Level of Awareness on HIV/AIDS among Selected Adolescent MSM in Barangay

Lapasan
Review of Related Literature
International
HIV/AIDS OVERVIEW

HIV stands for human immunodeficiency virus. If left untreated, HIV can lead to the disease
AIDS (acquired immunodeficiency syndrome).
Unlike some other viruses, the human body cant get rid of HIV completely. So once you have
HIV, you have it for life.
HIV attacks the bodys immune system, specifically the CD4 cells (T cells), which help the
immune system fight off infections. If left untreated, HIV reduces the number of CD4 cells (T
cells) in the body, making the person more likely to get infections or infection-related cancers.
Over time, HIV can destroy so many of these cells that the body cant fight off infections and
disease. These opportunistic infections or cancers take advantage of a very weak immune system
and signal that the person has AIDS, the last state of HIV infection.
No effective cure for HIV currently exists, but with proper treatment and medical care, HIV can
be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If taken the
right way, every day, this medicine can dramatically prolong the lives of many people with HIV,
keep them healthy, and greatly lower their chance of transmitting the virus to others. Today, a
person who is diagnosed with HIV, treated before the disease is far advanced, and stays on
treatment can live a nearly as long as someone who does not have HIV.
(https://www.aids.gov/hiv-aids-basics/hiv-aids-101/what-is-hiv-aids/)

AIDS stands for acquired immunodeficiency syndrome. AIDS is the final stage of HIV infection,
and not everyone who has HIV advances to this stage.
AIDS is the stage of infection that occurs when your immune system is badly damaged and you
become vulnerable to opportunistic infections. When the number of your CD4 cells falls below
200 cells per cubic millimeter of blood (200 cells/mm3), you are considered to have progressed
to AIDS. (The CD4 count of an uninfected adult/adolescent who is generally in good health
ranges from 500 cells/mm3 to 1,600 cells/mm3.) You can also be diagnosed with AIDS if you
develop one or more opportunistic infections, regardless of your CD4 count.

Without treatment, people who are diagnosed with AIDS typically survive about 3 years. Once
someone has a dangerous opportunistic illness, life expectancy without treatment falls to about 1
year. People with AIDS need medical treatment to prevent death. (https://www.aids.gov/hiv-aidsbasics/hiv-aids-101/what-is-hiv-aids/)

The HIV epidemic not only affects the health of individuals, it impacts households,
communities, and the development and economic growth of nations. Many of the
countries hardest hit by HIV also suffer from other infectious diseases, food
insecurity, and other serious problems. (https://www.aids.gov/hiv-aids-basics/hivaids-101/global-statistics/)

Since the beginning of the epidemic, more than 70 million people have been
infected with the HIV virus and about 35 million people have died of HIV. Globally,
36.7 million [34.039.8 million] people were living with HIV at the end of 2015. An
estimated 0.8% [0.7-0.9%] of adults aged 1549 years worldwide are living with
HIV, although the burden of the epidemic continues to vary considerably between
countries and regions. Sub-Saharan Africa remains most severely affected, with
nearly 1 in every 25 adults (4.4%) living with HIV and accounting for nearly 70% of
the people living with HIV worldwide. (http://www.who.int/gho/hiv/en/)

According to WHO , an estimated 35 million people have died from AIDS-related

illnesses since the start of the epidemic, including 1.1 million in 2015.
(https://www.aids.gov/hiv-aids-basics/hiv-aids-101/global-statistics/)

AIDS and HIV has reached epidemic proportions in many developing countries. It is
serious enough for the United States to consider it a threat to its national security
and in some nations has had a large impact on mortality rates and the economy.
(Anup Sha : AIDS Around the World http://www.globalissues.org/article/219/aidsaround-the-world)

RISK AND TRANSMISSION OF HIV

When HIV/AIDS first surfaced in the United States, it mainly affected men who had sex with
men. However, now it's clear that HIV is also spread through heterosexual sex.
Anyone of any age, race, sex or sexual orientation can be infected, but you're at greatest risk of
HIV/AIDS if you:

Have unprotected sex. Unprotected sex means having sex without using a new latex or
polyurethane condom every time. Anal sex is more risky than is vaginal sex. The risk
increases if you have multiple sexual partners.

