While a global decline in HIV incidence from 1999 to 2009 was reported by the Joint United Nations Programme on HIV and AIDS (UNAIDS), the Philippines is one of seven countries where there was an observed increase of more than 25 percent for the same period. In the past five years, reported new cases have spiked among MSM and PWID.

The United States Agency for International Development’s Reaching out to Most-at-Risk Populations (ROMP) is a three-year (2012-2015) HIV/AIDS prevention modelling project implemented by FHI 360, in support of the National AIDS-STI Prevention and Control Program of the Philippines Department of Health (DOH). It works on developing comprehensive prevention-care intervention models for males who have sex with males (MSM) and people who inject drugs (PWID) that DOH can use for future programming.

MSM and HIV: An alarming trend. The rate of HIV infection among MSM has lately seen a dramatic increase. In 2005 the ratio of homosexual to heterosexual transmission was 1:3. By 2010, 51 percent of new cases were among MSM. The 2011 Integrated HIV Behavioral and Serologic Surveillance conducted in 10 core cities reports that Quezon City has the highest MSM HIV prevalence.

Contributing factors include:

• Large MSM community
• A dense concentration of MSM friendly entertainment establishments and high number of gay cruising sites
• High-risk practices (anal sex and low condom use) and low knowledge of HIV prevention,
• Increasing HIV prevalence (1% in 2009 to 5.6% in 2011)

PWID and HIV: An exploding epidemic. The Dangerous Drugs Board estimates that up to 6.7 million Filipinos have used illicit drugs, and that etween10,000 - 20,000 have tried injecting. In 2009, the PWID population size estimate for Cebu City was pegged at 2,500 with another 2,500 in the contiguous cities of Mandaue and Lapu-Lapu. Cebu City recently saw an alarming increase in HIV prevalence among PWID.

Contributing factors include:

• High concentration of PWID
• High HIV risks: needle sharing, overlapping injecting and sexual risks, low condom use
• Increasing HIV prevalence (1% in 2009 to 53.16% in 2011 in Cebu City and 4% in 2011 in Mandaue City)

PROJECT COMPONENTS
The MSM component implemented in Quezon City and the PWID component in the tri-city of Cebu, Mandaue and Lapu-Lapu include:

• Improved outreach strategies to MSM and PWID
• Time-limited intensive peer driven intervention
• Improved quality of HCT in conveniently located sites
• Concrete linkages to HIV care and treatment that reduce loss to follow-up

GOAL
To contribute to maintaining national HIV prevalence among most-at-risk populations, specifically less than 10 percent for males having sex with males (MSM) and less than 58 percent for people who inject drugs (PWID) by 2015

PROJECT OBJECTIVES

• Identify and enhance existing HIV service delivery models that best reach out to MSM and PWID groups having low access and utilization of services or are hardly reached by current prevention programs
• Increase the demand and utilization by MSM and PWID for these enhanced services
• Capacitate local service providers and partner organizations in implementing, managing and sustaining a comprehensive package of services on HIV/STI prevention and management