The effects of establishment practices, knowledge and attitudes on condom use among Filipina sex workers.

The findings for a baseline assessment for a community-based HIV/STD prevention intervention for commercial sex workers (CSWs) and managers of the establishments that employ them in the Philippines is presented in this study. CSW knowledge, attitudes, behaviours and establishment policies concerning HIV prevention were assessed. Baseline assessments are part of an iterative process that will be used to modify the planned intervention. The preliminary findings point to the importance of an intervention that stresses changes in establishment policies and expectations as a means of reducing risk behaviours associated with HIV/STD transmission.

PIP: As of May 1996, 1025 HIV-infected individuals had been identified in the Philippines, 260 of whom had AIDS. However, in the Philippines' total population of 65 million, approximately 18,000 adults are estimated to carry HIV. Unprotected sex and multiple partners place prostitutes at risk of contracting and transmitting HIV and other STDs. There are 65,000 registered prostitutes and 200,000 or more freelance sex workers in the Philippines. 1394 registered prostitutes, of whom 98.6% were female, were recruited from commercial sex work establishments in 4 sites about 400 miles from Manila for participation in a study assessing prostitutes' knowledge, attitudes, behaviors, and establishment policies concerning HIV prevention. The participants were aged 15-54 of mean age 23.5 years. Establishment policies and practices appear to be more important than prostitutes' knowledge of HIV transmission or their attitudes toward condoms. Any intervention to prevent HIV/STD among prostitutes in the Philippines should therefore consider and possibly target sex work establishments' policies.

Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.

The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.

PIP: Between April and October, 1989, professors from the College of Public Health at the University of the Philippines in Manila compared data on 356 5-year-old children living in Manila, who had been admitted to a government hospital with diarrhea of 7 days duration, with data on 357 age and neighborhood matched controls to study the relationship between personal and domestic hygiene behavior and hospitalized severe childhood diarrhea. To address selection bias, the researchers chose controls who could potentially use the hospital services. All the children were from low-income families. As standards of hygiene for overall cleanliness and kitchen hygiene fell, the risk of severe diarrhea increased. Specifically, children in the group with a middle score in overall cleanliness acquired severe diarrhea at 2 times the rate as those with a low score (i.e. better hygienic conditions). Those in the high score group acquired it at 3.9 times the rate as those in the low score group. For kitchen hygiene, the odds ratios were 2.7 and 5.3, respectively. Living conditions did not influence the rate of diarrhea. Living conditions included inside and outside sanitary conditions, number of rooms, and presence or lack of a dining table. These findings suggested that effective health education programs aimed to change hygiene behavior could prevent severe diarrhea. Therefore, public health programs should develop suitable interventions for the education of mothers and of the general public.