Have another STI. Many sexually transmitted infections (STIs) produce open sores on
your genitals. These sores act as doorways for HIV to enter your body.

Use intravenous drugs. People who use intravenous drugs often share needles and
syringes. This exposes them to droplets of other people's blood.

Are an uncircumcised man. Studies indicate that lack of circumcision increases the risk
of heterosexual transmission of HIV.

(http://www.mayoclinic.org/diseases-conditions/hiv-aids/basics/risk-factors/con20013732)

Only certain body fluidsblood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal
fluids, and breast milkfrom a person who has HIV can transmit HIV. These fluids must come
in contact with a mucous membrane or damaged tissue or be directly injected into the
bloodstream (from a needle or syringe) for transmission to occur. Mucous membranes are found
inside the rectum, vagina, penis, and mouth.
In the United States, HIV is spread mainly by:

Having anal or vaginal sex with someone who has HIV without using a
condom or taking medicines to prevent or treat HIV.
o

Anal sex is the highest-risk sexual behavior. For the HIV-negative

partner, receptive anal sex (bottoming) is riskier than insertive anal
sex (topping).

Vaginal sex is the second highest-risk sexual behavior.

Sharing needles or syringes, rinse water, or other equipment (works) used

to prepare injection drugs with someone who has HIV. HIV can live in a used
needle up to 42 days depending on temperature and other factors.

Less commonly, HIV may be spread:

From mother to child during pregnancy, birth, or breastfeeding. Although the

risk can be high if a mother is living with HIV and not taking medicine,
recommendations to test all pregnant women for HIV and start HIV treatment
immediately have lowered the number of babies who are born with HIV.

By being stuck with an HIV-contaminated needle or other sharp object. This is

a risk mainly for health care workers.

(http://www.cdc.gov/hiv/basics/transmission.html)
The spread of HIV (called HIV transmission) is only possible if these fluids come in
contact with a mucous membrane or damaged tissue or are directly injected into
the bloodstream (from a needle or syringe). Mucous membranes are found inside
the rectum, the vagina, the opening of the penis, and the mouth.

Two behaviors pose the greatest risks for the acquisition of HIV: penetrative sex
(vaginal or anal) with multiple partners without using condoms, and sharing
infected needles and syringes to inject drugs. Unprotected vaginal sex is a risk not
only for HIV, but also, of course, for pregnancy ( Young People Most at Risk of HIV: A
Meeting Report and Discussion Paper from the Interagency Youth
Working Group, U.S. Agency for International Development, the Joint United Nations
Programme on
HIV/AIDS (UNAIDS) Inter-Agency Task Team on HIV and Young People, and FHI
. Research Triangle Park,
NC: FHI, 2010.

Retrieved From : https://www.fhi360.org/sites/default/files/media/documents/Young

%20People%20Most%20at%20Risk%20of%20HIV_0.pdf)
THE RESPONDENTS (MSM)
In the United States, HIV is spread mainly through anal or vaginal sex or by sharing
drug-use equipment with an infected person. Although these risk factors are the
same for everyone, some groups merit special consideration because of their age.
New infections are increasing among young men who have sex with men (Risk by
Age Group : http://www.cdc.gov/hiv/group/age/index.html)

In 2014:

Gay and bisexual men accounted for 83% (29,418) of the estimated new HIV diagnoses
among all males aged 13 and older and 67% of the total estimated new diagnoses in the
United States.

Gay and bisexual men aged 13 to 24 accounted for an estimated 92% of new HIV
diagnoses among all men in their age group and 27% of new diagnoses among all gay
and bisexual men.

