The threat of HIV and other sexually related diseases

Reported cases increased substantially increased over the past year.Among the 15-24 year olds, reported
HIV infections nearly tripled between 2007 and 2008 from 41 cases to 110 per year, which is substantial cause for
alarm. In 2009, 15-24 year olds make 29% of all new infections; in 2009, the number of new infections among 20-24
equals the number of new infections among 25-29; with 10 cases see July DoH AIDS Registry Report. The
substantial increase from the past year can be traced from the adolescents early engagement in health risk
behaviour, due to serious gaps of the knowledge on the dangers of drugs, as well as the cause as well as
causes on the transmission of STD and HIV AIDS , dangers of indiscriminate tattooing and body-
piercing and inadequate population education. Under this threat, young males are prone to engaging in health
risk behaviour and more young fermales are also doing the same without protection and are prone to aggressive
or coercive behaviours of others in the community such that it often results to significant number of unwanted
pregrancies,septic abortion and poor self-care practices.

Attitudes, Lifestyles, Sense of Values, Norms and Behaviours of Adolescents

Health Risk Behaviors

A significant proportion of young people engage in high-risk behaviors 23% ever had pre- marital sex, 57% of first
sex experience was unplanned and unplanned. About 70% - 80% of their most recent sexual experiences were
unprotected (YAFS, 2002).

The 2002 Young Adult Fertility and Sexuality Survey showed that the proportion of 15-24 year olds who were currently
smoking, drinking and using drugs were 20.9%, 41.4% and 2.4%, respectively. The proportion is higher among males
compared to females. A comparative data (1994 and 2003) showed that among 15 24 year olds, smoking
increased by 23%; drinking increased by 10%; drug use increased by 85%; and pre martial sex increased by 30%
(YAFSS, 2003). The likelihood of engaging in pre-marital sex is higher among those who smoke, drink alcohol or take
drugs. As a consequence of substance and alcohol abuse, some have mental and neurological disorders; others spend
the productive years of their life behind bars with hardcore lawless adults.

Health Seeking Behavior

Adolescents are more likely to consult the health center (45%) or government physician (19%) for their health needs
(Baseline Survey for the National Objectives for Health, 2000). The most common reasons for not consulting were the
lack of money, lack of time, fear of diagnosis, distance and disapproval of parents. Dental examination and BP
monitoring were the most common reasons for consultation (62.4% and 37.8%, respectively).Similalry, Conditions
relating to pregnancy, childbirth and post partum were among the leading reasons for utilization of in-patient, emergency
room and out patient health services at DOH-Retained Tertiary General Hospitals.

Low Contraceptive Use

The overall use of contraception among sexually active adolescents is at 20%. Non- desire for pregnancy and high
awareness of contraceptive methods were not enough to encourage adolescents to use contraceptives. Among the
reasons cited for the low contraceptive use were:

Contraceptives were given only to married individuals of reproductive age

Even if they were made available to adolescents, the culture says that it is taboo for young unmarried
individuals to avail of contraceptive services and commodities.
Condom use is perceived mainly for STIs, HIV/AIDS prevention rather than contraception

The practice Abortion and Unmet need for Contraception

In 2000, induced abortion among adolescents reached 319,000. This is due to the inadequate knowledge on preventing
unwanted pregnancies. Consequences of teen-age pregnancies among young mothers include not being able to finish
school and reduced employment options and opportunities. In addtion, the social stigma and fear brought about by
unwanted pregrancy pushes the young mother to resort to abortion. Although the disapproval rating for abortion remains
to be high, there is an increasing trend among those who approve of it (from 4% to 6% in males and 3.5% to 4% in
females).On contraceptive use , adolescents also don't use condoms for prevention of HIV,it's not only that they don't
use them for contraception.

Risk of HIV/AIDS due to Unprotected Sex

Adolescents including children living in exteme conditons and great exposure to sexual exploitation and abuse belong
to high-risk categories threatened by unprotected sex. Latest data on these shows that majority of people engaged in
sex work are young and 70 % of HIV infections involve male-to-male sex. The proportion of young people reported to
have STDs/HIV and AIDS is increasing. The YAFS survey showed that although awareness about STDs is increasing,
misconceptions about AIDS appear to have the same trend. The proportion of those who think AIDS is curable more
than doubled (from 12% in 1994 to 28% in 2002). Many adolescents also resort to services of unqualified traditional
healers, obtain antibiotics from pharmacies or drug hawkers or resort to advices from friends (e.g. drinking detergent
dissolved in water) without proper diagnosis to address problems of STDs. Improper or incomplete treatment may mask
the symptoms without curing the disease increasing the risk of transmission and development of complications. The
limited use of condoms to protect adolescents from risk of HIV is an issue to reflection for condom use is not only to
prevent pregranancy but also preventing sexually transmitetd disease. r The YAFS 2002 survey showed that Filipino
males and females are at risk of STIs, HIV/AIDS. It was reported that 62 % of sexually transmitted infections affect the
adolescents while 29 % of HIV positive Filipino cases are young people. In addition, it was revealed that thirty seven
percent (37%) of Filipino males 25 years of age have had sex before they marry with women other than their wives.
Some will have paid for sex while others will have had five or more partners.

