Friday, April 21, 2017

Triangle of Self-Care: The Game of Safe and Satisfying Sex

By Carlos Diego A. Rozul

There are some things from our childhood that we leave behind. We throw away our old clothes, our old school books, and even our old security blanket. Not all things from our past are thrown away, however. There are a lot that we carry into adulthood such as the lessons we’ve learned, the memories we’ve formed with old friends, and for some of us, even our old toy collection! As we grow older, the games we play tend to get more and more complicated. From the simple rules of Snakes and Ladders to the complex dynamics of a strategic board game, we play to obtain the same objective - to win. When we realize our nature as sexual beings, we begin to play with trust, pleasure, and health. In the game of safe and satisfying sex, the choice is ours to pick what card to draw.


Mutual Masturbation and Dry Humping

The first card we may have drawn when first engaging in sex is manual sex and frottage. In more accessible terms, mutual masturbation (jack off or fingering) and dry humping. These practices pose the lowest risk for HIV infection as the virus has variable chances of survival depending on where the body fluids go. One would be at higher risk if the body fluids come into contact with an open wound, the anus, or the vagina. The mechanics for transmission are as follows:



Oral Sex

A tier up comes oral sex, which includes practices such as felatio (blowjobs), cunnilingus (kissing the clam), and analingus (tossing salad). Oral sex has higher risk due to the possibility of having tiny lesions on the gums or tongue that may go unnoticed after one’s daily hygiene routine. Some men and women may have sores (singaw) that they are not aware of having. It is important to know that one should not engage in oral sex at least two hours before and after brushing one’s teeth. The mechanics for transmission are as follows:


Penetrative Vaginal Sex

One option at the higher end of the risk spectrum is unprotected penile-vaginal contact or simply vaginal sex. The increased modes and mediums for HIV to effectively exit one body and enter another is noteworthy. The risk for transmission reaches its peak if sex is rough. The mechanics for transmission are as follows:


Penetrative Anal Sex

The most high-risk sexual activity one may engage in is penile-anal contact or simply anal sex. Despite it having similar risks to vaginal sex, the possibility of bleeding is much higher than with vaginal sex since the anus does not produce its own lubrication when aroused and penetrated. Unlike the vagina, the anus would require plenty of lubrication and less roughness for the decreased risk of bleeding during sex. The mechanics for transmission are as follows:


Risk Multipliers

Like many games, there are certain instances wherein one can multiply the damage points inflicted to the other player. For sex, certain practices increase the risk of infection. First is the use of different substances such as drugs and alcohol. This can impair one’s judgement to make better choices before and during sex. Second is not communicating clear intentions when meeting with a quick sex partner. It is important that one is clear about what one wants out of a certain meetup. This eliminates the possibility of getting pressured into a potentially unprotected situation.


Protection

A game isn’t complete without a way to protect oneself from the attacks of the antagonists. Similarly, not all defensive moves can deflect the onslaught of the enemy, so it is important to always keep oneself and one’s partner informed about the risks taken when engaging in sex.

First form of protection is the correct and consistent use of condoms (including dental dams) and lubricants. Correctly putting on a condom or dental dam is usually the first line of defense for HIV transmission. It would be best to check the condom before use. Make sure that the condom hasn’t passed its expiration date, and is not too sticky and odorous.

Using plenty of water-based lubricant also decreases the risk of the condom or dental dam being damaged. Silicon-based lubricant, however, may damage the condom or dental dam further due to the interaction of the silicon and plastic polymers.

A second option for protection can be Pre-Exposure Prophylaxis (PrEP). When taken regularly, PrEP can effectively protect you from getting infected with HIV even when having sex without a condom. It is important to note, however, that PrEP only protects you from HIV and not from other sexually transmitted infections (STIs). So, it is important to still wear a condom to avoid this from happening.



The game of safe and satisfying sex could easily be seen as an oppositional turn-based strategy game of who can pleasure the other better. However, it is important to realize that, in this game, you and your partner are teammates. You have the duty to support and protect each other from the real opponent - HIV and other STIs - which can alter your relationship and lifestyle. As teammates, it is important to communicate before sex.

