Over the past five years, social and behavioral studies show that certain groups may be a high risk for HIV/AIDS. The term "populations at risk" expresses that in particular societies some groups may ne at a higher risk for HIV than others due to economic, social and even biological circumstances.

In a 2000 report by Tan et al., five groups were identified as more susceptible than others for HIV in the Philippines: women, young adults, men who have sex with men, sex workers, and overseas Filipino workers.

WOMEN

Women are more vulnerable to HIV/AIDS because of psychological, social and cultural circumstances.

HIV is passed more easily from men to women, rather than from women to men, for anatomical and physiological reasons. Moreover, the reproductive tracts of young women are prone to injury during intercourse, increasing their risk of contracting STIs and HIV.

Socially, women are less capable of protecting themselves or negotiating for safe sex. This applies to female sex workers negotiating ith clients, as well as to women in general who may be put at risk by their partners' risky sexual behavior.

In a 2001 study by Tempongko and Ramos-Gagante in three major cities, about 40 percent of women respondents admitted to having no confidence to ask their regular partners to use ocndoms even if they have adequate knowledge of HIV/AIDS/STI. Most of the women also cannot articulate their sexual needs. About 43 percent of them admitted to having been forced into sex at times, and 15 percent believed it was their "obligation" to have sex with their partners.

Since many women are unable to find jobs in the formal sector, they have no stable source of income, bcoming economically dependent on their husbands or boyfriends. If a woman finds herself in an abusive relationship, escape or disengagement is difficult due to economic considerations. Given this inequity that comes with economic dependence, a woman's ability to protect herself from the consequences of her partner's high-risk sexual activity may be greatly reduced.

YOUNG ADULTS

Preliminary results of the 3rd Young Adult Fertility and Sexuality (YAFS3) study by the University of the Philippines Population Institute (UPPI) show that young adults have liberal attitudes on sexuality and sexual practices.

The YAFS3 survey shows that young adults engage in commercial and unprotected sex. Though young adults still seem to have poor knowledge about STI/AIDS a third of young adults think AIDS can be cured, and a large proportion thinks that they are not vulnerable to AIDS.

Another study, conucted in 2000 by Tempongko et al., was done in Manila universities to identify the level of knowledge, attitudes and perceptions of third and fourth year college students (18-22 years old) on STI/HIV/AIDS. The study found that although there seemed to be a good level of knowledge on STI/HIV/AIDS transmission and prevention, misconceptions were still present. Premarital sex and inconsistent condom use were common. Unprotected sex with acquaintances, romantic partners or friends was not seen as dangerous. Condoms were used only during intercourse with sex workers, but even in such occasions, respondents rported non-use due to unavailability. Condoms were also perceived to reduce sexual pleasure.

The combination of immature sexual attitudes and lack of information places young adults at a risk of contracting HIV/AIDS. And the stifling of sex education in schools by conservative lobbies does not help in reducing this risk.

MEN WHO HAVE SEX WITH MEN (MSM)

Among reported HIV cases in the Philippines, more than 20 percent involve male-to-male transmission. The rate could be higher, but because of the stigma attached to same-sex sexual activity, males are not likely to admit they engaged in homosexual activity.

A HAIN study in 2000 pointed out that many MSM have retreated into the "shadow" populations to avoid the stigma of coming out to their family and work colleagues. There is strong stigmatization, including cases of discrimination, harassment and outright physical violence against homosexuals. Moreover, religious attitudes labeling homosexual acts as "sinful" perpetuate this stigma against homosexuals.

It should be noted, though, that not all MSM are homosexuals. Male sex workers, who may otherwise be considered heterosexual, may have male clients. On the other hand, some MSM still consider themselves "real" men, such as those who have sex with other men in prison, ships or construction yards.

Sexual relationships of many MSM tend to be anonymous and casual bacause of the need to keep their identities hidden. This is done to avoid shame and social stigma. Living in the "shadows" hinders MSM access to HIV/AIDS information, education and treatment. Whether they consider themselves homosexual or heterosexual, MSM face a high risk of contracting HIV/AIDS because of their circumstances and social attitudes towards them.

SEX WORKERS

The illegal status of sex work hinders the access of sex workers to information on reproductive health and STIs, health services and education programs, increasing their vulnerability to infection. Moreover, this makes them unable to negotiate for safe sex and impose sexual practices.

In a 2000 HAIN study (A Matter of Time), different risk levels among various types of sex workers were found. Women and child sex workers are more susceptible to infectio than males because of a lesser ability to negotiate for safe sex. On the Other hans, freelance sex workers and male sex workers may be getting little information on HIV/AIDS because of few information programs targeted for them.

Although entertainment establishments are issued certificates that insure clients of "wholesome" and "sanitary" services, these arrangements may push sex workers and establishment owners to conceal risky behavior and actual infections to get their certification. In some sentinel sites, STI infection rates were high even among registered sex workers with weekly-updated health cards. This policy creates a false sense of security among patrons of entertainment establishments who perceive these as places free of HIV/AIDS or STIs.

OVERSEAS FILIPINO WORKERS (OFWs)

Current statistics indicate that about 30 percent of Filipinos infected with HIV are OFWs (NHSS 2002).

The vulnerability of migrant workers is determined and influenced by several factors. Each of these factors occur during various stages of the migration cycle and nature of their employment. A study conducted by Kalayaan/CARAM Philippines (1998) among 450 first-time departing migrant workers revealed that low knowledge on HIV/AIDS, low condom use, poor health-seeking behavior and an attitude of invincibility towards HIV/AIDS affect their vulnerability to infection. A gap between knowledge and behavior has also been reported among the respondents. Moreover, their low knowledge on the everyday realities, such as emotional loneliness caused by being aay from home, cultural adaptations and difficult working conditions that await them also contribute to their vulnerability.

The Scalabrini Migration Center conducted a study in 2000 to assess population mobility and HIV vulnerability in the Brunei-Indonesia-Malaysia-Philippines (BIMP) area. The study showed low awareness on STIs and HIV/AIDS among migrants. Different living and working conditions of Filipino migrants suggest that they have different degrees of vulnerability to HIV, most vulnerable being those working in the entertainment or sex industry.

Seafarers are also at a high risk of contracting HIV. About 20 percent of the 1.2 million seafarers worldwide are Filipino. In 1996, there were 307 shipping companies deploying 200,000 Filipino seamen.

Macho values put seafarers at risk because of the belief that it is but natural for men to pursue sex at every opportunity. FGDs and interviews conducted by HAIN revealed that seafarers believe that one of the benefits of becoming a seafarer is to "taste" women at every port. Many commercial sex workers are available in almost every port, and are sometimes brought on board. But according to a study by the DOLE-OSHC, only 49 percent of seafarers practice safe sex. Knowledge on HIV/AIDS among seafarers was found to be low, accompanied by the high-risk secxual practices.