(HIV Among Gay and Bisexual Men:

https://www.cdc.gov/hiv/group/msm/)
HIV prevalence, unrecognized infection, and HIV testing
among men who have sex with men--five U.S. cities, June
2004-April 2005.
Well into the third decade of the human immunodeficiency virus (HIV) epidemic,
rates of HIV infection remain high, especially among minority populations. Of newly
diagnosed HIV infections in the United States during 2003, CDC estimated that
approximately 63% were among men who were infected through sexual contact
with other men, 50% were among blacks, 32% were among whites, and 16% were
among Hispanics. Studies of HIV infection among young men who have sex with
men (MSM) in the mid to late 1990s revealed high rates of HIV prevalence,
incidence, and unrecognized infection, particularly among young black MSM. To
reassess those findings and previous HIV testing behaviors among MSM, CDC
analyzed data from five of 17 cities participating in the National HIV Behavioral
Surveillance (NHBS) system. This report summarizes preliminary findings from the
HIV-testing component of NHBS, which indicated that, of MSM surveyed, 25% were
infected with HIV, and 48% of those infected were unaware of their infection. To
decrease HIV transmission, MSM should be encouraged to receive an HIV test at
least annually, and prevention programs should improve means of reaching persons
unaware of their HIV status, especially those in populations disproportionately at
risk.
(https://www.ncbi.nlm.nih.gov/pubmed/15973239?report=abstract)
n multivariate analysis, men reporting four or more male sex partners, unprotected
receptive anal intercourse with any HIV serostatus partners and unprotected
insertive anal intercourse with HIV-positive partners were at increased risk of HIV
infection, as were those reporting amphetamine or heavy alcohol use and alcohol or
drug use before sex. Some depression symptoms and occurrence of gonorrhea also
were independently associated with HIV infection

(Risk factors for HIV infection among men who have sex with
men
21 March 2006 - Volume 20 - Issue 5 - p 731739

http://journals.lww.com/aidsonline/Abstract/2006/03210/Risk_factors_for_HIV_infecti
on_among_men_who_have.13.aspx)

Estimated Per-Act Probability of Acquiring HIV from an

Infected Source, by Exposure Act
Receptive Anal Intercourse 138 risk of 10,000 exposures (HIV Risk Behaviors:
http://www.cdc.gov/hiv/risk/estimates/riskbehaviors.html)

Although the HIV risk factors are the same for everyone, some gender groups are
far more affected than others. Gay, bisexual, and other men who have sex with
men, for example, account for the majority of new HIV infections in the U.S. each
year despite making up only 2% of the population. (Who is at Risk for HIV:
https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/who-is-at-risk-forhiv/)

Individual-level risks for HIV acquisition in MSM have been well documented, and
include unprotected receptive anal intercourse, high frequency of male partners,
high number of lifetime male partners, injection drug use, high viral load in the
index partner, African- American ethnic origin (in the USA), and non-injection-drug
use, including use of amphetamine-type stimulants (ATS). 3335 Recent data suggest
individual-level risks might be insufficient to explain the high transmission dynamics
evident in MSM outbreaks, and that biological, couple, network-level, and
community-level drivers might be crucial to understand why HIV transmission rates
remain so high in MSM populations

(Global epidemiology of HIV infection in men who have sex

with men
Published 2012: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805037/)
VARIABLES
INDEPENDENT
AGE

n estimated 9,731 youth aged 13 to 24 were diagnosed with HIV in 2014 in the United States.
Eighty-one percent (7,868) of diagnoses among youth occurred in persons aged 20 to 24.
Among youth aged 13 to 24 diagnosed with HIV in 2014, 80% (7,828) were gay and bisexual
males.
(HIV among youth: http://www.cdc.gov/hiv/group/age/youth/)

Although the HIV risk factors are the same for everyone, some groups merit special
consideration because of their age. For example, in the U.S. new HIV infections are
increasing among young men who have sex with men, especially young, black men
who have sex with men (ages 13-24), despite remaining steady overall. (Who is at
Risk for HIV: https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/whois-at-risk-for-hiv/)

