Knowledge, attitudes, and related practices of Filipino seafarers regarding cardiovascular diseases

Background: Globally, cardiovascular diseases (CVD) remain the leading cause of mortality. Due to the nature of their work and lifestyle on board, Filipino seafarers have a high propensity towards acquiring CVD. This study aimed to determine the knowledge, attitudes, and practices related to CVD of Filipino seafarers. Materials and methods: This study utilised a descriptive cross-sectional study design. Self-administered questionnaires were distributed among 136 male seafarers who went into a private general hospital for their pre-employment medical examination. Results: Eating fatty foods (77.0%), cigarette smoking (68.4%) and lack of exercise (65.4%) were identified by the respondents as the top three most common risk factors for CVD. Avoiding fatty or oily foods (85.3%) and exercising regularly (83.1%) were identified by the respondents as preventive measures for CVD. High blood pressure and shortness of breath were identified by more than half of the respondents as a sign and symptom of CVD, respectively. But the respondents failed to identify other equally important signs and symptoms. Majority of the respondents (> 80%) had high level of perception with respect to the six constructs of the health belief model. Some respondents had admitted engagement in risk-taking behaviours such as smoking (36.0%) and physical inactivity (27.2%). Majority were into high fat and salt diet (70.6%) and current alcohol consumption (79.4%). Conclusions: Although the respondents had favourable attitudes towards CVD, there were knowledge gaps in risk factors, preventive measures, and recognition of signs and symptoms. Hence, some were still engaging in risk-taking behaviours such as smoking, irregular involvement in physical activity, unbalanced diet, and alcohol intake.

The Manila Declaration on the Drug Problem in the Philippines

When Philippine President Rodrigo R. Duterte assumed office in 2016, his government launched an unprecedented campaign against illegal drugs. The drug problem in the Philippines has primarily been viewed as an issue of law enforcement and criminality, and the government has focused on implementing a policy of criminalization and punishment. The escalation of human rights violations has caught the attention of groups in the Philippines as well as the international community. The Global Health Program of the Association of Pacific Rim Universities (APRU), a non-profit network of 50 universities in the Pacific Rim, held its 2017 annual conference in Manila. A special half-day workshop was held on illicit drug abuse in the Philippines which convened 167 participants from 10 economies and 21 disciplines. The goal of the workshop was to collaboratively develop a policy statement describing the best way to address the drug problem in the Philippines, taking into consideration a public health and human rights approach to the issue. The policy statement is presented here

Condom Negotiations among Female Sex Workers in the Philippines: Environmental Influences

BackgroundSocial and structural influences of condom negotiation among female sex workers (FSWs) remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.MethodsFemale bar/spa workers (N = 498), aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use) and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking) associated with condom negotiation, adjusting for individuals nested within venues.ResultsOf 142 FSWs who traded sex in the previous 6 months (included in the analysis), 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment--trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34-49.90), economic environment--sex without a condom to make more money (AOR = 1.52, 95% CI 1.01-2.30), policy environment--sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49-4.48), and individual risk--substance use (AOR = 2.36, 95% CI = 1.28-4.35) were independently associated with FSWs' lack of condom negotiation with venue patrons.ConclusionsFactors in the physical, economic, and policy environments, over individual (excepting substance use) and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation for FSWs trafficked/coerced into their work, substance using, and impacted by economic conditions and policies that do not support condom availability

