Safe Sex and Dangerous Words

By Connor Smith

In a speech given on February 20^th , President Rodrigo Duterte of the Philippines began an odd and dangerous digression in which he stated that condoms should not be used during sex due to the fact that they reduced the pleasure of the act.

While President Duterte has made many comments warranting concern and controversy during his tenure in office, this comment comes at a particularly dangerous time for the Philippines.As a nation that has long been working to control its HIV rates, the Philippines has faced increasing trouble with the disease in recent years. While HIV rates have stagnated or fallen in other parts of the Asia-Pacific region, HIV rates within the Philippines have been on the rise, prompting the Philippine Department of Health to declare the disease epidemic a national emergency. Between 2010 and 2016, the HIV infection rate within the Philippines grew by 140%, marking the Philippines as the clear leader of growing HIV infection rates across the entire Asia-Pacific region.

While President Duterte did suggest using other forms of birth control in place of condoms—such as pill or rod implant methods, so as to maximize male pleasure—it’s clear that his comments were thoughtless in terms of the wellbeing of his citizens. Condom usage is essential in stemming the transmission of HIV through sexual intercourse, and has been the target of many Asian-Pacific nations that have struggled with lowering HIV rates among two key demographics: sex workers and men who have sex with men. The Philippines struggles with the latter of these two especially, as 80% of all new cases of HIV are either among men who have sex with men or transgender women who have sex with men. In a time when the government needs to be encouraging condom usage in order to curtail the ongoing epidemic, the President’s comments reinforce the misconception that contraceptives only need be used to prevent pregnancy—an idea especially dangerous to the key vulnerable demographics for HIV.

While the Philippine Department of Health is seeking to expand HIV testing and treatment in response to the worsening epidemic, prevention of transmission is perhaps the most key component in winding down the HIV crisis. The experience of nations surrounding the Philippines indicates what programs are most successful in reducing HIV transmission. When faced with similarly worsening rates of HIV transmission during the 1990s, Thailand greatly increased its funding for treatment and prevention of the disease. The 100% Condom program was instituted both to encourage condom usage within the nation’s vast sex industry, as well as increase access and usage of condoms in the general population. In response to this initiative, the rates of HIV transmission in Thailand dropped from around 200,000 per year in 1991 to 17,000 per year in 2003.

It’s clear that increasing condom access and usage is a cornerstone in the fight to decrease HIV transmission rates, especially among men who have sex with men. As of 2015, this key demographic in the HIV epidemic only used condoms at a rate of about 50% in the Philippines—still a significant increase from the 36% rates as of 2011. While a 14% increase in condom usage is certainly a positive change, the use of barrier contraceptives needs to be much higher in order to begin to effectively lower transmission rates; by the time Thailand reached success in lowering HIV transmission rates, they had increased condom usage in sex workers past 90%.

Though the Philippines are struggling to reduce their rates of transmission, the global trend is a positive one. Worldwide, the number of new cases of HIV reduced from 2.1 million in 2015 to 1.8 million in 2016, representing a positive outlook for the world’s fight against the ongoing epidemic. All across the world, nations are effectively implementing programs to reduce transmission and treat those who are infected, with the focus of reducing transmission through education of safe sex practices and increasing access to barrier contraceptives. It is for this reason that President Duterte’s rhetoric is so dangerous—numerous examples exist across the globe of nations beginning to control the HIV epidemic by discouraging high risk behaviors such as unprotected sex, all the while President Duterte, leader of a nation especially in peril, encourages his people to forgo the simplest and most effective defense against infection. Now should be the time for leaders to support and bolster their public health initiatives so as to finally dismantle the HIV crisis, not sabotage their own people through carelessness and costly remarks.

 

Sources:

Conde, Carlos H. “Philippines HIV Epidemic Declared a National Emergency.” Human Rights Watch, Human Rights Watch, 2 Aug. 2017. https://www.hrw.org/news/2017/08/01/philippines-hiv-epidemic-declared-national-emergency.

“Fueling the Philippines’ HIV Epidemic | Government Barriers to Condom Use by Men Who Have Sex With Men.” Human Rights Watch, Human Rights Watch, 6 June 2017. https://www.hrw.org/report/2016/12/08/fueling-philippines-hiv-epidemic/government-barriers-condom-use-men-who-have-sex.

Pasha-Robinson, Lucy. “Philippines HIV cases soar 3,147% in 10 years as Duterte says condoms ‘not satisfying’.” The Independent, Independent Digital News and Media, 20 Feb. 2018. http://www.independent.co.uk/news/world/asia/philippines-hiv-cases-rise-duterte-condoms-unsafe-sex-increase-a8219886.html.

Wamsley, Laurel. “Philippines’ Duterte Mocks Condom Use Amid Skyrocketing HIV Rates.” NPR, NPR, 20 Feb. 2018. https://www.npr.org/sections/thetwo-way/2018/02/20/587304958/philippines-duterte-mocks-condom-use-amid-skyrocketing-hiv-rates.