UPDATES ON SEXUALRELATED ISSUESUniversity of Northern PhilippinesGraduate SchoolMaster of Arts in Nursing
SEXUAL HEALTH ISSUESSexual health is a broad area that encompasses manyinter-related challenges and problems. Key among th...
CHILDSEXUALABUSE
A. CHILD SEXUAL ABUSESexual abuse - rape, incest and acts oflasciviousness continue to plague our children.The same goes t...
Statistics:The Department of Social Welfare and Developmenthas served the following in 2010:• 1,247 sexually abused childr...
•The Department of Justice reports a total of 15,830cases involving sex and commercial exploitation ofchildren as of Decem...
Key Facts:• Majority of the offenders are family members orsomeone close to the family.• Both males and females sexually o...
• Child sexual abuse usually begins with a sexoffender gaining both the parent‘s and the child‘strust and friendship. Once...
• Sexual abuse and exploitation can cause long-lasting problems well into adulthood. It isimportant to get your child into...
• There is an Increasing incidence of childpornography and cyber-related crimes.• Cybersex is viewed as a source of income...
• Awareness on child pornography and childprotections laws is low.• Efforts/initiatives of both government and non-governm...
RAPE TRAUMA
B. RAPE TRAUMA• Rape is one of the most prevalent forms ofviolence against women (VAW) in the Philippines.• Reported rape ...
• The government with the aid of NGOs have takeninitiatives to set up crisis centers for rape survivorsin collaboration wi...
Rape is committed under the followingcircumstances:A man has sexual intercourse with a woman:• Through force, threat or in...
Any person who, under any of the above conditions,commits an act of sexual assault through oral or analsex or by inserting...
Rape Crisis CenterThe Department of Social Welfare andDevelopment (DSWD), the Department of Health(DOH), the Department of...
• Providing rape victims with psychologicalcounseling, medical and health services, includingtheir medico-legal examinatio...
• Developing and undertaking a training program forlaw enforcement officers, public prosecutors,lawyers, medico-legal offi...
There are many influences on the manner inwhich each individual survivor of sexual violencecopes and on the length of time...
• Ability to cope with stress• Attitude of those immediately contacted after theassault• The age and developmental stage o...
DOMESTIC VIOLENCE
C. DOMESTIC VIOLENCEDomestic violence is threatening behavior,violence or abuse inflicted upon a woman or herchild. It may...
The law enumerates certain acts which can be aground for a criminal case. These include actsthat:• cause physical harm to ...
• inflict physical harm on one‘s self to control a woman‘sactions or decisions• force a woman or her child to engage in an...
How widespread is domestic violence?• In 2009, the Philippine National Police (PNP) hasrecorded a 37.4 percent increase in...
What can I do about domestic violence?• Seek immediate protection from the properauthorities. Every police station has a W...
• While you may apply for a protection order on yourown, it is best to consult with a lawyer. You mayalso go to the DOJ Pu...
Where can I go for help?• Crisis Intervention Unit• Department of Social Welfare and Development(DSWD)• Women and Children...
• Department of Justice (DOJ)• Women‘s Desk• Philippine General Hospital (PGH)• Women and Children Crisis Care and Protect...
INCEST
D. INCEST• In 1995, the DSWD defined incest as sexualabuse committed against children and adults bypersons related to the ...
• The 1998 Family Code is so far the only existinglegislation that has no reference to incest. Butits pertinent provision ...
• The only official document in the Philippines thatdefines incest is the Philippine Plan for GenderDevelopment (PPGD). Th...
Despite the varying perspectives on the abuser-victim/survivor relationship that qualifies an abuse asincest, there is a c...
Philippine Situation:• A recent joint study by the United NationsChildrens Fund (UNICEF) and the University of thePhilippi...
• A DSWD study in 2000 showed that the majority ofthe perpetrators of child abuse are acquaintances,followed by neighbors,...
Senate Bill:SBN-1500: Anti-Incest ActAn Act Criminalizing Incestuous Sexual RelationsFiled on July 15, 2010 by Defensor Sa...
SEXUALLY TRANSMITTEDINFECTIONS
E. SEXUALLY TRANSMITTED INFECTIONSSexually transmitted infections (STIs) are a publichealth issue• According to 2005 WHO e...
Infections and transmission• STIs are infections that are spread primarilythrough person-to-person sexual contact.• Severa...
Common bacterial infections:• Neisseria gonorrhea (causes gonorrhea orgonococcal infection)• Chlamydia trachomatis (causes...
Common viral infections:• Human immunodeficiency virus (causes AIDS)• Herpes simplex virus type 2 (causes genital herpes)•...
Parasites:• Trichomonas vaginalis (causes vaginaltrichomoniasis)• Candida albicans (causes vulvovaginitis in women;inflamm...
The main syndromes of common STIs are:• urethral discharge• genital ulcers• inguinal swellings (bubo, which is a swelling ...
STI syndromic approach to patient management:• The traditional method of diagnosing STIs is bylaboratory tests. However, t...
• The syndromic approach is a scientificapproach and offers accessible and immediatetreatment that is effective. It is als...
Prevention• The most effective means to avoid becominginfected with or transmitting a sexuallytransmitted infection is to ...
WHO response:• The control of STIs is a priority for WHO. The WorldHealth Assembly endorsed the global strategy forthe pre...
