The passage of the Philippine AIDS Prevention and Control Act in 1998 marked a watershed in the countrys fight against HIV/AIDS. Six years later, however, implementation of this law is plagued by religious opposition to condoms, lack of political will, and deliberate government policies that interfere with the provision of complete HIV/AIDS information. HIV prevention in the Philippines is conducted in an environment both hostile to reproductive health and conducive to messages that privilege sexual abstinence over condom use. However comprehensive the AIDS law on paper, it has proved a weak match for government-promoted anti-condom policies and misinformation about HIV/AIDS.
To a large extent, HIV prevention efforts in the Philippines are a casualty of the politics of birth control. Many people at risk of HIV view condoms as purely a method of contraception, a predictable outcome of the Catholic church hierarchys denunciation of condoms as a form of birth control. The Philippines Department of Health diverts scarce resources away from effective HIV/AIDS education and prevention to organizations that promote natural family planning, ignoring the fact that these programs offer limited protection against HIV or against pregnancy. Religious conservatives oppose comprehensive reproductive health legislation, minimizing the critical link between womens health and HIV prevention. Such actions closely mirror trends in the United States, where restrictions on international family planning services have had a devastating impact on HIV prevention efforts.
Like their counterparts in the United States, however, condom opponents in the Philippines do not stop at birth control. At their most extreme, they oppose condom use for any purpose and make false scientific claims about the effectiveness of condoms against HIV/AIDS. They demonize condoms not only as tantamount to abortion, but as a promoter of sexual promiscuity and moral weakness. In response to rising HIV rates, they offer abstinence until marriage as a primary prevention strategy, even for populations such as sex workers and gay men. Such messages imply that marriage is the ultimate prophylactic against AIDS, despite the prejudice this implies for many people living with the disease, as well as the risk it poses for people who cannot rely on their spouses fidelity.
In this environment, service providers who attempt to deliver comprehensive HIV prevention services confront constant resistanceor worse, possible retribution from government officials. School-based educators are told to withhold information about condoms from students, while others are told to sanitize comprehensive HIV prevention materials on television, radio, and the Internet. Nongovernmental organizations that advocate for expanded condom access risk censure from anti-condom elected officials. Community health outreach workers resort to distributing condoms in inconspicuous places for fear of being noticed by city authorities and told to cease and desist.
Restricting access to condoms not only violates individual human rights, but also detracts attention from the larger challenges of HIV prevention. Preventing HIV/AIDS requires a full range of human rights protections for people at risk of HIV, including legal protections that enhance womens ability to negotiate safer sex, freedom from police harassment for populations such as sex workers and men who have sex with men, and access to female-controlled HIV prevention technologies such as female condoms and microbicides.209 Male latex condoms cannot and will not slow the spread of AIDS until marginalized populations, particularly women, are able to negotiate condom use and make informed decisions about their health. In the meantime, the struggle to empower vulnerable populations to protect their health is only frustrated by governments who question the efficacy and morality of condom use in the name of an agenda other than HIV prevention.
In the Philippines, as in any country, preventing HIV/AIDS requires that the government not only refrain from outright censorship, but actively confront misinformation and take steps to ensure that vulnerable populations can make informed decisions about their health. Governments that are charged with the protection of public health cannot sit back and allow condoms to be publicly disparaged while people become infected with HIV. They cannot, if they are to respect the rights to information, health and life, support programs that make misleading statements about condoms while at the same time failing to implement programs that in fact are the most effective at preventing this fatal disease.
The Philippines has all the ingredients of an explosive AIDS epidemic: widespread high-risk behaviors, low AIDS awareness, sporadic condom useand a government that panders to anti-condom Catholic bishops. The country appears to have an opportunity to stave off an HIV/AIDS catastrophe, but only if it acts quickly and decisively. Promoting condoms as part of a comprehensive HIV prevention strategy would not just be sound health policy. It would be a test of the governments commitment to confronting the stigma of HIV/AIDS and respecting the dignity and human rights of those living with and affected by the disease.
209 See, e.g., L.L. Heise and C. Elias, Transforming AIDS Prevention to Meet Womens Needs: A Focus on Developing Countries, Social Science and Medicine, vo. 40, no. 7, pp. 931-943 (1995), especially pages 936-938. See also, Human Rights Watch, Policy Paralysis: A Call for Action on HIV/AIDS-Related Human Rights Abuses Against Women and Girls in Africa (New York: Human Rights Watch, 2003), and reports cited therein.