A ‘Google Maps’ for condoms in the Philippines
With a 174% rise in new HIV infections from 2010 to 2017 – condom promotion is the first piece of the prevention puzzle for the Philippines.
A new app for gay and other men who have sex with men is connecting users with free condoms in ‘safe spaces’ across Manila, the country’s capital.
The ‘Safe Spaces’ app by LoveYourself, a community-based organisation providing health and empowerment services to men who have sex with men and transgender people, was inspired by Pokémon Go and lets users know where their closest condom dispenser is.
The app is featured in this month’s Lancet HIV and aims to reduce new HIV infections among gay men and transgender women, only one-third of whom reported using a condom in the last year. The main reason for not using a condom was that it was ‘not available’.
A lack of condom promotion and low condom use is blamed for an explosion in HIV infections in the Philippines, with new HIV infections increasing by a staggering 174% in the seven short years from 2010. No other country has experienced such a hike in new HIV infections – neither in the Asia Pacific region nor around the world.
What is more alarming is that the majority of these new infections are among men, and especially young gay men. While the overall HIV prevalence countrywide is 0.1%, around 5% of men who have sex with men are living with HIV, and 90% of new infections are among men who have sex with men and transgender people. Additionally, knowledge of HIV status in this group is poor with less than 14% of gay men under 25 aware of their status.
While condoms are widely available to buy or get in a health centre, wide-spanning stigma and discrimination towards gay men affect access to this vital prevention tool. The ‘Safe Spaces’ app seeks to bridge this gap with 30 dispensers in safe spaces, including lesbian, gay, bisexual, and transgender (LGBT) friendly spaces, cafes, bathhouses and universities. It aims to increase this number to 150 in the city by the end of 2018.
The Philippines’ staunch Catholicism is not helping to break down many of the taboos around sex, even for those in heterosexual relationships, let alone same-sex relationships. In a landmark new HIV bill, the age of consent for HIV testing will be dropped from 18 to 15 and age-appropriate sex education will be compulsory in school. But the same bill also fails to mention ‘condom promotion’ in any of the literature and implementation will always be a barrier, said Human Rights Watch researcher in the Philippines Carlos Conde to the Lancet HIV.
Philippine President Rodrigo Duterte is also not helping matters – earlier this year he said: “Don’t use condoms because they don’t feel good,” to the shock of advocates and international media worldwide.
Conde continued, “We know the situation is dire […] what’s more concerning is the irresponsible government response [which] is inadequate[…] For an epidemic that is affecting primarily MSM [men who have sex with men] because of low condom use, you’d think we’d be flooded with advertisements promoting condoms with MSM but that’s not the case.”
The Safe Spaces app is just one of a number of programmes initiated by LoveYourself, who is stepping in to reach key affected populations where the government has not.
The organisation has two HIV testing and counselling centres in Manila which have diagnosed just under half of all new HIV infections in the city. They focus on sex-positive campaigns to reach young men who have sex with men, and have partnered with the Asia Pacific Coalition on Male Sexual Health (APCOM) to launch a new app promoting HIV testing in the city called ‘testMNL’. They are also handing out pre-exposure prophylaxis (PrEP) to 250 young men and transgender women in the city as part of a two-year pilot programme with UNAIDS/World Health Organization (WHO).
Ronivin (Vinn) Garcia Pagtakhan, the Executive Director and Founder of LoveYourself, told the Lancet HIV, “It’s always our dream to reach more people. Sex is taboo, but in order for us to do big things, we need to continue to partner with media organisations to create buzz.”
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