Two weeks ago I attended a two-day workshop as part of Puerto Princesa City’s Local AIDS Council. Mayor Lucilo Bayron recently created the Council in order to address the rapidly growing problem of HIV in our city. The Philippines now has 11 cities with an HIV incidence (or infection) rate greater than 5%. Puerto Princesa is one of these cities.
Despite long boasting of a “low and slow” infection rate, the Philippines is now one of only 7 countries worldwide where the rate of HIV infection is still increasing. In 2015, there were 22 new HIV cases reported every day – that is nearly one new infection every hour! And these are only reflecting the people who get tested. Many more cases are unreported.
New HIV infections are an especially big problem among 15-24 year olds in the country. Part of the problem is that many people are having sex, and having sex without using condoms. We have incredibly low condom use even among people engaging in high-risk sex. Risky sexual behavior includes having sex with commercial sex workers, men having sex with men, and having sex with multiple partners. We also have high rates of injecting drug use, with many people sharing needles. Because of a lack of comprehensive sex education, we also have very low levels of knowledge about sex, including about pregnancy and sexually transmitted infections like HIV.
Risky sexual behavior in the Philippines starts at about 15 years old. Department of Health (DOH) statistics show that Palawan’s young people begin having sex about one year earlier than the national average. Now consider that most people do not get tested for HIV until they are 21. That is up to 7 years of people at risk of HIV infection possibly carrying the virus and passing it on to multiple partners who in turn pass it on to multiple partners. Our youth start having sex so young, and they don’t use condoms. This is fueling the HIV epidemic.
Interestingly, DOH research shows that when young people use a condom the first time they have sex, they are then more likely to use condoms every time they have sex. Conversely, every added year that young people have sex without using a condom makes them much less likely to use condoms even when they are engaging in high-risk sex. These findings demonstrate that young people must be taught how to use condoms correctly and consistently so that when they begin engaging in sexual activity, they will do it safely, and help avoid HIV infection. When young people don’t use protection once they’ve started having sex, future interventions won’t help them much because they’re already used to not using condoms.
If we’re going to win the war against HIV, we must be willing to provide young people with comprehensive sex education so they will know about the threats they face especially with high-risk behavior. We must also promote the distribution and use of condoms so that when young people do engage in sex, they will do it safely.
One of the members of the Local AIDS Council is a nun whom I found to be very thoughtful, smart and compassionate. But when the Council was discussing the possibility of stocking motels with condoms, she protested, saying that it would be insulting to some people to be presented with condoms, and that if young people are there and they are given condoms, they will surely engage in sex.
I had to respectfully disagree. Condoms do not make anyone have sex. As we have seen, huge numbers of young Filipinos are having sex, and most are not using protection. If people want to have sex, they will do it whether or not condoms are available. Likewise if young people are committed to not having sex because of religious or moral beliefs, simply placing a condom in their vicinity is not going to make them suddenly abandon their values and start having sex with the first person available. Condoms are not the enemy, and at this point, condoms coupled with education are the only tools we have to fight the further spread of HIV.
*All statistics used in this article are from the presentation of Dr. Genesis Samonte, Chief of the HIV Surveillance Unit of the National Epidemiology Center of the Department of Health (DOH-NEC)