To determine the prevalence of HIV, syphilis and Hepatitis B among returning male seafarers and the prevalence of risk behaviors for HIV transmission, National Health Sentinel Surveillance Sites National Epidemiologic Center Department of Health (NHSSS-NEC-DOH) commissioned Field Epidemiologic Training Program Alumni Foundation, Inc (FETPAFI) to undertake this study. A two-stage cluster sampling design was employed with returning male Filipino seafarers as respondents. Data gathering was through a self-administered questionnaire and blood specimens were collected for HIV, syphilis and Hepatitis B testing.
From September 23-November 22, 2002, 420 seafarers coming from 84 clusters participated in the study. They were mostly college educated, married with a median age of 33 years. During the past year, 2-6% claimed to have experienced signs and symptoms of STIs. Two of every five seafarers underwent HIV testing, mostly in 2001.
Only 28-38% of the study participants knew that mutual monogamy, consistent condom use and consistent use of clean needles and syringes prevent HIV transmission. Most seafarers had information on HIV/STIs with the Pre-Departure Orientation Seminar (PDOS) as the most common source. However, 15 % of seafarers did not receive such information either from the PDOS or other sources. There is no difference in the level of knowledge on HIV/STI prevention between those who received information prior to deployment and those who did not.
A total of 144 (34%) study participants had sex with women and 1% had sex with other men during their last tour of duty. Condom use was consistently practiced by approximately three of every five seafarers. Among the inconsistent or non-users of condoms, the most common reason cited why condoms were not used was its unavailability in times of need.
Thirty six percent of seafarers who had sex during their last tour of duty had Higher Risk Sex Encounters (HRSEs). They had a total of 155 sex partners, almost all being female sex worker (FSWs) and occurred in countries with HIV prevalence among FSWs.
A total of 358 (85%) study participants had sex with women and less than 1% had sex with other men upon returning to the Philippines from their last tour of duty. Among those who had sex with Higher Risk Sexual Partners (HRSPs), condom use during the last sexual encounter with FSWs was 62% and 22% for those who had non-commercial/ non-regular (NCNR) partners.
All the blood samples tested negatively for HIV and syphilis while 7% were positive for Hepatitis B.
Although HIV prevalence among male Filipino seafarers is still less than 1%, their global exposure to risky practices for HIV is alarming. Engaging in unprotected sex with HRSPs, especially in countries with high HIV prevalence among FSWs, renders the seafarers vulnerable to acquiring HIV. They may transmit the virus to unsuspecting partners in the Philippines, thus making them the bridge through which HIV may spread in the Philippine general population. There is, therefore, a need for a concerted effort to devise innovative ways to increase the seafarers' level of knowledge on HIV/STI prevention since the PDOS is not delivering the desired impact. Likewise, the factors that would effect behavior change other than knowledge should be identified and properly addressed.
The seafarers are undeniably one of the groups vulnerable to HIV in the Philippines. Thus, they should be included as one of the groups under surveillance by the NHSSS-NEC-PDOH. This could be better realized with the cooperation of the different manning agencies. The same methodology employed in this study may be replicated for succeeding surveillance activities since it was able to answer the study objectives.
