Youth and HIV

1. Network of Youth Leaders for Health Congress
25 – 27 May 2011
Clark Field, Pampanga
Youth and HIV
Jose Gerard Belimac, MD, MPH
Medical Specialist II
Manager, National AIDS and STI Prevention and Control Program
(NASPCP)
National Center for Disease Prevention and Control (NCDPC)
Pampanga

2. • Young People?
• Youth?
• Children?
• Adolescent?
National AIDS/STI Prevention and Control Program
Infectious Disease Office

3. • Young People 10 – 24 yr old
• Youth 15 – 24 to 30 yr old
• Children below 18yr old
• Adolescent: 10 – 19 yr old
National AIDS/STI Prevention and Control Program
Infectious Disease Office

4. Purpose
- To inform Youth leaders on HIV risks
and vulnerabilities so that leaders can
fully maximise their potential as
agents of change in their communities
National AIDS/STI Prevention and Control Program
Infectious Disease Office

5. Outline of Presentation
• Facts on HIV and AIDS
– Basic information on HIV
– Risks and Vulnerabilities
– Impact of HIV to individuals, families and
communities
• Epidemiology
• Examples of Interventions
National AIDS/STI Prevention and Control Program
Infectious Disease Office

6. HIV primarily weakens/destroys the
Immune System
What is Immune System
is a complex network of cells and
chemicals in our body
protects against foreign organisms
get rid of anything that is an invader
it is coordinated by “helper cells” (also
known as CD4 cells)
 if the "coordinator" of the
process(CD4 cell), body open to attack
by opportunistic infections;
 CD4 are slowly destroyed by HIV

7. HIV AIDS
• virus that causes AIDS
• A person can look and
feel healthy even if they
have HIV.
• A person with HIV can
pass the virus to
others.
• HIV weakens the body’s
ability to fight infection,
making a person very
sick. This is called AIDS.
• It can take years for a
person infected with HIV
to develop AIDS
It takes 2 to 10 years before a person develops AIDS.
Progression to AIDS can be delayed by HIV treatment

8. HIV can only be acquired from the following
BODY FLUIDS:
Body Fluid Means of Transmission
Semen
(including pre-ejaculate)
Unprotected vaginal/anal sex
(man – woman, man – man)
Blood Transfusion of blood contaminated
with HIV, re-use and sharing of
injecting equipments among drug users
Vaginal Fluid Unprotected sex
(man-woman)
Breastmilk From mother to child (mostly during
delivery and breastfeeding) but this is
greatly reduced now because of
treatment

9. How can HIV infection be avoided?
Abstinence
(most effective)
Be mutually
faithful
Correct and
Consistent use of
Condoms
National AIDS/STI Prevention and Control Program
Infectious Disease Office

10. STI symptoms by Gender
(DOH, 1994)
Reproductive Health
Indicator
At least one
serious RH
problem (as %)
Vaginal / Penile
discharge
(as %)
Painful
urination
(as %)
FEMALE
In-School Youth 15.0 3.1 12.1
Out-of-School Youth 35.2 6.8 19.1
Working Youth 26.0 4.5 17.9
Total Female Youth 24.4 4.7 15.9
MALE
In-School Youth 24.1 1.5 21.3
Out-of-School Youth 22.9 1.9 19.4
Working Youth 25.3 4.5 22.4
Total Male Youth 24.3 4.7 21.4

11. Individual
Vulnerabi-lity
Risk
Structural factors
Population mobility and
migration Conflict
Injecting drug use
•Needle sharing
Social factors
Low literacy
Gender inequalities
Limited work
opportunities
H
I
V
Access to service
Discrimination
Poor Service
Sexual
transmission
•Partner change
•Condom use
•STI cofactors

12. Out of School Youth (OSY) as an HIV
Vulnerable Sectors
- may have completed school, dropped out, or never
started school
- may have jobs or be married, or may be girls who have
been forced to quit school because they need to work in
the home, are pregnant, or have babies.
- work in factories, live on the street, hawk vegetables in
the market, stay at home for housework or child care, or
are unemployed
- Street children, adolescent sex workers, orphans, child soldiers, and
other such groups are generally, but not always, out of school.