As with any game, we won’t be winning all the time. Each sexual encounter is yet another game to win against HIV and STIs. When we feel the game didn’t go in our favor, we must take the time to step back, evaluate the situation, and act accordingly. This could range from changing the condom when changing positions and after ejaculation to getting tested with your partner after the window period (3 months). Don’t be afraid to talk to your partner about your concerns after sex.



Images by Christian Watson Vergara and Carlos Diego A. Rozul



References:
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.183.7571&rep=rep1&type=pdf

Tuesday, April 18, 2017

HIVisions -- A Youth in Crisis: HIV/AIDS and Awareness

By Kris Tangco

The HIV crisis has gone on for four decades, and for four decades the world has struggled against it. Doctors, scientists, educators, policy makers, writers, artists – people of all walks and all colors have, in their own ways, sought to make sense of this crisis and its relationship with society. From citizens to states, from medicine to prayer, from cures to cries for reform, people’s visions of how to respond to the crisis are as diverse as the people who bear its scars. The goal of this series is to give you a glimpse of these visions: the roles people of different passions and disciplines have played in this crisis that, as of January 2017 as recorded by the Department of Health’s Epidemiology Bureau, is infecting 28 Filipinos daily.


The HIV crisis in the Philippines requires urgent attention due to increasing rates of HIV infection, in contrast to a worldwide trend of plateauing or decreasing rates. Moreover, of the 26 Filipinos daily who contract HIV, 8 of them are aged 15-24 years old[1]. The age group contributing to the biggest proportion of cases has also become younger, with the 25-34 years age group accounting for more than half of detected cases, with the 15-24 years age group trailing behind at 28%.

The Philippine government has enacted legislation aimed at increasing the effectiveness of intervention[2] as the face of the epidemic in the country changes with the median age of People Living with HIV (PLHIVs) getting younger. Globally, young people are considered most vulnerable to HIV/AIDS infection. This situation is a result of a general lack of correct knowledge about HIV/AIDS that can be addressed by reproductive and sexual health education and other socioeconomic circumstances that expose the youth to risky behavior[3]. In fact, a Young Adult Fertility and Sexuality (YAFS) study in 2014 reports that 14% of Filipino girls aged 15 to 19 years old are either pregnant for the first time or already mothers[4]. Four percent (4%) of 15-24 year olds infected with HIV are females[5].

Knowledge of HIV/AIDS and Sexual Attitudes

A paper prepared for the 2004 Annual Meeting of the Population Association of America by Elmer Laguna from the University of the Philippines Population Institute gives us insights on the knowledge of Filipino youth on HIV/AIDS and its impact on their decision to engage in various sexual practices. Laguna cites the AIDS Risk Reduction Model which states that being correctly informed on reproductive health is the starting point from which one is able to make commitments in changing one’s risky behavior and enacting solutions to perform low-risk behavior[6,7].

Findings from the study revealed that awareness of the existence of a disease known as HIV/AIDS is universal among the youth, but misconceptions about the disease exist for a sizable proportion of the sector. More than a quarter believe that HIV/AIDS is a punishment from God for people who have sex outside marriage. A significant proportion also mentioned that AIDS is curable, and more than half believe that only persons with multiple sex partners are at risk of acquiring the virus[8]. In 2016, the increase in HIV cases among the youth is indicative that the level of knowledge of HIV/AIDS among the youth still needs urgent attention.


Linked with HIV/AIDS knowledge are prevailing sexual attitudes and behaviors. Elmer Jose from the Department of Psychology of the Polytechnic University of the Philippines conducts a study on these on respondents aged 15-24 years[9]. Cultural mores on premarital sex stemming from the country’s Catholic background is noteworthy as high percentages of respondents hold sex as sacred and must be reserved after marriage. In spite of the significant reservations against premarital sex, more than a quarter of respondents reported having had premarital intercourse, with 80% having not used condoms - an overwhelming majority.

