abortions. having access to safe abortion can have positive impacts on women's health and life, and vice versa. "legislation of abortion on request is necessary but an insufficient step towards improving women's health. in some countries where it abortion is legal and has been for decades, there has been no improvement in access to adequate services making abortion unsafe due to lack of healthcare services. it is hard to get an abortion due to legal and policy barriers, social and cultural barriers (gender discrimination, poverty, religious restrictions, lack of support), health system barriers (lack of facilities or trained personnel). however, safe abortions with trained personnel, good social support, and access to facilities, can improve maternal health and increase reproductive health later in life. the maputo protocol, which was adopted by the african union in the form of a protocol to the african charter on human and peoples' rights, states at article 14 (health and reproductive rights) that: "(2). states parties shall take all appropriate measures to: c) protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus." the maputo protocol is the first international treaty to recognize abortion, under certain conditions, as a woman's human right. the general comment no. 36 (2018) on article 6 of the international covenant on civil and political rights, on the right to life, adopted by the human rights committee in 2018, defines, for the first time ever, a human right to abortion - in certain circumstances (however these un general comments are considered soft law, and, as such, not legally binding). "although states parties may adopt measures designed to regulate voluntary terminations of pregnancy, such measures must not result in violation of the right to life of a pregnant woman or girl, or her other rights under the covenant. thus, restrictions on the ability of women or girls to seek abortion must not, inter alia, jeopardize their lives, subject them to physical or mental pain or suffering which violates article 7, discriminate against them or arbitrarily interfere with their privacy. states parties must provide safe, legal and effective access to abortion where the life and health of the pregnant woman or girl is at risk, and where carrying a pregnancy to term would cause the pregnant woman or girl substantial pain or suffering, most notably where the pregnancy is the result of rape or incest or is not viable. in addition, states parties may not regulate pregnancy or abortion in all other cases in a manner that runs contrary to their duty to ensure that women and girls do not have to undertake unsafe abortions, and they should revise their abortion laws accordingly. for example, they should not take measures such as criminalizing pregnancies by unmarried women or apply criminal sanctions against women and girls undergoing abortion or against medical service providers assisting them in doing so, since taking such measures compel women and girls to resort to unsafe abortion. states parties should not introduce new barriers and should remove existing barriers that deny effective access by women and girls to safe and legal abortion , including barriers caused as a result of the exercise of conscientious objection by individual medical providers. " when negotiating the cairo programme of action at the 1994 international conference on population and development (icpd), the issue was so contentious that delegates eventually decided to omit any recommendation to legalize abortion, instead advising governments to provide proper post-abortion care and to invest in programs that will decrease the number of unwanted pregnancies. the committee on the elimination of discrimination against women considers the criminalization of abortion a "violations of women's sexual and reproductive health and rights" and a form of "gender based violence"; paragraph 18 of its general recommendation no. 35 on gender based violence against women, updating general recommendation no. 19 states that: "violations of women's sexual and reproductive health and rights, such as forced sterilizations, forced abortion, forced pregnancy, criminalisation of abortion, denial or delay of safe abortion and post abortion care, forced continuation of pregnancy, abuse and mistreatment of women and girls seeking sexual and reproductive health information, goods and services, are forms of gender based violence that, depending on the circumstances, may amount to torture or cruel, inhuman or degrading treatment." the same general recommendation also urges countries at paragraph 31 to in particular, repeal: a) provisions that allow, tolerate or condone forms of gender based violence against women, including legislation that criminalises abortion". in 2008, the parliamentary assembly of the council of europe, a group comprising members from 47 european countries, has adopted a resolution calling for the decriminalization of abortion within reasonable gestational limits and guaranteed access to safe abortion procedures. the nonbinding resolution was passed on april 16 by a vote of 102 to 69. accesses to abortion is not only a question of legality but also an issue of overcoming de facto barriers, such as conscientious