13. What are the needs of OSY?
• Same needs as other youth:
– food and shelter
– sense of connection or belonging
– skills in problem-solving and life planning, job or vocational
training
– access to appropriate services
– empowerment to take responsibility for their own lives
– and information on sexual health issues, including contraception
and HIV prevention.
– However, different populations of out-of-school youth have
specific needs defined by their circumstances.
Adapted

14. Estimated OSY in the Philippines
(By source)
Agency Estimated
OSY
Age
Inclusive
Notes
Department of
Health
4.84 million 6-24 2002
World Bank 9.01 million 15-25 2003
Department of
11.6 million 6-24 2006
Education
FLEMMS* 11.64 million No data 2003

15. Vulnerability of Young People to HIV and AIDS
(UNICEF, 2006)
• Knowledge of HIV, AIDS and condom increases with age,
and is high among those with high education and in school
adolescents
• Almost 2 out of 10 youths surveyed are sexually active
• More young people from the major urban cities have
engaged in sex
– Condom use still low among sexually active youth
– Younger youth are likely to use condom the first time, and this
improved slightly with higher number of older youth using
condom in their last sexual episode

16. Vulnerability of Young People to HIV and AIDS
(UNICEF, 2006)
• Attitude
– About 4 of 10 youths and healthworkers
believe that discussing condoms among
youth only promotes promiscuity
– Even among healthworkers, a substantial
17 percent agreed to the statement that
using condom is sign of not trusting one’s
partner.

17. Other vulnerabilities (15 – 24 yr old)
(HAIN OR, 2008)
• OSY rely more on friends especially on issues such as sexuality
• When asked how to prevent STI, ways cited are withdrawal,
choosing the right partner, and taking of medicines/antibiotics
• More males than females mentioned the use of condom as a way
to prevent STI
• 94% are aware of condom but only 45% know that use of
condom during sex can reduce the risk of HIV infection
• Majority are currently in a relationship and had engaged in
sexual intercourse.
National AIDS/STI Prevention and Control Program
Infectious Disease Office

18. Some HIV Risks (15 – 24 yr old)
(HAIN OR, 2008)
• OSYs exhibit a more liberal attitude towards sex, with higher
percentage engaged in almost all types of sexual practices:
multiples sex, unprotected sex, commercial sex, sex with same sex
• A third of sexually active OSY reported they had ever experienced
being forced against their will to have sex, with males having a
slightly higher rate than female (35%,32%)
• Males reported to have had an average of six sexual partners while
women had an average of two.
National AIDS/STI Prevention and Control Program
Infectious Disease Office

19. Biological Risk
• Cervix of adolescents is more
vulnerable to STI

20. What Happens when one is Infected
with HIV? – The Impact of AIDS

21. Impact of HIV/AIDS Effects of HIV/AIDS on
Individuals, Families and Households
• Need for care and support
• Sickness and death
• Psychological losses and burdens related to sickness,
death, decline in well being and increased insecurity
• Loss of the family’s adult members at their most
productive ages
• Reduction in nutrition
• Loss of productivity
• Loss of income, increase in poverty, diversion of
resources
• Increase in dependants
• Orphaning

22. Impact of HIV/AIDS Effects of HIV/AIDS on
Individuals, Families and Households
• Breakup of families
• Increased dependency ratios and pressure on surviving
adults caring for additional family members
• Population shifts due to both mortality and migration
• Increased violence associated with crime and stigma,
increase in discrimination

23. Adults and children estimated to be living with HIV, 2009
Network of Youth Leaders for Health Congress
25 – 27 May 2011
Clark Field, Pampanga
Total: 33.4 million
• Africa:
22 million
• South and South East
Asia:
6 million
• almost 7,000 (PHL)

24. 6,498 reported HIV cases
(January 1984 to March 2011)
Source: Philippine HIV Registry

25. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
2011
2006 to 2010
2001 to 2005
1996 to 2000
1991 to 1995
1984 to 1990
FEMALE
MALE
HIV/AIDS cases disaggregated by sex
(1984 to 2011)
Source: Philippine HIV Registry

26. Distribution of Male and Female HIV Cases by
Age group (1984 to 2011)
Source: Philippine HIV Registry
Note: Scales are different for males and females