• The Strategy urges partners to ensure that womenand children have access to a universal package ofguaranteed benefits, i...
ILLEGAL SEX
F. ILLEGAL SEX• Prostitution in the Philippines is illegal. It is aserious crime with penalties ranging up to lifeimprison...
Violence and coercion against prostitutes• Women and children involved in prostitutionare vulnerable to rape, murder, AIDS...
• Over a third reported that they had beensubject to violence or harassment, mostcommonly from the police, but also from c...
• Over 50 percent of the women surveyed inPhilippine massage parlors said they carried outtheir work ―with a heavy heart,‖...
SEXUALHARASSMENT
G. SEXUAL HARASSMENTAs defined by the Philippine Anti-Sexual HarassmentAct of 1995, sexual harassment is ―a request for as...
In a work-related environment, sexual harassmentis committed when:• The sexual favor is made as a condition in thehiring o...
What to do in case of sexual harassment?1. Say ‗No‘ or ‗Stop it‘ firmly and loud enough forsomeone to hear.2. Document the...
SEPARATION
H. SEPARATIONANNULMENT, DIVORCE AND LEGAL SEPARATIONIN THE PHILIPPINESIs divorce allowed under Philippine laws?No, divorce...
Is “annulment” different from a “declarationof nullity” of marriage?Yes. In essence, ―annulment‖ applies to amarriage that...
So, if a marriage is void from the verybeginning (void ab initio), there’s no need tofile anything in court?For purposes o...
What are the grounds for annulment?• Lack of parental consent in certain cases.• Insanity.• Fraud.• Force• Impotence• STD
What if a spouse discovers that his/her spouse is ahomosexual or is violent, can he/she ask forannulment?Homosexuality or ...
What are the grounds for legal separation?• Repeated physical violence or grossly abusiveconduct directed against the peti...
• Final judgment sentencing the respondent toimprisonment of more than six years, even ifpardoned.• Drug addiction or habi...
• Sexual infidelity or perversion.• Attempt by the respondent against the life of thepetitioner.• Abandonment of petitione...
If you’re separated from your spouse for 4years, is that a sufficient ground forannulment?No. De facto separation is not a...
What are the grounds for declaration of nullity ofmarriage?• Minority• Lack of authority of solemnizing officer• Absence o...
• After securing a judgement of annulment or ofasolute nullity of mariage, the parties, beforeentering into the subsequent...
LOSS (ABORTION)
LOSSAbortions in the world• An abortion is the termination of a pregnancy bythe removal or expulsion of an embryo or fetus...
• The data on abortions displayed on the Worldometerscounter is based on the latest statistics on worldwideabortions publi...
Abortion in the Philippines• The basic status of Abortion in the Philippines isthat it is illegal, or banned by rule of la...
• The act is criminalized by the Revised Penal Codeof the Philippines, which was enacted in 1930 andremains in effect toda...
• There is no law in the Philippines that expresslyauthorizes abortions in order to save the womanslife; and the general p...
• It was reported in 2005 that official estimates thenranged from 400,000 to 500,000 and rising, and thatthe World Health ...
• Two-thirds of Filipino women who have abortionsattempt to self-induce or seek solutions from thosewho practice folk medi...
DESEXUALIZATION
I. DESEXUALIZATION• Women‘s sexuality has been used to removewomen‘s power for decades. Desexualization ofwomen take away ...
• About 140 million girls and women worldwide arecurrently living with the consequences of FGM.• FGM is mostly carried out...
Female genital mutilationKey facts:• Female genital mutilation (FGM) includesprocedures that intentionally alter or cause ...
• The practice is mostly carried out by traditionalcircumcisers, who often play other central roles incommunities, such as...
WHO efforts to eliminate female genital mutilationfocus on:• strengthening the health sector response: guidelines,training...
WHO is particularly concerned about theincreasing trend for medically trained personnelto perform FGM. WHO strongly urges ...
AGING PROCESS(Sexuality and Aging)
J. AGING PROCESS (Sexuality and Aging)Sexual health is important at any age. And the desirefor intimacy is timeless. While...
Aging and mens sexual health• Testosterone plays a critical role in a manssexual experience.• Testosterone levels peak in ...
• The penis may take longer to become erect,and erections may not be as firm.• It may take longer to achieve full arousal ...
Aging and womens sexual health• As women approach menopause, their estrogenlevels decrease, which may lead to vaginaldryne...
Medical conditions and sexual health• Any condition that affects your general healthand well-being may also affect your se...
• High blood pressure, for instance, can affectyour ability to become aroused, as can certainmedications used to treat hig...
Looking forward not backMany couples want to know how to get back to thesexual arousal and activity levels they experience...
Thank you!!!BARROGA, Marilyn RichelleDIGUEL, Brenda LeeGRAGERA, Jennifer C.LA MADRID, Cyprene GrailMASIGMAN, Mary AnnPAEST...
