Introduction: The COVID-19 pandemic declared by the WHO has affected many countries rendering everyday lives halted. In the Philippines, the lockdown quarantine protocols have shifted the traditional college classes to online. The abrupt transition to online classes may bring psychological effects to college students due to continuous isolation and lack of interaction with fellow students and teachers. Our study aims to assess Filipino college students’ mental health status and to estimate the effect of the COVID-19 pandemic, the shift to online learning, and social media use on mental health. In addition, facilitators or stressors that modified the mental health status of the college students during the COVID-19 pandemic, quarantine, and subsequent shift to online learning will be investigated. Methods and analysis: Mixed-method study design will be used, which will involve: (1) an online survey to 2,100 college students across the Philippines; and (2) randomly selected 20–40 key informant interviews (KIIs). Online self-administered questionnaire (SAQ) including Depression, Anxiety, and Stress Scale (DASS-21) and Brief-COPE will be used. Moreover, socio-demographic factors, social media usage, shift to online learning factors, family history of mental health and COVID-19, and other factors that could affect mental health will also be included in the SAQ. KIIs will explore factors affecting the student’s mental health, behaviors, coping mechanism, current stressors, and other emotional reactions to these stressors. Associations between mental health outcomes and possible risk factors will be estimated using generalized linear models, while a thematic approach will be made for the findings from the KIIs. Results of the study will then be triangulated and summarized. Ethics and dissemination: Our study has been approved by the University of the Philippines Manila Research Ethics Board (UPMREB 2021-099-01). The results will be actively disseminated through conference presentations, peer-reviewed journals, social media, print and broadcast media, and various stakeholder activities.

Objective: The study aimed to demonstrate the feasibility of an unassisted and community-based HIV self-testing (HIVST) distribution model and to evaluate its acceptability among men-having-sex-with-men (MSM) and transgender women (TGW).Methods: Our demonstration study focused on implementing the HIVST distribution model in Metro Manila, Philippines. Convenience sampling was done with the following inclusion criteria: MSM or TGW, at least 18 years old, and had no previous HIV diagnosis. Individuals taking HIV pre-exposure prophylaxis, on antiretroviral therapy, or female sex at birth were excluded. The implementation of the study was done online using a virtual assistant and a delivery system via courier due to COVID-19-related lockdowns. Feasibility was measured by the number of HIVST kits successfully delivered and utilized and the HIV point prevalence. Moreover, acceptability was evaluated by a 10-item system usability scale (SUS). HIV prevalence was estimated with linkage to care prioritized for reactive participants.Results: Out of 1,690 kits distributed, only 953 (56.4%) participants reported their results. Overall, HIV point prevalence was 9.8%, with 56 (60.2%) reactive participants linked to further testing. Furthermore, 261 (27.4%) of respondents self-reported, and 35 (13.4%) of the reactive participants were first-time testers. The HIVST service had an overall median and interquartile range (IQR) SUS score of 82.5 (IQR: 75.0, 90.0), rendering the HIVST kits very acceptable.Conclusions: Our study suggests the acceptability and feasibility of HIVST among the MSM and TGW in Metro Manila, Philippines, regardless of their age or HIV testing experience. In addition, other platforms of information dissemination and service delivery of HIVST should be explored, including access to online instructional videos and printed materials, which may facilitate easier use and interpretation of results. Furthermore, due to our study’s limited number of TGW respondents, a more targeted implementation strategy to reach the TGW population is warranted to increase their access and uptake of HIVST.

Background: The Dengvaxia® (dengue vaccine) controversy has been identified as one of the main reasons for the measles vaccine hesitancy in the Philippines. Our study aimed to identify various issues related to the Dengvaxia® controversy and to link these issues with the social perspective of measles vaccine refusal. Methods: Semi-structured interviews and a focus group discussion using ethnography research were conducted with 41 parents and healthcare workers in Pasay City. Using Victor Turner's Social Drama Theory, our study identified existing social issues relating to the different angles of the Dengvaxia® controversy and the measles vaccine hesitancy. Results: Misinformation on the failed Dengvaxia® rollout implementation has challenged the fundamental understanding of the importance of immunization programs. Our findings on vaccine hesitancy in the community showed a complex problem with compounded factors, including medical populism, moral panics and other social views. We described how Pasay City’s clinic waiting room became a significantly important scenario where individuals often discuss information, concerns and experiences on vaccines and vaccine hesitancy. Conclusion: Our study suggests that the Dengvaxia® controversy may reduce the measles vaccination confidence in the Philippines. Lack of transparency played a crucial role in this dilemma, producing a cascading effect on the other vaccines' safety.

