Risks for HIV Infection in a Low Prevalence Country Ofelia T. Monzon, M.D.,* Jose M. Capellan, M.D.,* Angelita Balis, M.S.,* Ernesto Sotocua, Jr., M.D.,** Cristina Costa, M.D.,*** Virginia Florentino, M.D.,**** Fem J. Paladin, M.S.* and Cynthia B. Lazo, MT* (*The Department or Health Research Institute for Topical Medicine; **N. Reyes Memorial Medical Center; ***Manila Health Department; ****Mandaluyong Health Department; Poster Presentation at the IVth International Conference on AIDS, Stockholm, Sweden, June 12-16, 1988) No Abstract Available [Phil J Microbiol Infect Dis 1989; 18(1):4-9] Key Words: HIV/AIDS, immunodeficiency, sexual transmission, STD Published reports from various parts of the world indicate that human immunodeficiency virus (HIV) infection is primarily transmitted through three major routes: sexual, blood/blood products administration, and maternal to child. 1 Of these routes, sexual transmission appears to be the most frequent mode of infection. The risk of acquiring HIV infection via sexual contact can be directly related to the probability that a sexual partner is infected and the type of sexual practice observed. Thus, in a country where HIV infection has not previously been known, the likelihood of native residents acquiring HIV infection will depend on sexual exposure to infected partners coming from other countries. This risk increases as the number of such partners increase especially in the presence of unprotected sexual contact (without condom usage) and anal sex. These behaviors extensively studied and reported from other countries are believed to increase the chances of acquiring HIV infection. 2 Testing for HIV infection in the Philippines began in 1985. Preliminary data gathered from a small number of homosexual/bisexual males reported the presence of such risky behaviors as anal sex and minimal condom usage. 3 In 1987, subsequent data from the continuing surveillance showed the presence of HIV infection in 0.17% of females and 0.14% of males. 4 To focus attention on behavioral changes needed to lessen transmission of HIV infection from the infected to uninfected Filipinos, this report contains relevant information on the subpopulation group at risk for both acquiring and transmitting HIV infection within this country, MATERIALS AND METHODS Subjects Males and females working in sex-oriented establishments in Manila, Quezon City, Makati, and Mandaluyong were recruited into the study. These subjects receive fees for sexual favors from their clients, in addition to a minimal stipend given by their employer. The establishments included bars, discotheques, massage parlors, and sauna baths. Methods The subjects were recruited at any of the following locations: at the VD Clinic of the Manila Health Department, at private sexually transmitted diseases (STD) clinics in the tourist area of Manila, and at their places of employments. Informed consents were obtained and questionnaires were administered by trained members of the investigating group. Information was elicited with regards to demographic data, length of employment, use of drugs including alcohol intake, sexual behavior and practices, number and country of origin of sexual partners in the previous six months, and past and current medical history. A brief physical examination with