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Updates on sexual related issues

  1. 1. UPDATES ON SEXUALRELATED ISSUESUniversity of Northern PhilippinesGraduate SchoolMaster of Arts in Nursing
  2. 2. SEXUAL HEALTH ISSUESSexual health is a broad area that encompasses manyinter-related challenges and problems. Key among the issues andconcerns are human rights related to sexual health, sexualpleasure, eroticism, and sexual satisfaction, diseases (HIV/AIDS,STIs, RTIs), violence, female genital mutilation, sexualdysfunction, and mental health related to sexual health.During a meeting held in Antigua, Guatemala in May 2000,an expert group convened by the Pan American HealthOrganization and WHO in collaboration with the World Associationfor Sexology (WAS) compiled an overview of sexual concerns andproblems that should be addressed in order to advance sexualhealth (PAHO/WHO 2000).Sexual health concerns are life situations that can beaddressed through education about sexuality and society-wideactions in order to promote the sexual health of individuals. Thehealth sector has a role to play in assessment, and in providingcounseling and care.
  3. 3. CHILDSEXUALABUSE
  4. 4. A. CHILD SEXUAL ABUSESexual abuse - rape, incest and acts oflasciviousness continue to plague our children.The same goes true for children victims ofcommercial sexual exploitation – childtrafficking, child prostitution and childpornography.
  5. 5. Statistics:The Department of Social Welfare and Developmenthas served the following in 2010:• 1,247 sexually abused children, 1,168 or 93 % ofwhich were female• 127 sexually exploited, 120 or 94 % of which werefemale• 390 victims of child trafficking, 368 or 94% ofwhich were female• Children victims of pornography are lumped withinthose sexually exploited. In 2010, there were eight8 victims, seven of which were female.
  6. 6. •The Department of Justice reports a total of 15,830cases involving sex and commercial exploitation ofchildren as of December 2010 based on a nationwidecase inventory in 2006 to 2007.•As of December 2009, a total of 20 establishmentswere permanently closed by the Department ofLabor and Employment from 2005 – 2009 foremploying minors in prostitution or in obscene orlewd shows pursuant to Republic Act 9231. A total of58 victims of child labor have been reported.
  7. 7. Key Facts:• Majority of the offenders are family members orsomeone close to the family.• Both males and females sexually offend, howevermales represent a higher percentage of known sexoffenders.• While media reports cases of abuse andexploitation, many other cases remain unknown tothe general public either because information isn‘tpublicized or because the offenses have not beenreported.
  8. 8. • Child sexual abuse usually begins with a sexoffender gaining both the parent‘s and the child‘strust and friendship. Once a relationship has beenestablished, the offender will begin to test thechild‘s knowledge and ability to protect themselves• Children who are well informed and empowered toact, and who have someone who will listen to themcan, in many cases, prevent or stop sexual abuse.Offenders do not usually choose victims who arelikely to resist or tell.• Sexual exploitation and abuse can lead tounwanted pregnancies among girls and put them atrisk to HIV/AIDS infection.
  9. 9. • Sexual abuse and exploitation can cause long-lasting problems well into adulthood. It isimportant to get your child into counseling afterabuse has been disclosed. It is necessary andhealthy for child victims to seek immediateprofessional help.• Sexual exploitation of children may come in variousforms -child pornography, child trafficking or childprostitution.• Children and young people are primary users ofinternet and mobile technology.• Accessibility of children and young person totechnology makes them highly vulnerable to childpornography and other forms of cyber-abuse.
  10. 10. • There is an Increasing incidence of childpornography and cyber-related crimes.• Cybersex is viewed as a source of income, it canbe operate even within the family.• There are small-scale and large-scale internationalorganized networks operating inside through andoutside of the Philippines.• There are already a number of laws pertinent tothe protection of children. Among them is RepublicAct 9775 or the Anti-Child Pornography Act wasenacted in 2009.
  11. 11. • Awareness on child pornography and childprotections laws is low.• Efforts/initiatives of both government and non-government are on-going, encourage/expandpartnerships to other sectors like ISP, civic,business group, media others.
  12. 12. RAPE TRAUMA
  13. 13. B. RAPE TRAUMA• Rape is one of the most prevalent forms ofviolence against women (VAW) in the Philippines.• Reported rape cases ranked third (13.1%) of thetotal reported VAW cases in the country from 1999to 2009.• The hard fact is that this is not yet the truerepresentation of the problem.• Due to cultural and social stigmatization associatedwith rape, many women victims prefer to maintaintheir silence and not report their ordeal to theauthorities.
  14. 14. • The government with the aid of NGOs have takeninitiatives to set up crisis centers for rape survivorsin collaboration with the different sectors of thecommunity to help victims deal with the traumaand encourage them to report rape.• Several rape-related laws have also been passed toaddress the concern.• Through the provision of suitable legal support andhealth services, it is hoped that women victims ofrape be encouraged to come forward for properintervention and justice to be served accordingly.
  15. 15. Rape is committed under the followingcircumstances:A man has sexual intercourse with a woman:• Through force, threat or intimidation;• When the victim is deprived of reason or isunconscious;• Through fraudulent machination or grave abuse ofauthority; and• When the victim is under 12 years of age or isdemented, even if none of the above conditionsare present.
