The Role of Non-Formal Education in Combating the HIV Epidemic in the Philippines and Taiwan

From the abstract: "The Philippines is experiencing a low but slowly growing prevalence of HIV, with a UN [United Nations] estimate of 6,000-11,000 cases out of a population of 91 million, and a 150% increase in new cases in 2008 compared to previous years. Earlier education programmes employed non-formal educational training techniques in the southern Philippines to [focus on] high-risk groups such as female sex workers [FSW] and their establishment managers; the effort was expanded to [focus on] males in the community. In comparison, as of 2009, Taiwan has an estimated 40,000 cases of HIV/AIDS in a population of 23 million. It experienced a major increase in HIV infection among injecting drug users, from 77 newly reported cases in 2003 to 2,381 such cases in 2007. This article compares and contrasts the response to the epidemic in each country, describing non-formal educational programmes targeted and tailored to specific high-risk populations."

The researchers find: "In summary, the non-formal educational programmes in each country highlight the importance of environmental factors and their predictive ability in modifying HIV prevention behaviours among FSWs in the Philippines and IDUs in Taiwan. The results underscore the importance of developing structural and organizational interventions to prevent HIV/STDs. In addition to improving knowledge, efficacy, and skills related to needle use and safe sexual practices, health workers involved in these non-formal educational activities should work closely with community gatekeepers to create a supportive environment for HIV prevention.

...With respect to HIV prevention, non-formal educational activities play an important role for children who drop out of school or do not have the opportunity to attend as well as for the adult population and vulnerable groups. The education of female bar workers in the Philippines [footnotes removed by editor] and the HIV education in the correctional systems for IDUs [injecting drug users] in Taiwan  are examples of best practices for designing, implementing, and evaluating non-formal educational programmes. Both countries draw upon the assistance of NGOs [non-governmental organisations] to carry out non-formal educational activities.

Our analysis leads to six suggestions for policy:
1. Individual behavioural surveillance should be conducted regularly with at-risk groups to monitor behaviour that could lead to HIV infection as well as for priority setting.
2. Organizational efforts at behaviour change must establish normative standards regarding regular attendance at local social hygiene clinics and training of peer educators in establishments and worksites, as well as in the prison system.
3. Non-formal education must focus on delivering appropriate messages to the [focus]  audience, using approaches that are both culturally sensitive and gender-sensitive.
4. More intervention research should be encouraged to [focus on] vulnerable groups, as in the testing of incarcerated injection drug users and condom use among female bar workers.
5. Indicators of programme effectiveness should be developed for implementation, followed by empirical studies to provide evidence of success, e.g., HRPs [harm reduction programmes].
6. Highly motivated IDU inmates should be trained as peer counselors who can serve as outreach health education workers in their communities upon release."