Low Rate of AIDS Virus in Philippines Is a Puzzle

Public health officials are stumped by a paradox in the Philippines, where a very low rate of condom use and a very low rate of HIV infection seem to go hand in hand. AIDS prevention efforts often focus on the use of condoms, but they are not widely available in the mostly conservative Roman Catholic country.

As of January, government figures showed that just 1,810 people had tested positive for HIV. UNAIDS estimates that the actual number may be closer to 9,400, in a population of 84 million -- still an extraordinarily low rate of about 0.01 percent. More than half the population is of reproductive age, and only 23 percent of sexually active young men say they have ever used a condom. Only 4 percent say they use condoms regularly. Only two out of five sex workers say they use them regularly.

Experts say a lucky combination of factors may for the moment have slowed the arrival of an epidemic, including a low ratio of customers to sex workers, a low prevalence of ulcerated STDs like syphilis and herpes, and a small number of IV drug users. Anal sex also appears to be less common. Also, most men in the Philippines are circumcised and there has been speculation that this could be a factor in preventing infection.

Like other experts, Jean-Marc Olive, the World Health Organization representative for the Philippines said the low number of reported infections was not simply the result of poor record-keeping. “It’s not a reporting issue,” he said. “It’s a real fact that we don’t understand really why AIDS infection is so low here in the Philippines. There is no strong, clear-cut factor that will tell us, this is the reason why,” said Olive. “I think it’s a number of different factors adding up. I think they are lucky, but that’s not at all the way to control AIDS.”

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