  16. 16. Any person who, under any of the above conditions,commits an act of sexual assault through oral or analsex or by inserting an instrument or object into theanal or genital orifice of another person.In the Philippines, there are two laws enacted thatdirectly address rape namely:• R.A. 8353: The Anti-Rape Law of 1997• R.A. 8505: The Rape Victim Assistance andProtection Act of 1998
  17. 17. Rape Crisis CenterThe Department of Social Welfare andDevelopment (DSWD), the Department of Health(DOH), the Department of the Interior and LocalGovernment (DILG), the Department of Justice(DOJ), and a lead non-government organization(NGO) with proven track record or experience inhandling sexual abuse cases, shall establish in everyprovince and city a rape crisis center located in agovernment hospital or health clinic or in any othersuitable place for the purpose of:
  18. 18. • Providing rape victims with psychologicalcounseling, medical and health services, includingtheir medico-legal examination;• Securing free legal assistance or service, whennecessary, for rape victims;• Assisting rape victims in the investigation to hastenthe arrest of offenders and the filing of cases incourt;• Ensuring the privacy and safety of rape victims;• Providing psychological counseling and medicalservices whenever necessary for the family of rapevictims;
  19. 19. • Developing and undertaking a training program forlaw enforcement officers, public prosecutors,lawyers, medico-legal officers, social workers, andbarangay officials on human rights andresponsibilities; gender sensitivity and legalmanagement of rape cases; and• Adopting and implementing programs for therecovery of rape victims.The DSWD shall be the lead agency in theestablishment and operation of the Rape CrisisCenter.
  20. 20. There are many influences on the manner inwhich each individual survivor of sexual violencecopes and on the length of time the symptoms maybe present. These factors include:• Support systems• The relationship with the offender• The degree of the violence used• Social and cultural influences• Previous experience with stress
  21. 21. • Ability to cope with stress• Attitude of those immediately contacted after theassault• The age and developmental stage of the survivor(adolescent survivors are more vulnerable)It is essential that all legal, medical and policeprocedures must not cause further trauma tosurvivors who must be given all possible support toovercome and survive the ordeal.
  22. 22. DOMESTIC VIOLENCE
  23. 23. C. DOMESTIC VIOLENCEDomestic violence is threatening behavior,violence or abuse inflicted upon a woman or herchild. It may be caused by the husband, ex-husband,live-in partner, boyfriend, ex-boyfriend, the fatherof her child or anyone with whom she has had anintimate (sexual or dating) relationship with.Acts of domestic violence are punishable bylaw, specifically under The Violence Against Womenand their Children Act of 2004.
  24. 24. The law enumerates certain acts which can be aground for a criminal case. These include actsthat:• cause physical harm to the woman or her child• compel a woman or her child to do somethingwhich they can choose not to do• restrict a woman or her child‘s freedom ofmovement through force or intimidation. This maybe by depriving or threatening to deprive thewoman and/or her children of financial supportwhich they are legally entitled to
  25. 25. • inflict physical harm on one‘s self to control a woman‘sactions or decisions• force a woman or her child to engage in any sexualactivity (other than rape)• cause emotional or psychological distress to the womanor her child, such as stalking, harassing, destroying thewoman‘s personal belongings, infidelity• cause mental or emotional anguish, public ridicule orhumiliation. This includes verbal abuse.
  26. 26. How widespread is domestic violence?• In 2009, the Philippine National Police (PNP) hasrecorded a 37.4 percent increase in reports onviolence against women (VAW) from the previousyear.• Physical injuries and/or wife battering account for45.5 percent of all reported VAW cases in the last12 years.• More than half of physical violence cases iscommitted by a husband or domestic partner.Sexual violence committed by the husband ordomestic partner of a woman represents 60.5percent of the reported cases.
  27. 27. What can I do about domestic violence?• Seek immediate protection from the properauthorities. Every police station has a Women andChildren Protection Desk that you can go to forhelp.• The DSWD can also offer you a safe place to stay ifyou need to leave your home for protection. Thereare a number of government-run shelters that canprovide you with the support you need.• If you feel that reporting the incident to the properauthorities or staying in a shelter is not enough toensure your safety, you may apply for a protectionorder at your barangay or in court.
  28. 28. • While you may apply for a protection order on yourown, it is best to consult with a lawyer. You mayalso go to the DOJ Public Attorney‘s Women‘s Deskat the Public Attorney‘s Office in your area forlegal help.• Anyone who has witnessed violence against awoman and/or her child may also file a complaint.This is because the law considers violence againstwomen and children as a public crime. This meansthat the victim is not the only one who may file acomplaint against the abuser.
  29. 29. Where can I go for help?• Crisis Intervention Unit• Department of Social Welfare and Development(DSWD)• Women and Children‘s Concern Division• Philippine National Police (PNP)• Violence Against Women and Children ProtectionDesk• National Bureau of Investigation (NBI)• Public Attorney‘s Office Women‘s Desk
  30. 30. • Department of Justice (DOJ)• Women‘s Desk• Philippine General Hospital (PGH)• Women and Children Crisis Care and ProtectionUnit• East Avenue Medical Center (EAMC)There is also a Women and Children‘s ProtectionDesk in the police station nearest you which canprovide immediate help when needed.
  31. 31. INCEST
  32. 32. D. INCEST• In 1995, the DSWD defined incest as sexualabuse committed against children and adults bypersons related to the victims by blood.• The Bureau of Child and Youth Welfare (BCYW)expanded its definition in 1996 by includingsexual abuse committed against a person byany member of the household.