At an individual level, many factors affect young peoples health. In terms of HIV,
young people are less likely to be able to prevent themselves from becoming infected.
They often do not have sufficient correct knowledge about HIV, the skills to use the
knowledge that they do have (to negotiate condom use, for example), or access to the
services and commodities that they need.
Studies from more than 50
countries have identified a number of common determinants that are associated with
behaviors that could undermine adolescents health, such as early sexual activity and
substance use.
6

These determinants could either increase the risk of negative behaviors (risk factors) or protect against them (protective factors). Young People Most at
Risk of HIV: A Meeting Report and Discussion Paper from the Interagency Youth
Working Group, U.S. Agency for International Development, the Joint United Nations
Programme on
HIV/AIDS (UNAIDS) Inter-Agency Task Team on HIV and Young People, and FHI
. Research Triangle Park,
NC: FHI, 2010.

Retrieved From : https://www.fhi360.org/sites/default/files/media/documents/Young

%20People%20Most%20at%20Risk%20of%20HIV_0.pdf)
HIV transmission in the second decade of life

Unprotected sex is the most common cause of HIV among young people, with sharing infected
needles second.11 Adolescence is often associated with experimentation of risky sexual and
drug-related behaviours, increasing a young person's vulnerability to HIV.
For some, this is a result of not having the correct knowledge about HIV and how to prevent it,
highlighting the need for HIV and sexual and reproductive health education. For others, it is the
result of being forced to have unprotected sex, or to inject drugs.12

(Young people, adolescents and HIV/AIDS:

http://www.avert.org/professionals/hiv-social-issues/keyaffected-populations/young-people)

EDUCATIONAL ATTAINMENT
At the national level in Africa there is a positive relationship between literacy rates
and HIV infection rates (Figure 1)1: More literate countries have higher rates of HIV
infection. More literate African countries tend to be the most developed on the
continent and they share a number of features that make them vulnerable to high
rates of HIV infection.
(A report prepared for the UNESCO Global Monitoring Report 2005 by Matthew
Jukes and Kamal Desai.
portal.unesco.org/education/.../6c5eeae6d430e16f1fc891d55e026769Jukes_+M_3.
do..)

search shows that well-designed, well-implemented HIV/STD prevention programs can

significantly reduce sexual risk behaviors among teens. A review of 48 comprehensive
curriculum-based sex and STD/HIV education programs found that none of these programs
increased the likelihood of teens having sex, while about two-thirds had a significant impact on
reducing sexual risk behaviors among young people,6,7 including

delay in first sexual intercourse

decline in the number of sex partners

increase in condom or contraceptive use

(Schools Play a Key Role in HIV/STD and Teen Pregnancy

Prevention
http://www.cdc.gov/features/hivstdprevention/)
OBJECTIVES:

To assess whether educational status is associated with HIV-1 infection in developing countries
by conducting a systematic review of published literature.
METHODS:

Articles were identified through electronic databases and hand searching key journals. Studies
containing appropriately analysed individual level data on the association between educational
attainment and HIV-1 status in general population groups were included.

1 Permission not yet sought for reproduction of graphs.

RESULTS:

Twenty-seven articles with appropriately analysed results from general population groups in
developing countries were identified, providing information on only six countries. Large studies
in four areas in Africa showed an increased risk of HIV-1 infection among the more educated,
whilst among 21-year-old Thai army conscripts, longer duration of schooling was strongly
protective against HIV infection. The association between education and schooling in Africa was
stronger in rural areas and in older cohorts, but was similar in men and women. Serial prevalence
studies showed little change in the association between schooling and HIV over time in
Tanzania, but greater decreases in HIV prevalence among the more educated in Uganda, Zambia
and Thailand.
CONCLUSIONS:

In Africa, higher educational attainment is often associated with a greater risk of HIV infection.
However, the pattern of new HIV infections may be changing towards a greater burden among
less educated groups. In Thailand those with more schooling remain at lower risk of HIV
infection.