Cross-linking findings from Jose and Laguna’s studies, the influence of religion is a palpable force in shaping people’s attitudes towards sex and HIV/AIDS. Quite ironically, Laguna reports that Catholic respondents are generally more aware about the existence of HIV/AIDS. Consequently, the view that HIV/AIDS is a punishment for those who engage in sexual intercourse outside marriage is prevalent and may be a reason for someone to feel stigmatized about activities geared towards HIV/AIDS awareness and understanding — from talking about one’s sexual behavior to getting oneself tested and receiving treatment. Secondly, the alarmingly low rate of condom use among respondents who reported engaging in sexual intercourse whilst being aware of HIV/AIDS is a worrisome contradiction that puts into question the effectiveness of reproductive health education programs[10].

Condom Use and HIV Testing Among the Youth

In 2015, a qualitative study on condom use conducted by the Epidemiology Bureau of the Department of Health (DOH) tackled reasons that drove subjects to or barred them from using condoms. Similarly, reasons that drove subjects to or barred them from getting tested for HIV/AIDS were identified.While the study focused on men having sex with men (MSMs), persons aged less than 24 years comprised majority (64%) of the respondents[11].

The study revealed that there are more barriers than drivers for using condoms. Access to condoms and lubricants, knowledge and awareness about HIV, and perceived risk determined whether or not respondents used condoms. Moreover, personal motivations drove respondents to use condoms for protection or abandon them for sexual pleasure. Social perceptions centering on the “cleanliness” of their partner also determined condom use.

Of the numerous factors the study considered, love and romantic relationships, and spontaneity, or “heat of the moment” sex, are barriers that had no corresponding drivers. “Here, the meaning of being in a relationship and not using a condom to show trust and fidelity becomes the barrier to condom use[12]”. In other words, personal motivation towards safety and cleanliness is overpowered by multiple barriers including personal motivations towards sexual pleasure, love and romantic relationships. Finally, the spontaneity of sex implies that the physical urge to have sex is a barrier to condom use[13].

Similarly, there were more barriers than drivers for getting tested for HIV/AIDS. Access to services, knowledge and awareness of HIV/AIDS, and perceived or felt risks of acquiring the virus determined whether or not respondents got themselves tested. On the level of personal motivation, it was either respondents wanted to validate their negative status or were prevented by fear of finding out their HIV/AIDS status. Stigma associated with HIV, however, is a barrier to testing that had no opposing drivers[14].

The study clearly reveals that there were consistently more factors barring people from using condoms and getting tested for HIV/AIDS than factors driving people to use condoms and getting themselves tested for HIV/AIDS. As a response to these findings, the study recommends a model for awareness intended for the general population, including the youth, with the goal for effecting behavioral change. In order for knowledge and awareness to be instilled effectively, the model identifies three levels of knowledge: conceptual knowledge which makes HIV understandable, social awareness of the reality of HIV, and personal awareness of PLHIVs[15].

LoveYourself Caravans


LoveYourself has an initiative called LoveYourself Caravans, an HIV/AIDS awareness campaign which includes conducting HIV101 and on-site testing at universities and colleges and workplaces. In response to the growing rate of infections among the youth, LoveYourself Caravans is increasing the number of schools it targets to collaborate with on-campus awareness programs. In light of the three-tiered awareness model recommended by DOH’s 2015 qualitative study, we ask LoveYourself Programs Officer Earl Patrick Penabella to see where LoveYourself Caravans’ programs stand.

The HIV101 modules conducted by LoveYourself attempts to address an awareness program’s requirement to instill conceptual knowledge, and to a certain extent also instill social awareness through videos and group dynamics alluding to the reality of HIV/AIDS. “Social awareness though is difficult to quantify; its end results are more qualitative in nature,” says Earl. He admits though that the the capacity of LoveYourself’s HIV101 programs to raise personal awareness still leaves much to be desired. “The program can consider sharing testimonials from PLHIVs, who can talk about their experiences before students and educators,” muses Earl.

An integral part of LoveYourself Caravans' campaigns in colleges and universities is advocating the use of condoms, a topic that is not well received in secular institutions. Earl reports that 4 out of 5 schools denied the program from distributing condoms and demonstrating its usage, relegating learning about the contraceptive tool to Powerpoint slides. “There are a few ways we can go around this setback - LoveYourself has tools to ensure that we do get the message across. The most basic expectation of an awareness campaign is to move the audience one notch up - which means if they have zero knowledge, then it is to equip them with the knowledge,” he explains.