  33. 33. • The 1998 Family Code is so far the only existinglegislation that has no reference to incest. Butits pertinent provision (Article 37) pertains toincestuous marriages, not to incest itself:―Marriages between the following areincestuous and void from the beginning, whetherthe relationship between the parties belegitimate or illegitimate: (1) Betweenascendants and descendants of any degree; and(2) Between brothers and sisters, whether of fullor half blood.‖
  34. 34. • The only official document in the Philippines thatdefines incest is the Philippine Plan for GenderDevelopment (PPGD). The PPGD defines incest as:―the commission of sexually inappropriate acts oracts with sexual overtones, with a child oradolescent, by an older person or adult who wieldsauthority through emotional bonding with thatchild or younger person.‖There are three elements that recur in theexisting understanding of incest. These are:• Age• Relationship• Sexual abuse
  35. 35. Despite the varying perspectives on the abuser-victim/survivor relationship that qualifies an abuse asincest, there is a common recognition that an essentialelement of incest is betrayal of trust.Compared with stranger abuse, incest has a differentpsychological and emotional impact on the victimbecause of the relationship of trust between the victim-survivor and the abuser.“A child molested by a stranger can run home for helpand comfort. A victim of incest cannot.”
  36. 36. Philippine Situation:• A recent joint study by the United NationsChildrens Fund (UNICEF) and the University of thePhilippines Center for Womens Studies Foundationfound that the culprits in a third of the reportedcases of child sex abuse were relatives — usuallythe father or uncle.• The research indicated that 70 percent of childrendid not report the abuse; they suffered in silence.
  37. 37. • A DSWD study in 2000 showed that the majority ofthe perpetrators of child abuse are acquaintances,followed by neighbors, and one-third are fathers ofthe victims. Uncles, brothers, employers, andcousins follow in the ranking.• In a report to the Philippine Congress, the DSWDdisclosed: 62.5 per cent of child-abuse casesreported in the last years were not filed in court bythe childrens families because of loss of interest inthe case.• The main reason is that the victims are ashamed ofpeople knowing of their situation because it doesnot only put them to shame but all of those in thefamily.
  38. 38. Senate Bill:SBN-1500: Anti-Incest ActAn Act Criminalizing Incestuous Sexual RelationsFiled on July 15, 2010 by Defensor Santiago,MiriamLegislative status: Pending in the Committee(9/1/2010)
  39. 39. SEXUALLY TRANSMITTEDINFECTIONS
  40. 40. E. SEXUALLY TRANSMITTED INFECTIONSSexually transmitted infections (STIs) are a publichealth issue• According to 2005 WHO estimates, 448 million newcases of curable STIs (syphilis, gonorrhoea,chlamydia and trichomoniasis) occur annuallythroughout the world in adults aged 15-49 years.• This does not include HIV and other STIs whichcontinue to adversely affect the lives of individualsand communities worldwide.• In developing countries, STIs and theircomplications rank in the top five diseasecategories for which adults seek health care.
  41. 41. Infections and transmission• STIs are infections that are spread primarilythrough person-to-person sexual contact.• Several, in particular HIV and syphilis, can also betransmitted from mother to child during pregnancyand childbirth, and through blood products andtissue transfer.• STIs are caused by bacteria, viruses and parasites.Some of the most common infections are below.
  42. 42. Common bacterial infections:• Neisseria gonorrhea (causes gonorrhea orgonococcal infection)• Chlamydia trachomatis (causes chlamydialinfections)• Treponema pallidum (causes syphilis)• Haemophilus ducreyi (causes chancroid)• Klebsiella granulomatis (previously known asCalymmatobacterium granulomatis causesgranuloma inguinale or donovanosis).
  43. 43. Common viral infections:• Human immunodeficiency virus (causes AIDS)• Herpes simplex virus type 2 (causes genital herpes)• Human papillomavirus (causes genital warts and certainsubtypes lead to cervical cancer in women)• Hepatitis B virus (causes hepatitis and chronic casesmay lead to cancer of the liver)• Cytomegalovirus (causes inflammation in a number oforgans including the brain, the eye, and the bowel).
  44. 44. Parasites:• Trichomonas vaginalis (causes vaginaltrichomoniasis)• Candida albicans (causes vulvovaginitis in women;inflammation of the glans penis and foreskin[balano-posthitis] in men).
  45. 45. The main syndromes of common STIs are:• urethral discharge• genital ulcers• inguinal swellings (bubo, which is a swelling in thegroin)• scrotal swelling• vaginal discharge• lower abdominal pain• neonatal eye infections (conjunctivitis of thenewborn).
  46. 46. STI syndromic approach to patient management:• The traditional method of diagnosing STIs is bylaboratory tests. However, these are oftenunavailable or too expensive.• Since 1990 WHO has recommended a syndromicapproach to diagnosis and management of STIs inpatients presenting with consistently recognizedsigns and symptoms of particular STIs.• The syndromic approach uses flowcharts to guidediagnosis and treatment is more accurate thandiagnosis based on clinical tests alone, even inexperienced hands.
  47. 47. • The syndromic approach is a scientificapproach and offers accessible and immediatetreatment that is effective. It is also more cost-effective for some syndromes than use oflaboratory tests.• The pathogens causing any particular syndromeneed to be determined locally and flow chartsadapted accordingly. Furthermore, regularmonitoring of the organisms causing eachsyndrome should be conducted on a regularbasis to validate the treatmentrecommendations.
