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HOLY TRNITY UNIVERSITY


CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter presents the collected foreign and local literature and
foreign and local studies that would support and validate the study being
conducted. These are authored by either Filipino or Foreign authors.
Local Literature
MANILA, Philippines -- Manila Archbishop Luis Antonio Tagle has called
on the priests, religious, seminarians and laypeople of the Archdiocese of
Manila to learn more about HIV/AIDS.
Education about HIV and AIDS is necessary for the local church to
come up with an effective and appropriate pastoral response to the silent
epidemic, Tagle wrote in a circular published on the Manila archdiocese's
website.

Nine new cases of HIV are reported daily, of which 52 percent is in the
National Capital Region, Tagle wrote in the circular. While the global trend is
decreasing, the number of HIV cases is rising in the Philippines while the
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time it takes for cases to double continues to shorten, he wrote. "Of the
9,669 reported cases from 1984 to May 2012, 5,245 cases (or 54 per cent of
total cases) were recorded between 2010 and 2012. What is alarming is that
the 20-29 year old age group has had the most number of cases."

Infectious diseases doctor Fr. Dan Cancino of the Ministers of the
Infirm told NCR in May that common causes of infection are injection drug
use and men having sex with men.

Manila archdiocese's website announced two workshop this month that
will be conducted by Msgr. Robert Vitillo, special advisor on HIV and AIDS
for Caritas Internationalis and head of the International Delegation to the UN
in Geneva.

At the request of the Catholic Bishops' Conference of the Philippines,
Caritas Internationalis and the Catholic Medical Mission Board organized the
workshops: the first for priests and religious Aug. 22-23 at the San Carlos
Seminary auditorium, San Carlos Formation Complex, EDSA, Makati City;
the second for seminarians and laypeople Aug. 24 at Layforce chapel in the
same compound.


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He cited the bishops' conference's 2011 pastoral letter on AIDS,"Who
Is My Neighbor?". The letter emphasized the need for church workers to
develop basic knowledge and pastoral skills for ministry to people living with
HIV and AIDS.
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The state of the HIV epidemic in the Philippines has been described as
"low and slow", which is in stark contrast to many other countries in the
region. A review of the conditions for HIV spread in the Philippines is
necessary. 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,
__________________________
6
Viehland N.J., "Philippines archbishop encourages HIV/AIDS awareness
workshops", (August 15, 2012), http://ncronline.org/blogs/ncr-
today/philippines-archbishop-encourages-hivaids-awareness-workshops.
Date accessed: October 21, 2013
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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.
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.
7


In December 2009, 125 new HIV cases were confirmed by the DOH, a
staggering 232% increase compared to the same period last year (n=38 in
2008). Seventy-three percent of HIV-positive individuals are male, and
sexual contact accounts for 90% of HIV transmission. The infections are
concentrated among sexual workers, MSM, IDUs, and overseas contract
workers.

__________________________
7
Farr A.C. and Wilson D.P., "An HIV epidemic is ready to emerge in
the Philippines", (April 22, 2010), http://www.biomedcentral.com/1758-
2652/13/16. Date accessed: October 21, 2013

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Current trends in Philippine HIV infection are shifting to MSM and younger
populations; the age range associated with the most infections has shifted
from 30 to 39 years of age to 20 to 29 years of age. Infection through
homosexual contact increased from 40% in 2008 to almost 70% in 2009.
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Foreign Literature
In the case of AIDS, primary prevention the prevention of infection or
disease in an apparently healthy population- is directed toward the
preventing the disease in the sexual partners of those who are infected with
the virus. Public education must be a major focus in these preventive efforts.

Moreover, these recommendations need to be made to all people,
including those who are at high risk, those who engage in high risk sexual
practices (especially in epidemic areas), and those who are at apparently low
risk, sexually and demographically.
The general public needs and wants this information. In a survey by
the National AIDS Hotline, 89% of their callers requested information about


_______________________________
8
Nussbaum L., "The Philippines: Housing for People Living with
HIV/AIDS. The HIV/AIDS Epidemic", (July 2010),
http://www.thebody.com/content/art58857.html. Date accessed: October
21, 2013


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AIDS, with the highest demand (33%) being for information on
transmission.
9
Groups at highest risk of contracting AIDS include homo- and
bisexuals and intravenous drug users in large cities; hemophiliacs; female
prostitutes; heterosexuals. Evidence suggests that the HIV may also be
affecting more and more young people, particularly runaways. In passive
transmission, a mother can pass AIDS to her child before or during birth.
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Local Studies
Due to the increasing number of HIV positive cases in the Philippines
has been noted especially in the last three (3) years based from the results
of the Philippines AIDS Registry (passive surveillance).
The Department of Education initiates HIV/AIDS information
prevention campaign awareness nationwide, to promote a deeper knowledge
about AIDS and provide correct information and comprehensive


