One of the primary goals of Roots of Health is to provide educational outreach about reproductive health to women and girls. Once we begin our direct service, we will be working with underserved communities and withparticipants who have likely not had any formal education since grade school. We are currently still creating and tweaking our materials, so when we were invited to teach a two-day seminar at Palawan State University on reproductive health, we jumped at the chance to test our materials. The students were from the College of Nursing and were three years into their coursework. In the Philippines elementary school only goes up to 6th grade and high school only up to 10th grade, so students enter college at age 16. So despite being third year students, my seminar participants were only 18 or 19 years old. I assumed that, being nursing students, the participants would have already covered a lot of the material I was presenting. I was wrong!

I was shocked at the levels of knowledge, or lack thereof, that the students had about general reproductive health and HIV. Here are some of the highlights:

• Nearly 20% of the students believe that you can not get pregnant the first time you have sex, and 70% of them believe that you can not get pregnant while breastfeeding a baby.
• Only half the group believes that the condom is the only type of contraception that can prevent pregnancy and also prevent the transmission of sexually transmitted infections.
• More than 50% of the participants incorrectly identified saliva and urine as modes of transmission of HIV.
• Only 1/3 of the participants correctly identified breast milk as a possible mode of transmission of HIV for babies born to HIV+ mothers.
• Less than half of the participants believe that someone can have a sexually transmitted infection without manifesting any symptoms.

When it comes to attitudes about sex, the Filipino “macho” culture and gender expectations really emerged.

• One in three students do not believe that a girl can force her boyfriend to use a condom if they are having sex.
• One in four students believe that there is nothing a girl can do to prevent pregnancy if her partner refuses to use a condom.
• One in six students believe that a girl does not need to worry about sexually transmitted infections if her partner promises that he is being faithful.
• And finally, almost all the students stated that premarital sex is bad, but one in three respondents thinks it is ok for an unmarried boy to have sex, compared to one in six believing the same thing for unmarried girls.

At the close of the workshop I administered the same survey I gave the students at the beginning of the two day seminar. Attitudes did not change a great deal but some knowledge did increase, and many of the misperceptions students had about basic reproductive health and HIV were corrected.

This experience was very positive in that the students were thoughtful in their discussions and appreciated the chance to speak freely about issues that are seen as taboo. And I think many of them really learned some new things that hopefully will help protect their health. The experience also reinforced the immense need for disseminating information about reproductive health. The students I met are not necessarily wealthy, but they are much more privileged and educated than the communities we will be targeting in our work. When future nurses know so little, it is likely that individuals without any formal training or education will know even less. We have a lot of work to do!