  48. 48. Prevention• The most effective means to avoid becominginfected with or transmitting a sexuallytransmitted infection is to abstain from sexualintercourse or to have sexual intercourse onlywithin a long-term, mutually monogamousrelationship with an uninfected partner.• Male latex condoms, when used consistently andcorrectly, are highly effective in reducing thetransmission of HIV and other sexually transmittedinfections, including gonorrhea, chlamydialinfection and trichomoniasis.
  49. 49. WHO response:• The control of STIs is a priority for WHO. The WorldHealth Assembly endorsed the global strategy forthe prevention and control of STIs in May 2006.• More recently, the United Nations Secretary-General Global Strategy for Womens and ChildrensHealth highlighted the need for a comprehensive,integrated package of essential interventions andservices.
  50. 50. • The Strategy urges partners to ensure that womenand children have access to a universal package ofguaranteed benefits, including family-planninginformation and services, antenatal, newborn andpostnatal care, emergency obstetric and newborncare and the prevention of HIV and other sexuallytransmitted infections.• Such a package could accelerate the responsetowards meeting the lagging health-relatedMillennium Development Goals.
  51. 51. ILLEGAL SEX
  52. 52. F. ILLEGAL SEX• Prostitution in the Philippines is illegal. It is aserious crime with penalties ranging up to lifeimprisonment for those involved in trafficking.• It is covered by the Anti-Trafficking in Persons Act.• Prostitution is sometimes illegally available throughbrothels (also known as casa), bars, karaoke bars(also known as KTVs), massage parlors, streetwalkers and escort services.• As of 2009, one source estimated that there were800,000 women working as prostitutes in thePhilippines, with some of them believed to beunderage.
  53. 53. Violence and coercion against prostitutes• Women and children involved in prostitutionare vulnerable to rape, murder, AIDS and othersexually transmitted diseases.• Surveys of women working as masseusesindicated that 34 percent of them explainedtheir choice of work as necessary to supportpoor parents, 8 percent to support siblings and28 percent to support husbands or boyfriends.• More than 20 percent said the job was wellpaid, but only 2 percent said it was easy workand only 2 percent claimed to enjoy the work.
  54. 54. • Over a third reported that they had beensubject to violence or harassment, mostcommonly from the police, but also from cityofficials and gangsters.• A survey conducted by the International LaborOrganization revealed that in the experience ofmost of the women surveyed, prostitution isone of the most alienating forms of labor.
  55. 55. • Over 50 percent of the women surveyed inPhilippine massage parlors said they carried outtheir work ―with a heavy heart,‖ and 20percent said they were ―conscience-strickenbecause they still considered sex withcustomers a sin.‖• Interviews with Philippine bar girls revealedthat more than half of them felt ―nothing‖when they had sex with a client, the remaindersaid the transactions saddened them.
  56. 56. SEXUALHARASSMENT
  57. 57. G. SEXUAL HARASSMENTAs defined by the Philippine Anti-Sexual HarassmentAct of 1995, sexual harassment is ―a request for asexual favor, accepted or not, from an employer,employee, manager, teacher, instructor, professor,coach, trainer or other persons who have authority,influence or moral ascendancy over another.‖ It iscommitted by anyone who demands a sexual favor inexchange for work, promotion or other privileges.The Sexual Harassment Act not only covers thosewho are directly involved but also those whocooperate ―in the commission of‖ the violation.
  58. 58. In a work-related environment, sexual harassmentis committed when:• The sexual favor is made as a condition in thehiring or in the employment, re-employment orcontinued employment of an individual;• Granting an individual favorable compensation,terms, conditions, promotions or privileges, or• The refusal to grant sexual favor results in thelimiting, segregating or classifying the employeewhich in any way would discriminate, deprive ordiminish employment opportunities or otherwiseadversely affect said employee.
  59. 59. What to do in case of sexual harassment?1. Say ‗No‘ or ‗Stop it‘ firmly and loud enough forsomeone to hear.2. Document the event/s.3. Inform someone about what happened.4. File a complaint.***If your case is ignored and you wish to pursue it,then you might want to go to the police and file areport. Be prepared for a more taxing process,though. If you want justice, you‘ll need a lawyerand the judicial procedures can take a while.
  60. 60. SEPARATION
  61. 61. H. SEPARATIONANNULMENT, DIVORCE AND LEGAL SEPARATIONIN THE PHILIPPINESIs divorce allowed under Philippine laws?No, divorce is not allowed in the Philippines.However, there are certain instances wherein thedivorce secured abroad by the foreigner-spouse,and even by former Filipinos, are recognizedunder Philippine laws..
  62. 62. Is “annulment” different from a “declarationof nullity” of marriage?Yes. In essence, ―annulment‖ applies to amarriage that is considered valid, but there aregrounds to nullify it. A ―declaration of nullity‖ ofmarriage, on the other hand, applies tomarriages that are void or invalid from the verybeginning. In other words, it was never valid inthe first place.
  63. 63. So, if a marriage is void from the verybeginning (void ab initio), there’s no need tofile anything in court?For purposes of remarriage, there must be acourt order declaring the marriage as null andvoid. Entering into a subsequent marriagewithout such court declaration means that: (a)the subsequent marriage is void; and (b) theparties open themselves to a possible charge ofbigamy.