______________________
9
DeVita V.T. Jr., Hellman J., and Rosenberg S.A., AIDS, 2nd ed., (J.B.
Lippincott Company, 1988) p. 355
10
Wagman R.J., The New Complete Medical and Health Encylopedia,
Vol. 2., (J.G. Ferguson Publishing Company, Chicago, 1994) p. 584-585
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Education Br. Secretary Armin A. Luistro FSC said the order is
conducting the orientation workshop on HIV and AIDS education is pursuant
to Republic Act (R.A.) 8504 or the Philippine AIDS Prevention and Control
Act of 1988 and the Civil Service Commission Guidelines on the
Implementation of Workplace Policy and Education Program on HIV and
AIDs.
This move is guided by a sense of urgency to address the unabated
increase in the incidence of HIV infection in high- risk areas in the country,
.. The Philippines is one of two countries in Asia which has registered a spike
in HIV incidence in recent years. This is happening while the rest of the
region has been experiencing a downward trend, Luistro explained. Official
documents from the National Epidemiology Center (NEC) of the Department
of Health reported 313 cases in its 2012 March AIDS Registry, which means
ten cases of HIV infection are being reported in the country every day.

Last July 11 to 13 the DepEd has already completed trainings on
HIV/AIDS information and prevention program for the National Capital
Region with 8 Metro Manila divisions. Next was held last July 18 to 20 and
was attended by 8 more NCR divisions. The Visayas leg will be held in Cebu
on August 8 to 10 while the Mindanao leg will be in Davao on August 15 to
17, 2012. From the department, it will provide assistance to core of trainers
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to conduct and orient DepEd officials from the regions and divisions,
including health personnel and administrative officers, education supervisors
as well as alternative learning personnel.

First we create awareness, then we communicate accurate, appropriate and
comprehensive information, and then we institute measures on how to
prevent its spread by translating such knowledge into positive behavioral
change. This can be done through a continuing education and information
campaign that is culture and gender-sensitive for our employees and
teachers, said Luistro.
DepEd is duty-bound to accelerate the implementation of its HIV and
AIDS education program in compliance with its duties and responsibilities as
a member of the PNAC. According to UNICEFs country manager in the
Philippines, Vanessa Tobin, "We cannot be complacent any longer because
the rate of HIV cases in the Philippines is increasing at an alarming rate.
One-third of new HIV infections are occurring among young people aged 15
to 24". "There is no doubt that HIV + AIDS in the Philippines has an
adolescent face, Tobin added.Adolescence, she explains, is a critically
important age. It is during this second decade in a person's life, especially
among girls in poor families, that one is more likely to experience
exploitation, abuse, early pregnancy and childbirtha leading cause of death
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for teenage girls. This is reason UNICEF is investing in educating and
training the worlds 1.2 billion adolescents.
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The Philippines first AIDS case was diagnosed in 1984. By 1992, 84
cases of AIDS had been reported, and screening in a few cities had
identified fewer than 300 people seropositive for HIV. Nonetheless, certain
high-risk behaviors were believed to be widespread, including unprotected
commercial sex work, and needle sharing in IDUs. Although data on HIV
prevalence and risk behavior was sketchy, the potential for further spread
of HIV was evident. In addition, although many Filipinos had heard of
HIV, they lacked specific knowledge about the disease, its transmission
modes, and how best to protect themselves.
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THE United Nations (UN) on Wednesday expressed alarm over the
increasing number of human immunodeficiency virus (HIV) and acquired
immune deficiency syndrome (AIDS) cases in the country.
UN Special Envoy to Asia and the Pacific JVR Prasada Rao told the
House of Representatives Committee on Health during a hearing that the
Philippines is now facing the sub-population epidemic of HIV-AIDS.
________________
11
GMedia Center, "DepEd initiates HIV/AIDS information prevention
campaign
awareness",http://www.gmediacenter.net/index.php/publications/country-
specific/philippines/203-deped-initiates-hivaids-information-prevention-
campaign-awareness. Date accessed: October 21, 2013
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Aquino C., DAgnes L., Castro J., Borromeo, M. , Schmidt, K. and
Gill, K. Policy and Advocacy Efforts for HIV and AIDS Prevention: The AIDS
Surveillance and Education Project in the Philippines. Makati City,
Philippines: PATH (2003).

