‘Public apathy to AIDS on the rise’

It has been more than a year since the death of Sarah Jane Salazar, the bar girl who symbolized the scourge of Acquired Immune Deficiency Syndrome (AIDS) in the Philippines, and health officials fear that public apathy about the epidemic has risen with her passing.

Salazar became a household name in 1993 after announcing she was infected with the HIV virus, which causes AIDS.

Soon after, she became an official crusader for the government, traveling around the country to warn people about the disease.

Salazar, who said she acquired the HIV virus while working as a bar girl in Manila, died in June last year.

"It’s true with Sarah Jane coming out publicly to the media really helped the national AIDS awareness program a lot... the Philippines has this mentality and culture that they need to see in order to believe... when she passed away there were a lesser number of people who wanted to come out publicly to support the program," said Nenet Ortega, a program director at the Remedios AIDS Foundation in Manila.

Budgetary constraints and the Catholic Church’s antipathy toward condom use and contraceptive availability have not helped the AIDS awareness message either, health officials said.

"The Catholic Church is very strong in this country and they incite the government to be emotional rather than rational about the laws they promulgate regarding AIDS and even contraception," Manila clinical psychologist and trainer of AIDS counselors, Dr. Margarita Holmes, said.

Salazar, before her death, shocked the country’s powerful Church by carrying on an affair with a teenage boy and giving birth to a girl in 1996.

Mystery of low HIV rate

While the Philippines has so far escaped the ravages of the disease seen in Thailand and some other neighboring countries, AIDs experts see no reason for complacency.

"Considering the low use of condoms in this country, we run great risks for an epidemic that will eventually be high and rapid," noted medical anthropologist Dr. Michael Tan in a paper delivered to the National AIDS convention last year.

Reported cases totaled 1,561 in the Philippines as of September this year, while the World Health Organization (WHO) estimates the number of infections at 10,000.

In contrast, Australia, with a population a quarter the size of the Philippines was estimated by the WHO to have 12,000 cases while Vietnam with a similar-sized population had 122,000. Some researchers have surmised a lack of shared land borders with other Asian countries may have slowed HIV movement into the Philippines.

They also point to studies showing Filipino male sexual risk behavior to be lower than in many countries.

Relatively low rates of injected drugs are also thought to have been a contributing factor.

Medical officials, however, see the low condom use and thriving sex industry as major obstacles to containing AIDS.

There are no reliable figures on the number of prostitutes in the Philippines but estimates put it in the tens of thousands.

Not by choice

Joy, a 26 year old from Mindanao, works as a bar girl Makati, business district.

She said it was poverty and not choice that drove her into the sex industry.

"I am the one who has to help my family, to help my sister and brother and I have a daughter and no husband...before I worked as a maid, and in a canteen but it was not enough... the salary for a maid was sometimes P3,000 sometimes just P2,000 a month."

Ortega said the country’s economic slump has been worsening the situation.

"It is rising and they are becoming younger... most of them come from the provinces and because of poverty, incest or sexual abuse they usually run away and end up in Manila and have nothing to feed themselves...what happens is that they are being encouraged by those whom they meet in the street to join the sex industry," she said.

Joy said some men try to pressure her to have sex without a condom but she always refuses.

"Some guys say I can’t enjoy it, I will not feel good if I use a condom but I always say no, we don’t know each other, you don’t know me, I work in the bar."

Others, however, probably give in to the men’s demands.

"Some girls of course really need the money so yeah maybe they do it."

Despite the dangers and relentless monotony of bar work, Joy remains hopeful of a better future.

"I would like a simple family, and a small house... of course I want a husband and maybe a small business...that’s my ambition... maybe some day I’ll have that." – Rainier Allan Ronda