Adolescent sexuality in the Philippines

Summarised from the chapter HIV/AIDS by Deborah Balk, Lita J. Domingo, Grace T. Cruz and Tim Brown in Adolescent Sexuality in the Philippines. Editors, Corazon M. Raymundo, Peter Xenos and Lita J. Domingo. UP Office of the Vice Chancellor for Research and Development, University of the Philippines Population Institute, East-West Centre Population and Health Studies. 1999.

Young men in the Philippines are at substantial risk of HIV, according to evidence from the Young Adult Fertility and Sexuality Study (YAFS-11). As observed up to the age of 25, before they marry, 37% of Filipino men will have had sex with at least one other partner besides their wives, and a non-negligible share will have paid for sex. One-third of all men who are still single at age 24, will be engaging in activities with the potential for HIV transmission each year.

There is strong evidence of overlap between commercial and non-commercial casual sexual networks, providing avenues for general population spread of the virus.

The picture is more constrained for young women. Although 30% have had premarital sex by the age of 24, most report this was with their future husband. If the lower levels of risk reported by females are accurate, a large percentage of Filipino women will be placed at risk of HIV through the premarital and extramarital activities of their spouses.

The perception of risk remains comparatively low. Even among those men engaging in commercial sex without using condoms, only one-third feel that someone like them is likely to contract HIV. Expanded efforts to inform young men of the risks of unprotected sex (both commercial and non-commercial) are urgently needed.

Awareness of AIDS is high but knowledge appears to be somewhat more limited. There appears to be a strong perceived association of HIV with commercial sex and multiple sex partners, raising the question of whether these young people view sex with a boyfriend or girlfriend as potentially risky. This perception will need to be examined more closely in future studies. Increased emphasis on general heterosexual transmission routes would be valuable. There are large educational differences in AIDS knowledge, so future efforts to disseminate AIDS information should target the educationally less advantaged.

Condoms must be an essential component of efforts to slow the spread of HIV as young Filipinos, especially males, are neither abstinent or monogamous. But whilst awareness of condoms is high, there are significant gaps in knowledge. Only 58% of male respondents agreed that proper use of condoms can prevent HIV transmission. Levels of condom use remain low,; only about 20% of men who knew about condoms had ever used them. Consistent use rates are certainly much lower. Although males engaging in sexual activities carrying more risk - for example, commercial sex- are more than twice as likely to use condoms that other men, less than half (40%) report ever using a condom when paying for sex.

For reasons which are not yet clearly understood, HIV has spread slowly in the Philippines. But as YAFS-11 (the Young Adult Fertility and Sexuality Study) has found more than one-third of young males, and consequently their current and future female partners, are potentially vulnerable to HIV infection by the time they marry, there is no room for complacency. Sex workers are showing high rates of syphilis, and substantial overlap exists between commercial and casual sexual networks. But numerous social and religious barriers remain to the open discussion of risk behaviours, promotion of condoms, and training in the skills required to protect oneself from HIV. These barriers must be overcome if the country is to protect its youth and avoid a serious HIV/AIDS problem in the future.