LoveYourself Caravans’ HIV101 module includes the Triangle of Self Care[16], a LoveYourself paradigm that sufficiently tackles condom and lubricant use. LoveYourself Caravans is also planning to launch a peer educator program aimed at capacitating and training students with the skills and knowledge to facilitate LoveYourself’s HIV101 modules to fellow students, a scheme similar to LoveYourself’s campaigns but on a decreased scale. The peer educator programs will be held at LoveYourself’s facilities where respect for religious and cultural sensibilities is not an obstacle. “Schools may disallow us from doing condom usage demonstrations, but when we train our peer educators, they will be exposed to the actual thing,” solving the barrier to experiential learning.

Beyond Conceptual Learning



A partner of LoveYourself Caravans is the Ateneo entity of the Association for the International Exchange of Students in Economics and Commerce (AIESEC), a worldwide organization developing the leadership potential of the youth through experiential learning, volunteer experiences, and professional internships[17].

Being an international exchange organization, Project tHrIVe allows foreign volunteers, which the entity calls as “Exchange Participants (EPs),” to experience LoveYourself operations by spending a few days working at its clinics. The program lasts for six weeks, and the EPs are made to work with various organizations including LoveYourself, educating the youth about the dangers of HIV/AIDS transmission, working at its testing sites, and participating in events that the organizations may have.

Project tHrIVe with its hands-on approach to learning allows its participants first-hand encounters with clients at LoveYourself’s clinics. “Our EP’s time volunteering in LoveYourself Anglo really helped them to see the nerve-racking effects of having HIV. It made them want to educate the youth even more, because they know that it is the only way to lessen the number of people experiencing these emotions,” shares Nicole Ngo, lead of Project tHrIVe. Despite the impact the program bears on its EPs, the program is not without its limitations. “We often encounter logistical problems, and coordinating with various organizations can be difficult,” says Nicole. Moreover, the project head admits there is a need to be more stringent with the attendance of EPs. “Most of the EPs are traveling to the Philippines for the very first time and would also like to travel around the country. We do have to remind them that they come here first and foremost for the project, and sightseeing can come second.” A more obvious limitation would be the very nature of AIESEC itself as an the international exchange program -  the EPs who participate in Project tHrIVe are foreigners.

“This is why I’m thinking of proposing an on-the-job training program with our school partners,” says Earl. As the urgency to safeguard the youth from HIV/AIDS increases, there is a need to continually improve awareness programs starting from the basic HIV101 module. A group of researchers led by Dr. Emmanuel Baja at the University of the Philippines-Manila under the Newton Fund Program of the government of the United Kingdom are investigating the development of a virtual reality gaming application with HIV/AIDS and other STIs as its theme with the aim of promoting awareness of HIV/AIDS and testing in the Philippines[18]. The example given by this initiative as well as Ateneo-AIESEC’s Project tHrIVe highlight three levels of learning - conceptual, social, and personal. Moreover, the ever changing face of the epidemic requires a vigilance from advocates conducting awareness campaigns and constant innovation to ensure that the programs instill awareness and knowledge more effectively, and more members of vulnerable sectors are reached.


Photos from Project tHrIVe


HIVisions’ A Youth in Crisis will continue with more stories of noteworthy efforts from LoveYourself’s partners from the academe in its advocacy of HIV/AIDS awareness, testing, and prevention.

Wednesday, April 12, 2017

2017 Holy Week Clinic Schedule and ARV Protocols

For HIV testing clinics

For the Holy Week, the LoveYourself Anglo and Uni clinics will follow this special schedule:

April 12, 2017 (Wed) - OPEN
April 13 to 16, 2017 (Thu - Sun) - CLOSED

Clinic operations will resume on April 19, 2017 (Wed). Please be guided accordingly. Thank you!

You can also check out the regular clinic schedule and our clinic locations here.

For HIV treatment hub at Anglo

To give way to the Holy Week, LoveYourself Satellite Treatment Hub will follow this special schedule:

April 13 to April 16, 2017 (Thu - Sun) - CLOSED

Treatment hub operations will resume on April 19, 2017 (Wed)

For emergency purposes, we would like to endorse the mobile number 0995-6620152 for clients who really need to refill their ARVs during the Holy Week. 