  64. 64. What are the grounds for annulment?• Lack of parental consent in certain cases.• Insanity.• Fraud.• Force• Impotence• STD
  65. 65. What if a spouse discovers that his/her spouse is ahomosexual or is violent, can he/she ask forannulment?Homosexuality or physical violence, by themselves,are not sufficient to nullify a marriage. At the veryleast, however, these grounds may be used as basisfor legal separation.How is “legal separation” different fromannulment?The basic difference is this – in legal separation, thespouses are still considered married to each other,and, thus, may not remarry
  66. 66. What are the grounds for legal separation?• Repeated physical violence or grossly abusiveconduct directed against the petitioner, a commonchild, or a child of the petitioner.• Physical violence or moral pressure to compel thepetitioner to change religious or politicalaffiliation.• Attempt of respondent to corrupt or induce thepetitioner, a common child, or a child of thepetitioner, to engage in prostitution, or connivancein such corruption or inducement.
  67. 67. • Final judgment sentencing the respondent toimprisonment of more than six years, even ifpardoned.• Drug addiction or habitual alcoholism of therespondent.• Lesbianism or homosexuality of the respondent.• Contracting by the respondent of a subsequentbigamous marriage, whether in the Philippines orabroad.
  68. 68. • Sexual infidelity or perversion.• Attempt by the respondent against the life of thepetitioner.• Abandonment of petitioner by respondent withoutjustifiable cause for more than one year.The term ―child‖ shall include a child by nature orby adoption.
  69. 69. If you’re separated from your spouse for 4years, is that a sufficient ground forannulment?No. De facto separation is not a ground forannulment. However, the absence of 2 or 4years, depending on the circumstances, may beenough to ask the court for a declaration ofpresumptive death of the ―absent spouse‖, inwhich case the petitioner may again re-marry.
  70. 70. What are the grounds for declaration of nullity ofmarriage?• Minority• Lack of authority of solemnizing officer• Absence of marriage license (except in certaincases).• Bigamous or polygamous marriages (except in caseswhere the other spouse is declared aspresumptively dead).• Mistake in identity (those contracted throughmistake of one contracting party as to the identityof the other).
  71. 71. • After securing a judgement of annulment or ofasolute nullity of mariage, the parties, beforeentering into the subsequent marriage, failed torecord with the appropriate registry the: (i)partition and distribute the properties of the firstmarriage; and (ii) delivery of the children‘spresumptive legitime.• Incestous• Void by reason of public policy• Psychological Incapacity.
  72. 72. LOSS (ABORTION)
  73. 73. LOSSAbortions in the world• An abortion is the termination of a pregnancy bythe removal or expulsion of an embryo or fetusfrom the uterus, resulting in or caused by itsdeath. An abortion can occur spontaneously due tocomplications during pregnancy or can be induced.• Abortion as a term most commonly - and in thestatistics presented here - refers to the inducedabortion of a human pregnancy, while spontaneousabortions are usually termed miscarriages.
  74. 74. • The data on abortions displayed on the Worldometerscounter is based on the latest statistics on worldwideabortions published by the World Health Organization(WHO).• According to WHO, every year in the world anestimated 40-50 million women faced with anunplanned pregnancy decide to have an abortion.This corresponds to approximately 125,000 abortionsper day.• In the USA, where nearly half of pregnancies areunintended, and four in 10 of these are terminatedby abortion there are over 3,000 abortions per day.Twenty-two percent of all pregnancies in the USA(excluding miscarriages) end in abortion.
  75. 75. Abortion in the Philippines• The basic status of Abortion in the Philippines isthat it is illegal, or banned by rule of law.• Article II of the 1987 Philippine Constitution says,in part, "Section 12. The State recognizes thesanctity of family life and shall protect andstrengthen the family as a basic autonomous socialinstitution. It shall equally protect the life of themother and the life of the unborn from conception.
  76. 76. • The act is criminalized by the Revised Penal Codeof the Philippines, which was enacted in 1930 andremains in effect today. Articles 256, 258 and 259of the Code mandate imprisonment for the womanwho undergoes the abortion, as well as for anyperson who assists in the procedure, even if theybe the womans parents, a physician or midwife.Article 258 further imposes a higher prison term onthe woman or her parents if the abortion isundertaken "in order to conceal [the womans]dishonor".
  77. 77. • There is no law in the Philippines that expresslyauthorizes abortions in order to save the womanslife; and the general provisions which do penalizeabortion make no qualifications if the womans lifeis endangered.• Proposals to liberalize Philippine abortion lawshave been opposed by the Catholic Church, and itsopposition has considerable influence in thepredominantly Catholic country.• One study estimated that, despite legal restrictions, in1994 there were 400,000 abortions performed illegallyin the Philippines and 80,000 hospitalizations of womenfor abortion-related complications.
  78. 78. • It was reported in 2005 that official estimates thenranged from 400,000 to 500,000 and rising, and thatthe World Health Organization estimate was 800,000.Seventy percent of unwanted pregnancies in thePhilippines end in abortion, according to the WHO.• Approximately 4 in 5 abortions in the Philippines arefor economic reasons, often where a woman alreadyhas several children and cannot care for another.• While some doctors secretly perform abortions inclinics, the 2,000 to 5,000 peso (USD $37 to $93) fee istoo high for many Filipinos, so they instead buyabortifacients on the black market, e.g. from vendorsnear churches.