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Rao added that the Philippine government should now intervene to
prevent the fast and furious prevalence of the HIV-AIDS.
Philippine National Aids Council (PNAC) Executive Director Ferchito
Avelino said during the same hearing that the council needs P1.2 billion for
AIDS prevention through its education and awareness campaign.
We need funds to support our program against HIV-AIDS, Avelino
said. Health authorities said there were 431 new cases of HIV in June,
bringing to 2,323 the number of new cases since January 2013 and to
14,025 since the disease was detected in 1984. Of the 14,025 cases since
1984, 1,289 have become full-blown AIDS, the officials said.
Meanwhile, the Department of Health (DOH) said that from one case in
every three days in 2000, HIV cases have increased to one case a day in
2007, four cases a day in 2010, seven cases a day in 2011 and nine cases a
day in 2012, and a new HIV case every two hours in 2013.
It said that the reported common mode of HIV transmission of all the
cases in the Philippines was sexual contact and males having sex with males.
Males having sex with other males were the predominant type of sexual
transmission through heterosexual contact, followed by homosexual contact,
then bisexual contact, the DOH said. It added that other common mode of
transmission were through needle sharing among injecting drug users and
through mother-to-child transmission. The DOH said that HIV leads to AIDS.
The latter is a condition where the virus attacks and damages the immune
system of the body, eventually causing death.
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13
dela Cruz J.M.N., and Mayuga J.L., "UN alarmed by increasing HIV-AIDS
incidence in the Philippines", (August 28, 2013),
http://www.businessmirror.com.ph/index.php/en/news/nation/18619-un-
alarmed-by-increasing-hiv-aids-incidence-in-the-philippines. Date accessed:
October 21, 2013


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Foreign Studies
More than 92% of students were aware about HIV-AIDS disease, 83%
were aware about sexual route and 56 % were aware about the major
routes of transmission and 26% aware about major preventive measures,
but there were some mis conception about routes of transmission,
prevention, behavior and treatment.
Study suggest that there was good awareness about HIV-AIDS as a
disease and sexual route of transmission but awareness about all major
routes and preventive measures are still lacking. There are certain
misconceptions about routes of transmission, prevention, behaviour and
treatment.
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Men who have sex with men (MSM) are at increased risk for infection
with human immunodeficiency virus (HIV). In 2006, 57% of new HIV
infections in the United States occurred among MSM (1). To estimate and
monitor risk behaviors, CDC's National HIV Behavioral Surveillance system
(NHBS) collects data from metropolitan statistical areas (MSAs) using an
anonymous cross-sectional interview of men at venues where MSM
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14
Trivedi A., Verma P., and Singh M.P., A, "A Study to find out the
awareness about HIV/AIDS in adolescent school boys and girls of Bhavnagar
City", http://iasociety.org/Abstracts/A2176462.aspx. Date accessed:
October 21, 2013
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congregate, such as bars, clubs, and social organizations. This report
summarizes NHBS data from 2008, which indicated that, of 8,153 MSM
interviewed and tested in the 21 MSAs participating in NHBS that year, HIV
prevalence was 19%, with non-Hispanic blacks having the highest
prevalence (28%), followed by Hispanics (18%), non-Hispanic whites (16%),
and persons who were multiracial or of other race (17%). Of those who were
infected, 44% were unaware of their infection. Men who know their current
HIV infection status can be linked to appropriate medical care and
prevention services.

Once linked to prevention services, men can learn ways to avoid
transmitting the virus to others. Young MSM (aged 18--29 years) (63%) and
minority MSM (other than non-Hispanic white) (54%) were more likely to be
unaware of their HIV infection. Efforts to ensure at least annual HIV testing
for MSM should be strengthened, and HIV testing and prevention programs
should increase their efforts to reach young and minority MSM.
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15
Taussig J, Gern R, and Hoyte T, "Prevalence and Awareness of HIV
infection among men who have sex with men--21 cities, United States,
2008", (September 24, 2010),
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5937a2.htm. Date
accessed: October 21, 2013

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There is no set age at which HIV/AIDS education should start, and
different countries have different regulations and recommendations. Often
young people are denied life-saving AIDS education because adults consider
the information to be too adult for young people. These attitudes hinder
HIV prevention, as it is crucial that young people know about HIV and how it
is transmitted before they are exposed to situations that carry a risk of HIV
infection.
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Synthesis
The local literature states that the Philippines still has limited and most
of the population have their misconceptions regarding HIV/AIDS and its
prevention.
The foreign literature states that the awareness among the population
at risk on the prevention of HIV/AIDS is that they are not knowledgeable;
and that the little knowledge they have, according to the studies, most of
them are misconceptions on the prevention of HIV/AIDS.
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AVERT, Making HIV/AIDS Effective, http://www.avert.org/hiv-aids-
education-young-people.htm. Date accessed: October 21, 2013.