Educational attainment and HIV-1 infection in developing

countries: a systematic review.
(https://www.ncbi.nlm.nih.gov/pubmed/12031070)

HIV prevalence among young women aged 1524 years was 12.5% in the urban and
6.8% in the rural clusters. Neighbourhood educational attainment was found to be a
strong determinant of HIV infection in both urban and rural population, i.e. HIV
prevalence decreased substantially by increasing level of neighbourhood education.
The likelihood of infection in low vs. high educational attainment of neighbourhoods
was 3.4 times among rural women and 1.8 times higher among the urban women
after adjusting for age and other individual-level underlying variables, including
education. However, the association was not significant for urban young women
after this adjustment. After adjusting for level of education in the neighbourhood,
the effect of the individual-level education differed by residence, i.e. a strong
protective effect among urban women whereas tending to be a risk factor among
rural women.

Effects of neighbourhood-level educational attainment on

HIV prevalence among young women in Zambia
http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-9-310

RELIGION

Religion is also a potential determinant of

HIV risk. It is not clear whether church
members in general are less likely to be HIV positive than non-members.
There is
evidence, however, to suggest that members
of Pentecostal and independent churches
are less likely to engage in extra- and pr
e-marital sex, and are less likely to be HIV
positive, than members of other Christian
churches.
HIV Risk Factors: A Review of
the Demographic, Socio-economic,
Biomedical and Behavioural
Determinants of HIV Prevalence
in South Africa

Prepared by Leigh Johnson and Debbie Budlender

January 2002.
https://www.commerce.uct.ac.za/Research_Units/CARE/Monographs/Monographs
/mono08.pdf

Religion and HIV in Tanzania: influence of religious beliefs

on HIV stigma, disclosure, and treatment attitudes
esults indicate that shame-related HIV stigma is strongly associated with religious
beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that
people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001).
Most participants (84.2%) said that they would disclose their HIV status to their
pastor or congregation if they became infected. Although the majority of
respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said
that they would begin ARV treatment if they became HIV-infected. The multivariate
analysis found that respondents' hypothetical willingness to begin ARV treatme was
not significantly associated with the belief that prayer could cure HIV or with other
religious factors. Refusal of ARV treatment was instead correlated with lack of
secondary schooling and lack of knowledge about ARVs.
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2656538/)
Around a third of all HIV-positive people living in the UK are of African descent. 1
According to the BASSLine survey of HIV-positive Africans in England, 2 over 70% of
black Africans are Christian and just under 20% are Muslim, while only 6% say they

have no religion. The church is central to the lives of many HIV-positive African
people living in the UK, and recently the role of faith leaders in promoting HIV
awareness has been recognised, along with the need to provide clergy with
information about HIV prevention and treatment. Informed and knowledgeable faith
leaders are therefore crucial in a large section of the UKs HIV-positive population
finding support and acceptance at their place of worship.
( Faith in the Community 2009 http://www.aidsmap.com/Faith-in-thecommunity/page/2776685/#item1412642)
In Muslim communities, religious leaders are using Islamic principles to educate
adherents about the disease. In Senegal, which has one of the lowest HIV rates in
the region, Muslim leaders promote values such as abstinence and fidelity with a
view to HIV prevention and "endorse condoms within a marriage if they [are] used
for health reasons." Recognizing the potential benefits of involving religion in the
fight against AIDS, USAID in Indonesia has partnered with religious leaders to
"facilitate the implementation of HIV policy statements within the faith" and "share
a compilation of fatwa (religious guidance) on HIV prevention."