  79. 79. • Two-thirds of Filipino women who have abortionsattempt to self-induce or seek solutions from thosewho practice folk medicine.100,000 people end up inthe hospital every year due to unsafe abortions,according to the Department of Health , and 12% of allmaternal deaths in 1994 were due to unsafe abortion.• Some hospitals refuse to treat complications of unsafeabortion, or operate without anesthesia, as punishmentfor the patients.• The Department of Health has created a program toaddress the complications of unsafe abortion,Prevention and Management of Abortion and itsComplications.
  80. 80. DESEXUALIZATION
  81. 81. I. DESEXUALIZATION• Women‘s sexuality has been used to removewomen‘s power for decades. Desexualization ofwomen take away a woman‘s power by onlyfocusing on her sexuality instead of her wholeself.• A very severe, yet common case of thedesexualization of women is female genitalmutilation..
  82. 82. • About 140 million girls and women worldwide arecurrently living with the consequences of FGM.• FGM is mostly carried out on young girls sometimebetween infancy and age 15.• In Africa an estimated 101 million girls 10 years oldand above have undergone FGM.• FGM is a violation of the human rights of girls andwomen.• Female genital mutilation (FGM) comprises allprocedures that involve partial or total removal ofthe external female genitalia, or other injury tothe female genital organs for non-medical reasons.
  83. 83. Female genital mutilationKey facts:• Female genital mutilation (FGM) includesprocedures that intentionally alter or cause injuryto the female genital organs for non-medicalreasons.• The procedure has no health benefits for girls andwomen.• Procedures can cause severe bleeding andproblems urinating, and later cysts, infections,infertility as well as complications in childbirthincreased risk of newborn deaths.
  84. 84. • The practice is mostly carried out by traditionalcircumcisers, who often play other central roles incommunities, such as attending childbirths. However,more than 18% of all FGM is performed by health careproviders, and this trend is increasing.WHO response• In 2008, the World Health Assembly passed a resolution(WHA61.16) on the elimination of FGM, emphasizingthe need for concerted action in all sectors - health,education, finance, justice and womens affairs.
  85. 85. WHO efforts to eliminate female genital mutilationfocus on:• strengthening the health sector response: guidelines,training and policy to ensure that health professionalscan provide medical care and counseling to girls andwomen living with FGM;• building evidence: generating knowledge about thecauses and consequences of the practice, how toeliminate it, and how to care for those who haveexperienced FGM;• increasing advocacy: developing publications andadvocacy tools for international, regional and localefforts to end FGM within a generation.
  86. 86. WHO is particularly concerned about theincreasing trend for medically trained personnelto perform FGM. WHO strongly urges healthprofessionals not to perform such procedures.
  87. 87. AGING PROCESS(Sexuality and Aging)
  88. 88. J. AGING PROCESS (Sexuality and Aging)Sexual health is important at any age. And the desirefor intimacy is timeless. While sex may not be thesame as it was in your 20s, it can still be as fulfillingas ever.Communication is keyTo maintain a satisfying sex life, talk with yourpartner. Set aside time to be sensual and sexualtogether. When youre spending intimate time withyour partner, share your thoughts about lovemaking.Help your partner understand what you want fromhim or her. Be honest about what youre experiencingphysically and emotionally.
  89. 89. Aging and mens sexual health• Testosterone plays a critical role in a manssexual experience.• Testosterone levels peak in the late teens andthen gradually decline.• Most men notice a difference in their sexualresponse by age 60 to 65.
  90. 90. • The penis may take longer to become erect,and erections may not be as firm.• It may take longer to achieve full arousal andto have orgasmic and ejaculatory experiences.• Erectile dysfunction also becomes morecommon. Several medications are available tohelp men achieve or sustain an adequateerection for sexual activity.
  91. 91. Aging and womens sexual health• As women approach menopause, their estrogenlevels decrease, which may lead to vaginaldryness and slower sexual arousal.• Women may experience emotional changes aswell.• While some women may enjoy sex morewithout worrying about pregnancy, naturallyoccurring changes in body shape and size maycause others to feel less sexually desirable.
  92. 92. Medical conditions and sexual health• Any condition that affects your general healthand well-being may also affect your sexualhealth.• Illnesses that involve the cardiovascularsystem, high blood pressure, diabetes,hormonal problems, depression or anxiety —and the medications used to treat theseconditions — can pose challenges to beingsexually active.
  93. 93. • High blood pressure, for instance, can affectyour ability to become aroused, as can certainmedications used to treat high blood pressure.• In addition, any surgical procedure that affectsyour pelvis and your central nervous system willhave a temporary — but often significant —impact on your sexual response.• The body, however, is resilient. Given time toheal and some loving attention, you canbecome sexually responsive again
  94. 94. Looking forward not backMany couples want to know how to get back to thesexual arousal and activity levels they experienced intheir 20s, 30s and early 40s. Instead, find ways tooptimize your bodys response for sexual experiencesnow. Ask yourselves whats satisfying and mutuallyacceptable.Many books are available about how to maintain ahealthy sex life as you get older. In addition, manycouples find consulting with an expert helpful. Yourdoctor may be able to provide useful suggestions orrefer you to a specialist.
  95. 95. Thank you!!!BARROGA, Marilyn RichelleDIGUEL, Brenda LeeGRAGERA, Jennifer C.LA MADRID, Cyprene GrailMASIGMAN, Mary AnnPAESTE, GloriaSERRANO, CecilleVALENTON, Kathleen Anne Marie

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