Traumatic Associations amongst Men and Women Selling Sex in the Philippines

Background: The present study explores trauma-related factors (human trafficking or physical or sexual violence during transactional sex) associated with interest in future community mobilization around health and human rights. Community mobilization among persons selling sex aims to help participants overcome trauma and increase self-reliance through peer advocacy and collective action for improved human conditions. However, how violence and human trafficking impact community mobilization participation among men and women selling sex is less known. Methods: The current study uses data (n = 96) from the baseline survey of participants in the pilot Kapihan community mobilization intervention, which recruited 37 men and 59 women from Metro Manila, Philippines. Multiple logistic regression was used to analyze factors (violence, human trafficking) independently associated with the desire to participate in community mobilization, adjusting for socio-demographic variables. Results: An increased interest in participating in community mobilization around health and human rights was significantly associated with having experienced physical or sexual abuse in the sex trade (AOR = 10.86; CI 1.48–79.69) and less history of trafficking (AOR = 0.14; 95% CI 0.02–0.97), adjusting for age, gender, income, number of children, and whether they considered group goals or had previously participated in community mobilization. Conclusion: Understanding the impact of experiences with physical and sexual violence and human trafficking on health and human rights mobilization participation can inform the design and recruitment for future community-based interventions. Further investigation needs to explore why experiences with human trafficking, having more children, or being a woman lessened the desire to mobilize in this Philippines context. Findings imply that trauma may be more complex. More work is needed to better identify interventions for those with a history of being trafficked or victimized by physical or sexual violence during transactional sex exchanges

Socio-structural and behavioral risk factors associated with trafficked history of female bar/spa entertainers in the sex trade in the Philippines.

ObjectiveTo explore factors associated with trafficking (deceptive/coercive entry to sex trade) among female bar/spa entertainers who traded sex in the Philippines.MethodFemale bar/spa entertainers who traded sex in the past 6months were recruited from 25bar/spa venues in Metro Manila (April 2009-January 2010) and assessed via cross-sectional survey data collection for HIV-risk-related socio-structural factors associated with deceptive/coercive entry into the sex trade. The study employed hierarchical linear modeling.ResultsOf 166bar/spa entertainers assessed, 19 (11.4%) reported being deceived/coerced (i.e. trafficked) into their first jobs. Trafficking history was independently associated with current drug use (adjusted odds ratio [AOR] 2.05; 95% confidence interval [CI] 1.00-3.97) decreased availability of condoms at venues for entertainers (AOR 0.18; 95% CI 0.05-0.71) and, conversely, increased peer support for practicing safer sex behaviors (AOR 3.08; 95% CI 1.63-5.09). Those deceived/coerced into their positions were more likely than non-trafficked women to have been recruited by an agency who came to their rural province (AOR 12.07; 95% CI 1.77-82.25) as opposed to getting the job from advertisement (AOR 0.10; 95% CI 0.02-0.65) or a friend/acquaintance (AOR 0.02; 95% CI 0.00-0.48).ConclusionThe findings have implications for designing interventions to prevent and target trafficked women in the Philippines who may be more vulnerable to substance use and, potentially, HIV infection

Micro-Social Environmental Factors Associated with FSWs' Condom Negotiation with Venue Patrons.

<p>p<.05.</p>**<p>p<.10.</p>a<p>Sex workers had lower emotional, tangible social support (Norbeck scale) compared to a general sample.</p>b<p>(never = 1, always = 5);Due to missing data, certain percentages may reflect denominators smaller than N in column head.</p

Adaptation of Rhodes' Risk Environment Framework.

<p>Adaptation of Rhodes' Risk Environment Framework.</p

Factors Independently Associated with FSWs Not Negotiating Condom Use with Venue Patrons, Controlling for Individuals Nested within Venues (n = 142).

*<p>p<.05.</p>a<p>for those trading sex in past 6 months. Frequency of drug use is a crude measure. Missing n = 13: sex without condoms to make more money (n = 12), and whether they had sex without a condom because one was not available (n = 3).</p

Sociodemographic, Biologic, Behavioral Characteristics associated with FSWs' Condom Negotiation with Patrons.

*<p>p<.05.</p>a<p>self-reported.</p>b<p>Yes-No responses on type/how often drugs used.</p>c<p>never = 1, 1–2×/month = 2, 1×/week = 3, often not daily = 4, daily = 5; Note: Due to missing data, certain percentages may reflect denominators smaller than N given in the column head.</p