Political and Economic Factors

Marginalization and Poverty

The disturbing poverty situation of households and families where majority of the adolescents belong brings in
difficulties to meet adolescents.needs. Poverty is closely link to adolescent health issues. It reinforces to the
situation of adolescents vulnerability to health risks due to the lack of access to various services and unsupportive
social, political and economic environment. The following are some of the consequences of poverty faced by the
youth.

Limited Access to Information -among the greatest challenges for Filipino youth is access to correct and
meaningful information on sexual and reproductive issues.
Limited access to services and commodities-The lack of access to contraceptive services and supplies
was among the most frequently articulated concerns with regard to adolescent SRH. Programs such as the
AYHDP do recognize adolescents need for access to contraception.
Limited awareness of pertinent policies-While the AYHP Administrative order was issued in 2000, few key
informants knew of its existence. In fact, many key informants said that no ARH policy existed at the time they
were interviewed

Technological Factors

Rapid Advancement of Communication

The value of technological advancement could never be discounted. However, to the curious and adventurous
adolescents various modes of communications are oftentimes abused and misused such as the use of internet and
mobile phones. Adolescents then become vulnerable to exploitation, in cybersex and pornography exposing them
deeper into risky behaviour. In addtion the digital dependence and addiction causes alienation of adolescetns
to personal and closer mode of communciation resulting to a distorted image of the adoelscents relationships to the
 social environment. This also deprives the adolescents from productive activities where they
can develop themselves fully grown up and mature e conomic and socail being Moreover, communcation
advantcement has also produced adverstisements and television commercials whose image are not adoelsent-
friendly are paving the way for so much consumerism, distorted personal and family values

THE ADOLESCENTS HEALTH PROGRAM IN THE PHILIPPINES

8. International Policies, Passages and Laws as anchors

In International Laws

UN Convention on the Rights of Children

UN Convention the Action for the Promotion and Protection of the health of adolescents
Convention on the Elimination of all forms of discrimination againts women
1994 International Conference on Populaiton and Development ( ICPD)
1995 Fourth World Conference on Women
World Programme of Action for Youth 2000
MDG Goals :
Goal 2:Achieve Universal Primary Education
Goal 3:Promote Gender Equality
Goal 4 : Reduce Child Mortality
Goal 5: Improve Maternal Health
Goal 6:Combat HIV/AIDS, Malaria and other diseases

National Laws and Policies

o National Objectives for Health

o Fourmula One for Health

o Adolescent and Youth Health Policy (AYH)

o Adolescent and Youth Health and Develoment Program

o National Directional Plan for reaching the Un reahced Youth Population

o Reproductive Health Program AO#1 s1998

o Local Government Code

WHO, together with countries and areas in the Region and partner agencies, are working to promote healthy
development of adolescents and reduce mortality and morbidity. In the Western Pacific Region, several technical units
are working to implement interventions that improve adolescent health in the Region. The Philippines belong to the
Western Pacific Region and is committed to:

Recognize adolescents as vulnerable and a group in need

o Address Issues that have an evidence base

o Socio- Cultural perspectives

o Develop Innovative mechanisms to reach out to adolescents.

o Encourage collaboration and partnerships

o Program implementation is monitored and evaluated.

The Adolescent Health Program

The Adolescents Youth and Heath Development Programs was established in 2001 under the oversight of the
Department of Health in partnership with other government agencies with adolescent concerns and other
stakeholdres. The program is targeting youth ages 1024, and the program provides comprehensive implementation
guidelines for youth-friendly comprehensive health care and services on multiple levelsnational, regional,
provincial/city, and municipal.

The program is solidly achored on International and laws, passages and polices meant to address adolescents health
concerns. It is operating then within the facets and adolescents and youth health that includes disability, mental and
environmental health, reproductive and sexuality, violence and injury prevention and among others.

It employed strategies to ensure integration of the program intothe health care system in addition, broader society such
as building a supportive policy environment, intensifying IEC and advocacy particularly among teachers, families, and
peers, building the technical capacity of providers of care, and support for youth; improving accessibility and availability
of quality health services, strengthening multi-sectoral partnerships, resource mobilization, allocation and improved
data collection and management.

The program to address sexual and reproductive health issues likewise adopts gender-sensitive approaches. The
primary responsibility for implementation of the AYHDP, and its mainstreaming into the health system, falls to regional
and provincial/city sectors. Guidelines cover service delivery, IEC, training, research and information collection,
monitoring and evaluation, and quality assurance.