Erasmo, J. N. V. (2018). Reducing STI/HIV infections among adolescents and secondary school students (Unpublished master's thesis). Public Management Development Program, Development Academy of the Philippines.

Public Management Development Program Senior Executive Class Batch 6 Thesis (SEC)--Development Academy of the Philippines.

The Philippines shares to the current global challenge of addressing sexually transmitted infections (STIs) and Human Immunodeficiency Virus (HIV) infection. With a country prevalence of less than 1% of the general population, the country is still considered low-prevalent for HIV infection. However, based on the surveillance data of the Department of Health's (DOH), Epidemiology Bureau, HIV infection is fast and growing in the Philippines from 1984 to present. Newly diagnosed cases of HIV are expanding to the young key affected populations aged 15-24 years or the so-called millennials. The current health problem faced by the country is the increased incidence of STI and HIV among adolescents and secondary school students. This emerging group of 15-24 years old showed an increase of HIV cases by 230% from 2011 to 2015. Based on the current report of HIV prevalence among the young people, there were 34,729 HIV cases of 15-24 years old in 2016; 41,540 HIV cases in 2017, a total of 1,728 HIV cases were reported among 19 years old and below and the infection route is through sexual contact. The Department of Health is alarmed with the projection that by 2022, 62% of estimated new HIV infections will come from this age group. The projected number of cases may result to overwhelming scenario for the government and to the general public. The main issue resulting from the increased incidence of STI and HIV among the adolescents and the secondary school students is failure to access the available prevention and health care services for STI and HIV. Adolescents and secondary school students are hesitant to seek consultation and health services at the facility because of stigma and discrimination. Some adolescents and students find it difficult to open up their health concerns with their parents and to the local health service providers. Although the program on adolescent health and development has already been implemented in the local government units, the services may be limited in addressing the current concerns of the young people, the adolescents and the secondary school students. The DOH in the last quarter of 2016 and in the first quarter of 2017 was proposing to distribute condoms as barriers for the infection to address the increasing number of HIV-infected adolescents and secondary school students. The officials of the Department of Education, some church officials, some private sectors and some pro-life advocates were strongly opposing this purpose measure on various grounds. To address the issue of accessibility of adolescents and secondary school students to STI and HIV prevention and health care, 3 policy options are proposed. These are: Option 1 is setting-up a multi-sectoral/multi-stakeholder network to increase access to prevention and care services relative to HIV and STI; Option 2 is endorsement to the Department of Education the responsibility to educate on reproductive health and provide guidance and access to the prevention and care services; and Option 3 is expansion of the services of the Adolescent Health and Development Program. Each option or alternative was evaluated by framework analysis based on the four criteria: effectiveness of implementation of the proposed policy; efficiency of each proposed alternatives; acceptability of each policy; and measures in addressing unintended consequences. To further evaluate each option, a composite analytic framework was dome based on the following variables: epidemiologic, legal, intermediate outcomes and sectoral collaboration. Based on the criteria and variables used to evaluate and analyze the different options to address the current HIV epidemic faced by the adolescents and secondary school students, the scholar strongly recommends Option 1. This option if believed to have a great impact in addressing the accessibility of adolescents and secondary school students to STI and HIV prevention and health care services. The current structure in prevention and care services is prioritized to the key affected populations of HIV like the sex workers, men who have sex with men, injecting drug users and pregnant mother with HIV infection. With the adoption of this proposed policy, the adolescents and young people, including the secondary school students will be given appropriate health services by the trained health service providers. Health education and awareness campaign on STI and HIV by school personnel serves as the point of entry of health care in the proposed framework and network of referral for HIV cases for adolescents and for secondary school students. The secondary school students can then be assessed by DOH personnel for risk factors for potential STI and HIV transmission. The client is provided with continuous services including parent notification, counseling by church or religious leaders, barrier against disease transmission and voluntary counseling and testing at the nearest treatment hub or at Social Hygiene Clinic. In the past years, Philippines was able to establish the disproportionate burden of HIV among the key affected populations. These key populations which have the more established program strategies and related activities with partner agencies and local government units (LGUs) are males and transgender women who have sex with males (M/TSM), people in sex work and persons who use and inject drugs. Currently, more evidence points to the elevating need to urgently shift the focus in the increasing problem among the adolescent and young populations (DOH, 2016). Various factors have contributed to the current shift of target populations in the country. The setting-up of multi-sectoral/multi-stakeholder network defines the referral mechanism through the service delivery to the appropriate agencies for further services in preventing and controlling transmission of HIV and STIs. Networking is the current public management modality and a medium to deliver programs more accessible, available and affordable to adolescents and secondary school students. The proposed policy on network of sectors and stakeholders is aligned to the four-pronged focus of the Department of Health's 6th AIDS Medium Term Plan Targets (AMTP6) for 2017-2022. This policy can be piloted in a small area with high prevalence of STI and HIV cases in the region. This proposed policy ushers increase access to prevention and care services for STI and HIV among adolescents and secondary school students at the level of the community. Consequently, it is instrumental in reducing the projected 62% of new HIV infections by 2022 among the 15-24 years old or the millennials of today.