Religion's Role in Fighting AIDS

ISOBEL COLEMAN Dec 2, 2011
(http://www.theatlantic.com/international/archive/2011/12/religions-role-in-fightingaids/249416/
SOCIO-ECONOMIC STATUS

Socioeconomic status is commonly conceptualized as the social standing or class of an

individual or group. It is often measured as a combination of education, income and occupation.
Examinations of socioeconomic status often reveal inequities in access to resources, plus issues
related to privilege, power and control.
(Socio-Economic status: http://www.apa.org/topics/socioeconomic-status/)

Background

There is a scarcity of data in rural health centers in Nigeria regarding the relationship between
socioeconomic status (SES) and HIV infection. We investigated this relationship using indicators
of SES.
Methods

An analytical case-control study was conducted in the HIV clinic of a rural tertiary health center.
Data collection included demographic variables, educational attainment, employment status,
monthly income, marital status, and religion. HIV was diagnosed by conventional methods. Data
were analyzed with the SPSS version 16 software.
Results

A total of 115 (48.5%) HIV-negative subjects with a mean age of 35.497.63 years (range: 1554
years), and 122 (51.5%) HIV-positive subjects with a mean age of 36.358.31 years (range: 15
53 years) were involved in the study. Participants consisted of 47 (40.9%) men and 68 (59.1%)
women who were HIV negative. Those who were HIV positive consisted of 35 (28.7%) men and
87 (71.3%) women. Attainment of secondary school levels of education, and all categories of
monthly income showed statistically significant relationships with HIV infection (P=0.018 and
P<0.05, respectively) after analysis using a logistic regression model. Employment status did not
show any significant relationship with HIV infection.
Conclusion

Our findings suggested that some indicators of SES are differently related to HIV infection.
Prevalent HIV infections are now concentrated among those with low incomes. Urgent measures
to improve HIV prevention among low income earners are necessary. Further research in this
area requires multiple measures in relation to partners SES (measured by education,
employment, and income) to further define this relationship.

Relationship between socioeconomic status and HIV

infection in a rural tertiary health center
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003148/

Socioeconomic status and risk of HIV infection in an urban

population in Kenya.
OBJECTIVE:

To examine the relationship between socioeconomic status (SES), risk factors for HIV infection
and HIV status in an urban population with high prevalence of HIV infection in sub-Saharan
Africa.
METHODS:

Cross-sectional population survey of adults from the city of Kisumu, Kenya, in 1996. Around
1000 men and 1000 women aged 15-49 years were interviewed using a structured questionnaire,
and most gave a venous blood sample for HIV testing. SES was represented by a composite

variable of educational status, occupation and household utilities. Multiple regression was used
to examine whether SES was associated with HIV infection or with risk factors for HIV
infection.
RESULTS:

Human immunodeficiency virus prevalence was 19.8% in males and 30.2% in females. Higher
SES was associated with a more mobile lifestyle, later sexual debut and marriage among both
sexes, and with circumcision among men aged 25-49 and condom use among women aged 2549. Higher levels of alcohol consumption were associated with an increased risk of HIV infection
and were more common amongst those of higher SES. HSV-2 infection was strongly associated
with an increased risk of HIV infection and was more common among those of lower SES. HIV
was associated with a lower SES among females aged 15-24 whereas in males aged 15-24 and
females aged 25-49 there was some indication that it was associated with higher SES. Among
males aged 25-49 there was no association between HIV infection and SES.
CONCLUSIONS:

Risk of infection was high among groups of all SES. Risk profiles suggested men and women of
lower SES maybe at greater risk of newly acquired HIV infection. New infections may now be
occurring fastest among young women of the lowest SES.
(2002 https://www.ncbi.nlm.nih.gov/pubmed/12225512)