27. Distribution of Male HIV Cases by Age group
(2009 - 2011)
Source: Philippine HIV Registry

28. Distribution of Female HIV Cases by Age group
(2009 - 2011)
Source: Philippine HIV Registry

29. Modes of Transmission of HIV Cases
Source: Philippine HIV Registry

30. Mode of HIV Transmission Among 15-24yo
(2006 – 2010)
Source: Philippine HIV&AIDS Registry
N A T I O N A L E P I D E M I O L O G Y C E N T E R

31. The General Gameplan
(5th AIDS Medium Term Plan 2011 – 2015)
Vision
The spread of HIV infection is halted in the
Philippines
Goal
By 2016, the country will have prevented the
further spread of HIV infection and reduced the
impact of the disease on individuals, families,
sectors, and communities.
National AIDS/STI Prevention and Control Program
Infectious Disease Office

32. National Young People’s Forum
Committee on Children and HIV –
Council for the Welfare of Children
2009, 2010

33. Generally, some intervention the Youth
can work with are:
1. Cooperation with SK Officials on HIV programmes
2. Promotion of Peer Education Sytem in the Brgy Level
3. Targeted popularization of condoms
4. Promotion of the development and use of
Educational Entertainment for HIV and AIDS
modules
5. Encourage strong Alliance between Organizations
(including Faith – Based Organizations)
National AIDS/STI Prevention and Control Program
Infectious Disease Office

34. Generally, some intervention the Youth
can work with are:
7. Intensify, correct & update Advocacy campaigns
among all in school personnel and students
8. Inclusion of children and young peoples in the
monitoring and evaluation of programmes
9. Ensure that VCT is provided for free in all health
centers; ensure the availability of HIV IEC materials
in every health center
National AIDS/STI Prevention and Control Program
Infectious Disease Office

35. HIV Vulnerabilities thru the Eyes of
Young People
National AIDS/STI Prevention and Control Program
Infectious Disease Office

36. Acknowledgement to: Davao City

42. Summer Internship Programme for Young
People on HIV and AIDS
(2010)
Background:
• Very low knowledge of Youth on HIV and AIDS
• Limited manpower of health offices to educate the youth
• Recognised the Power of peers as good source of
information
Project:
• 240 YP trained and hired by DOH to conduct peer
education in their own communities (NCR, Cebu and
Davao)
• Daily visit to communities, supervised by doctors and
counselors from LGU and NGO
National AIDS/STI Prevention and Control Program
Infectious Disease Office

43. Summer Internship Programme for Young
People on HIV and AIDS
(2010)
Outcome:
1. Delivered education to almost 5,000 peers (one – on –
one)
2. Summer interns able to maintain group of peers for
self-help sessions weekly
3. Summer Interns eventually became school – based
advocates and educators and tapped by schools and
communities for HIV advocay and programmes
4. Sense of belongingness, heightened social
consciousness (poverty, independence, responsibility,
accountability)
National AIDS/STI Prevention and Control Program
Infectious Disease Office

44. Young People advocates leading the
observance of AIDS Candlelight
Memorial (Cebu, Summer 2010)

46. Young People advocates in one
of their duty stations in Davao
City (Summer 2010)

47. Summary
• The youth is at risk to HIV: Very low condom use, Biologically
more susceptible , engaged in partnerships often of limited
duration, face multiple obstacles to utilization of health care
• Behavioral risks of youth to HIV include early sexual initiation, and
failure to take appropriate prevention precaution
• HIV is a highly preventable infection
• Structures and systems are continuesly built to engage and
empower youth to be partners of HIV advocacies
• There is life after HIV infection, treatment is available, although
there is no cure yet
• Due to stigma and discrimination, HIV impact to person, family and
community is much broader

48. Challenges
• Socio-cultural resistance to behaviour change;
• Lack of knowledge about one’s HIV status (personal
denial, stigma, and poor geographical accessibility of
counseling and testing services)
• Geographic obstacles to accessing comprehensive care
• Lack of access to basic services due to poverty
• Stigma and discrimination
• Weak structures that enables delivery of HIV services

49. Believe in the Power of You.
Be responsible.
Stop HIV transmission.
National AIDS/STI Prevention and Control Program
Infectious Disease Office

50. www.pnac.org.ph
www2.doh.gov.ph/naspcp