Please note that this will be an appointment system wherein the TIME, DATE, and PLACE will be arranged by the person in charge. Thank you!

LoveYourself pays tribute to its heritage with its 16th batch of volunteers

By Mark Angello Ganon


Fresh faces dotted the People’s Hall of SM Aura Premier last April 8 as LoveYourself welcomed Batch Guinto, this year’s first set of recruits. Rising up to the call of being HIV awareness and prevention advocates, 42 individuals underwent a thorough screening process and are now on their way to creating ripples of positive change.
Photo by Joma Ragragio 
The Recruitment team, headed by Pete Tan, oversaw the screening and the interview of the applicants. The orientation was then headed by Bien Salaza of Love U: The Corporate University of LoveYourself, with the help of volunteers from the various committees. Co-founder Chris Lagman and Love U Chancellor Danvic RosadiƱo spoke of what it is like to grow in LoveYourself as a volunteer and what to look forward to as one journeys with the organization. Seasoned volunteers also shared their experiences with the new batch with the hopes of igniting a passion for volunteerism that sustains. 

Golden Heritage 
Created by Geno Maglinao
LoveYourself’s historic mother clinic was the inspiration behind the batch name, Guinto. First dubbed as LoveYourself Hub, the organization’s primary base was located at the busy streets of Leon Guinto in Manila. The hub opened on July 21, 2012 but was only initially open during the weekends since the Research Institute of Tropical Medicine (RITM) used the venue as its satellite clinic during the weekdays. On June 2013, however, due to the increasing number of clientele and increments in the daily new cases of HIV, RITM transferred the full operation of the hub to LoveYourself. Vinn Pagtakhan, founder, shared a few trivia about the iconic first hub: 

  • When the hub was launched, Vinn recited a poem that was created for the organization. 
  • There was only one nurse and one medical technologist in the hub, with Philip Tanpoco as the first clinic coordinator. 
  • The picture of the clinic in the ads looks exactly like the restaurant across the street. 
  • The average census per month back then was only five. Today, the organization caters to 60-100 clients during peak days. 

Another ode to heritage is the logo of Batch Guinto. Gathering inspiration from the weekly illustrated atlas of the “Windows of New York” project, Geno Maglinao, Head of Creatives, conceptualized the logo as a remembrance of what the clinic used to look like. Like the original clinic, the facade has two glass panes and an ornate barricade that separates the sidewalk from the main street of Leon Guinto. The exposed glass pane on the left is the entrance, while the right glass pane is hidden by a steel roll up door. This portion was always kept hidden since it was allotted for counseling sessions.

The notable difference between the logo and the actual hub is that the name Guinto replaces the original marquee, which contains "RITM Satellite Clinic." In illustrating the batch logo, the artist "pays tribute to the hub that was the witness to the organization’s humble beginnings" and with it, volunteers new and old alike, are "encouraged to look back to where we started, so it could give us renewed enthusiasm in the advocacy."

Transcending Times 
Photo by Leo Pura
Pushing the total number of volunteers to around 700, Batch Guinto adds new flavors to the organization. Through its partnership with Test MNL, Pilipinas Shell Foundation, ISEAN HIVOS, RITM-DOH, and the Taguig City Government, LoveYourself aims to continue expanding its reach in terms of the number of people involved, the timeliness of its affairs, and the sustainability of its programs.

As we trace back the roots of our beloved organization, we are again reminded that volunteers are the fuel that sustains the drive in the cause they advocate. With the increase in numbers, volunteers, seasoned and budding alike, are encouraged to help man its two clinics (LoveYourself Anglo at Shaw and LoveYourself Uni at Taft) and to engage in the various committees of the organization.

In the words of our dear founder himself, Vinn Pagtakhan, "More than a memory of the first community center, Guinto means gold. Gold reminds me of one of my favorite Chinese proverbs: 'Anyone can find the dirt in someone. Be the one that finds the gold.'"


Interested to be a volunteer of LoveYourself? Click here.

Friday, April 07, 2017

STATUS -- HIV Myths and Fictions, Debunked!