DEPENDENT
LEVEL OF AWARENESS OF HIV

A study of 110 female adolescents 14-18 years of age attending government senior secondary
schools (1 urban and 1 rural) in Chandigarh, India, in 1994 compared awareness of AIDS.
84.48% of urban and 90.39% of rural students agreed that the sex education they received in
school was inadequate. AIDS was identified as an infectious disease by 67.24% of urban and
63.36% of rural students. Modes of HIV transmission identified by urban and rural girls,
respectively, included: use of unsterilized needles for injection (81.03% and 25.0%), drinking
from the same glass as an infected person (6.89% and 17.3%), sex with an infected person
(81.03% and 59.62%), and mosquito bites (8.62% and 7.69%). 12.07% of urban students and
55.77% of their rural counterparts believed there is a cure for AIDS. The main sources of
information about AIDS for urban and rural students, respectively, were: newspaper articles
(56.89% and 21.15%), television (62.07% and 50.00%), magazine articles (34.49% and 9.62%),
conversations with friends (25.89% and 11.54%), and discussions with health care professionals
(13.79% and 1.92%). 82.76% of urban students and 67.31% of rural students were afraid of
contracting HIV/AIDS, while 29.31% and 61.54%, respectively, feared someone in their family
might become infected. Finally, 63.79% of urban and 51.92% of rural adolescents were aware
that a person can be HIV-infected yet appear healthy. Overall, these findings indicate that,

although these secondary school students had acquired information about AIDS from a variety of
sources, much of this information was inaccurate. There is a need for school-based sex education
programs to deepen students' knowledge of HIV/AIDS.

(Level of awareness about AIDS: a comparative study of

girls of two senior secondary schools of Chandigarh.
1997 http://www.popline.org/node/271380

Knowledge, attitudes and practices regarding

HIV/AIDS among male high school students
in Lao People's Democratic Republic
Results: The majority of students surveyed were aware that HIV can be transmitted by sexual
intercourse (97.7%), from mother to child (88.3%) and through sharing needles or syringes
(92.0%). Misconceptions about transmission of HIV were observed among 59.3% to 74.3% of
respondents. Positive attitudes towards HIV/AIDS were observed among 55.7% of respondents.
Nearly half of the surveyed students (45.3%) said that they would be willing to continue studying
in a school with HIV-positive friends, and 124 (41.3%) said they would continue attending a
school with HIV-positive teachers. Ninety-four (31.3%) students had a history of sexual
intercourse, and 70.2% of these students had used a condom. However, only 43.9% said they
used condoms consistently. Students with medium and high levels of knowledge were 4.3 (95%
CI=2.19.0, P<0.001) and 13.3 (95% CI=6.527.4, P<0.001) times more likely to display
positive attitudes towards people living with HIV. Similarly, safe practices related to safe sex
were also observed among students with medium (OR=2.8, 95% CI=0.98.8, P=0.069) and high
levels of knowledge (OR=1.9, 95% CI=0.66.2, P=0.284). More than three-quarters of students
mentioned television and radio as major sources of information on HIV/AIDS.
Conclusions: Despite adequate knowledge about HIV/AIDS among the school students,
misconceptions about routes of transmission were found. Negative attitudes to HIV/AIDS and
risky practices were also present. Educational programmes with specific interventions are
recommended to increase KAPs and to prevent new HIV infections among students in Lao PDR.
2013http://www.jiasociety.org/index.php/jias/article/view/17387/2877

HIV Prevalence and Awareness of Positive

Serostatus Among Men Who Have Sex With
Men and Transgender Women in Bogot,
Colombia

Conclusions. There is an urgent need to increase HIV detection among MSM and
transgender women in Bogot. HIV-positiveunaware group characteristics suggest
an important role for structural, social, and individual interventions.
2015https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504275/

Local

An unprecedented acceleration in the number of cases

has decreased doubling time from ten years (1996 to 2006), to
one year (2009 to 2010).
2

UNAIDS in its 2010 report noted

that the Philippines was one of only seven countries in the
world to have seen an increase of over 25% in HIV incidence
in the past decade.
6

New cases annually are up more than

800% from 2001, and m
ore than half of the total cases since
1984 were diagnosed in the last four years.
2

