Collective Coping Strategies for HIV-Related Challenges Among Men Who Have Sex With Men in Manila, Philippines.

Contextual factors, such as cultures of collectivism versus individualism, shape HIV coping strategies; despite this, little research regarding collective coping strategies applied to HIV exists. This may be important for the growing HIV epidemic in the Philippines, which has a collectivistic culture and where men who have sex with men (MSM) account for a majority of the cases. Fifteen semistructured, in-depth interviews with HIV-positive MSM and 6 interviews with community-based organization workers were conducted between June and August 2017. Data were analyzed using thematic framework analysis. Three strategies were identified: peer support, spirituality, and support from existing relationships. Each form of collective coping had unique mechanisms and benefits for dealing with HIV. Overall, helping MSM with HIV find a collective identity after an HIV diagnosis enables management of HIV-related challenges. Policies and research interventions that improve access to collective identities for MSM with HIV may improve management of HIV-related challenges.

"An Evil Lurking Behind You": Drivers, Experiences, and Consequences of HIV-Related Stigma Among Men Who Have Sex With Men With HIV in Manila, Philippines.

The Philippines has a rapidly growing HIV epidemic, with men who have sex with men (MSM) accounting for a majority of known cases. Currently, there is little understanding about MSM's experiences of HIV-related stigma in the Philippines and how they influence behavior and quality of life. Twenty-one interviews with MSM living with HIV and with communitybased organization workers were conducted in Manila from June to August 2017. MSM participants were affected by the intersection of HIV-related stigma and stigma toward homosexuality that are rooted in connotations of morality, "dirtiness," and sin. We identified specific patterns by which MSM living with HIV experienced enacted, felt, and internalized stigma and discuss implications of stigma for mental health, delays in HIV testing, and avoidance of HIV health services. Findings support the development of public health strategies in the Philippines that address stigma at societal and individual levels to reduce stigma-related harms.

A human rights-focused HIV intervention for sex workers in Metro Manila, Philippines: evaluation of effects in a quantitative pilot study.

OBJECTIVES: This study evaluated a brief human rights-focused HIV community mobilization intervention for sex workers in the Philippines, a country with one of the fastest rising number of HIV cases worldwide. METHODS: Five single-session group interventions to reduce sexual risk and increase HIV testing among 86 sex workers in Manila were evaluated with pre-post-test data via Wilcoxon's signed-ranks and Mann-Whitney tests. The 4-h intervention, Kapihan (August-November, 2013), integrated human rights with HIV skill-building. Demographic data, violence/trafficking victimization, human rights knowledge, and intentions to HIV test and treat were collected. RESULTS: Participants were median aged 23; female (69 %); had children (55; 22 % had 3+ children); used drugs (past 3 months: 16 %); sexually/physically abused by clients (66 %); 20 % street sex workers ever took an HIV test. Pre-post-test scores significantly improved in knowledge of HIV (z = -8.895, p < 0.001), reproductive health (z = -3.850, p < 0.001), human rights (z = -4.391, p < 0.001), ethical rights of research participants (z = -5.081, p < 0.001), and intentions to HIV test (z = -4.868, p < 0.001). CONCLUSIONS: Integrating human rights into HIV interventions may empower sex workers to address their health and human rights and test for HIV.

Social and structural factors associated with consistent condom use among female entertainment workers trading sex in the Philippines.

This paper examined socio-structural factors of consistent condom use among female entertainment workers at high risk for acquiring HIV in Metro Manila, Quezon City, Philippines. Entertainers, aged 18 and over, from 25 establishments (spa/saunas, night clubs, karaoke bars), who traded sex during the previous 6 months, underwent cross-sectional surveys. The 143 entertainers (42% not always using condoms, 58% always using condoms) had median age (23), duration in sex work (7 months), education (9 years), and 29% were married/had live-in boyfriends. In a logistic multiple regression model, social-structural vs. individual factors were associated with inconsistent condom use: being forced/deceived into sex work, less manager contact, less STI/HIV prevention knowledge acquired from medical personnel/professionals, not following a co-workers' condom use advice, and an interaction between establishment type and alcohol use with establishment guests. Interventions should consider the effects of physical (force/deception into work), social (peer, manager influence), and policy (STI/HIV prevention knowledge acquired from medical personnel/professionals) environments on consistent condom use.

Men-who-have-sex-with-other-males(MSM) in the Philippines- Identities, sexualities and social mobilities: A formative assessment of HIV and AIDS vulnerabilities

Men are primarily responsible for the transmission of HIV because of their participation in risk-taking activities such as unsafe sex (i.e. homosexual and/or heterosexual) and drug injections. Men, particularly men having sex with other males, were identified by the DOH-HIV Serologic Surveillance as one of the subpopulations with the highest risk of acquiring HIV. This can be attributed to their behavior towards safe sex, masculinity and their partner. The main objective of this study was to conduct a formative and qualitative assessment on HIV and AIDS among MSM (men who have sex with other males) in the Philippines by identifying the constructions of their sexual identities and their sexual behaviors and risks using the following themes: social mobility; and, health seeking behaviors. Multiple methods have been utilized in this study such as environmental scoping, key informant interviews and focus group discussion sessions in four selected sites in the Philippines. A Delphi technique was also used to solicit opinion of experts in the field of medical, allied medical and social sciences. Results of this study showed that MSM is a vulnerable and susceptible sub-population group to STI, HIV and AIDS due to the complexities of understanding their own sexualities, the gap between their actual and ideal health seeking behaviors and various sexual experiences that brought about the dynamics of sexual proclivities. The study recommends a strong programmatic design for intervention among MSM to become positive agents of change in STI, HIV and AIDS education.