By Brethren


Facts about HIV (Human Immunodeficiency Virus), like what it is and how it is transmitted, are readily available almost everywhere, especially on the internet. Yet there are quite a number of myths around HIV that remain to cloud people's perceptions about it. These are myths you might have read in a web article or in your social media feed.

Someone posted on Facebook a few years back about HIV-contaminated bananas. Though I have knowledge about HIV and how it can be transmitted, I still thought of it as quite alarming. Imagine getting HIV from a banana. Seriously? Well, now I have sufficient knowledge regarding HIV, and I am very sure that you cannot acquire HIV from a freaking banana.

Below, I listed down a few HIV myths. Are you ready to see them debunked? Okay then, let's get started.

1. You’ve got HIV. RIP!

Having HIV is not a death sentence. Though there is no cure yet, there is treatment for HIV, just like how there’s treatment but no cure for hypertension and diabetes. Taking antiretroviral drugs (ARV) on a regular basis, paired with a healthy lifestyle, allows a PLHIV (Person Living with HIV) to live a normal, productive, and long life.

ARVs are used for treating HIV. They do not cure HIV; rather, they prevent the virus from replicating or multiplying, thus preventing the immune system from weakening.

On the other hand, there’s the Pre-Exposure Prophylaxis popularly known as PrEP. It is a medication that serves as a measure to keep HIV from taking root and multiplying in the body. Therefore safeguarding the body from HIV infection.

2. I can get HIV by being around people who are HIV positive.

Medical studies show that HIV cannot be transmitted through touch, tears, sweat, or saliva. You cannot catch HIV by: (a) breathing the same air as someone who is a PLHIV, (b) touching a toilet seat or door knob handle after a PLHIV, (c) hugging, kissing, or shaking hands with someone who is a PLHIV, and (d) sharing utensils with a PLHIV.

However, HIV can be transmitted through blood, rectal fluid, seminal and vaginal fluids. It is most commonly spread by engaging with unprotected penetrative sex and by sharing needles and syringes used in taking prohibited drugs. Another way that it can be contracted is through mother-to-child transmission during pregnancy and through breastfeeding.

3. HIV is a homosexual disease.

Although MSM (men having sex with men) are the most at-risk population, HIV is not a homosexual disease. Anyone can be infected by HIV, whether you're gay, lesbian, transgender, bisexual, or straight. Everyone is vulnerable and may contract HIV, especially people who exhibit risky sexual behaviors, such as having sex without using condoms, having sex under the influence of alcohol and prohibited drugs, and having multiple sex partners.

4. You'll be infected with HIV if you eat HIV-contaminated food (bananas, apples, pineapples, etc.).

HIV lives outside the body for a very short period of time depending on specific environmental conditions. Even if small amounts of HIV-infected blood or semen were consumed, exposure to the air, heat from cooking, and stomach acid would destroy the virus.

Furthermore, changes in pH levels greatly affect the survival of HIV outside the body. pH levels below 7 or above 8 are not viable for long-term survival of HIV. It is also very sensitive to high temperature. Therefore, there is no risk of contracting HIV from eating food.

5. I can get HIV from mosquito bites.

HIV can indeed be transmitted through blood. Because of this, there is fear among people that HIV is spread through biting or bloodsucking insects. In contrast, studies show no evidence to support this claim even in places with many mosquitoes and high rates of incidence of HIV. When insects bite, they do not inject the blood of the person or animal they have last bitten. Also, HIV lives for only a short time inside an insect.

6. You can have "full-blown AIDS."

Wait, "full-blown AIDS"? There's no such thing as "full-blown AIDS." Let's go back to the basics. HIV is a virus, while AIDS (Acquired Immune Deficiency Syndrome) is a diagnosis given to PLHIVs having less than 200 CD4 cells. PLHIVs having <200 CD4 count are susceptible to opportunistic infections (OIs) jeopardizing their well-being.

These OIs are called “opportunistic” due the fact that they take advantage of a compromised immune system that could lead to a morbid effect, even death. In the Philippines, the most common OI is tuberculosis (TB), followed by candidiasis and Pneumocystis pneumonia (PCP).

To understand the reality of HIV, knowing which are myths and which ones are facts, come visit LoveYourself for free HIV testing and counseling. For more information click here.



Images by Christian Watson Vergara