In a recent
review of the HIV situation in the Philippines, Farr and
Wilson noted that this type of epidemiology, coupled with
increasing casual sex activity, poor condom u
se, poor

education and an inadequate public health response, make

the occurrence of a large HIV epidemic just a matter of time.
1

This paper examines the potentially catastrophic economic

and social impact of HIV in the Philippines, underlines the
urgency f
or action, and proposes a state
of
the
art, evidence
based strategy for elimination.
Transmission and Prevention
More than 90% of HIV transmission in the Philippines is
through sexual contact.
2

Demographics have changed

substantially over the last decade.
From a majority of cases
from heterosexual transmission, over 80% of new cases
diagnosed in 2011 were in men
who
have
sex
with
men
(MSM).
2

This shift from heterosexual to MSM transmission

may have exacerbated the increase in numbers due to the
fact that c
ircumcision has a minimal predicted impact on
MSM transmission in contrast to heterosexual transmission.
7

Age at time of diagnosis has likewise declined from a

majority in the 30
34 age group, down to the 25
29 age
group.
2

Prevention of HIV in the Philip

pines is severely
hampered by low condom use.
1

This is in part due to

religious pressure from the Catholic Church.
8

(HIV

in the Philippines: A Prime Target for Elimination

through Test
and
Treat

Salvana UP Manila : http://actamedicaphilippina.com.ph/sites/default/files/HIVElimination.pdf

Results

The past control of HIV in the Philippines cannot be attributed to any single factor, nor is it
necessarily a result of the actions of the Filipino government or other stakeholders. Likely
reasons for the epidemic's slow development include: the country's geography is complicated;
injecting drug use is relatively uncommon; a culture of sexual conservatism exists; sex workers
tend to have few clients; anal sex is relatively uncommon; and circumcision rates are relatively
high.
In contrast, there are numerous factors suggesting that HIV is increasing and ready to emerge at
high rates, including: the lowest documented rates of condom use in Asia; increasing casual
sexual activity; returning overseas Filipino workers from high-prevalence settings; widespread
misconceptions about HIV/AIDS; and high needle-sharing rates among injecting drug users.
There was a three-fold increase in the rate of HIV diagnoses in the Philippines between 2003 and
2008, and this has continued over the past year. HIV diagnoses rates have noticeably increased
among men, particularly among bisexual and homosexual men (114% and 214% respective
increases over 2003-2008). The average age of diagnosis has also significantly decreased, from
approximately 36 to 29 years.
Conclusions

Young adults, men who have sex with men, commercial sex workers, injecting drug users,
overseas Filipino workers, and the sexual partners of people in these groups are particularly
vulnerable to HIV infection. There is no guarantee that a large HIV epidemic will be avoided in

the near future. Indeed, an expanding HIV epidemic is likely to be only a matter of time as the
components for such an epidemic are already present in the Philippines.

An HIV epidemic is ready to emerge in the Philippines

Anna Farr and David Wilson
2010:

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868805/)
HIV/AIDS OVERVIEW PHILIPPINES
THE RESPONDENTS
VARIABLES
INDEPENDENT
AGE
EDUCATIONAL ATTAINMENT
RELIGION
SOCIO-ECONOMIC STATUS
DEPENDENT
LEVEL OF AWARENESS OF HIV AMONG MSM
Even though awareness of the disease is high [5], misconceptions of HIV/AIDS are
widespread among health workers, as well as in the general population [2]. For
example, a survey of 1200 males found that many respondents believed that
antibiotics, prayer and keeping fit would protect against HIV/AIDS [32]. Many young
people also believe that HIV/AIDS can be prevented or treated by a concoction of
drinks, douching with detergents, interrupting coitus and washing the penis [5]. The
Young Adult Fertility Survey found that a large proportion (60%) of young people
believed that there was now a cure for HIV/AIDS and, as such, they could become
more complacent [45].

An HIV epidemic is ready to emerge in the Philippines

Anna Farr and David Wilson
2010:

(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868805/)