Introduction The rampant distribution of idealised images on the internet may lead the general public to improve their body appearance in a way that is sometimes excessive, compulsive or detrimental to other aspects of their lives. There is a decreasing appreciation of body image among emerging adults and an increasing trend on skin-lightening practices linked with psychological distress. This protocol describes the mixed-method approach to assess the relationships among body image perception, skin-lightening practices and mental well-being of Filipino emerging adults and determine the factors that influence them. Methods and analysis An explanatory sequential mixed-method approach will be used. A cross-sectional study design will involve an online self-administered questionnaire of 1258 participants, while a case study design will involve in-depth interviews with 25 participants. Data analysis will use generalised linear models and structural equation modelling with a Bayesian network for the quantitative data. Moreover, the qualitative data will use an inductive approach in thematic analysis. A contiguous narrative approach will integrate the quantitative and qualitative data. Ethics and dissemination The University of the Philippines Manila Review Ethics Board has approved this protocol (UPMREB 2022-0407-01). The study results will be disseminated through peer-reviewed articles and conference presentations.

Background: Several studies have linked social media use to increased risks for anxiety and depression. Cargo seafaring is one occupation prone to constant mental health instability due to workload, social isolation, and harsh working conditions. We examined the effect of daily social media exposure, occupational experience, and socioeconomic factors on anxiety and depression disorders among cargo seafarers. Materials and methods: We assessed the anxiety and depression disorders of 153 cargo seafarers using Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9 scales. We fitted generalised linear models to estimate associations between depression and anxiety disorders and daily social media exposure, occupational experience, and socioeconomic factors. Results: Approximately 30% and 37% of the seafarers had mild, moderate, or severe anxiety and depression disorders. The prevalence of anxiety was 2.68 times higher (adjusted prevalence ratio [aPR] 2.68, 95% confidence interval [95% CI] 1.30–5.50) and 2.27 times higher (aPR 2.27; 95% CI 1.12–4.62) among seafarers who spend > 2 to 4 hours and > 4 hours each day, respectively, on social media compared to seafarers who spend only up to 2 hours. In addition, seafarers who were on social media daily for > 2 to 4 hours (aPR 1.49; 95% CI 0.86–2.60) and > 4 hours (aPR 1.34; 95% CI 0.75–2.40) had a higher prevalence of depression compared to seafarers who were on social media daily for only up to 2 hours. Non-Catholics or seafarers with ≤ 10 years of occupational experience had a higher prevalence for anxiety and depression disorders than Catholics or seafarers with > 10 years of occupational experience. Conclusions: Daily social media exposure for > 2 hours, working for ≤ 10 years, or being a non-Catholic may contribute to the increase in the seafarers’ susceptibility to depression and anxiety disorders. The establishment of support groups for cargo seafarers is warranted to promote mental health awareness and well-being. Background: Several studies have linked social media use to increased risks for anxiety and depression. Cargo seafaring is one occupation prone to constant mental health instability due to workload, social isolation, and harsh working conditions. We examined the effect of daily social media exposure, occupational experience, and socioeconomic factors on anxiety and depression disorders among cargo seafarers. Materials and methods: We assessed the anxiety and depression disorders of 153 cargo seafarers using Generalised Anxiety Disorder-7 and Patient Health Questionnaire-9 scales. We fitted generalised linear models to estimate associations between depression and anxiety disorders and daily social media exposure, occupational experience, and socioeconomic factors. Results: Approximately 30% and 37% of the seafarers had mild, moderate, or severe anxiety and depression disorders. The prevalence of anxiety was 2.68 times higher (adjusted prevalence ratio [aPR] 2.68, 95% confidence interval [95% CI] 1.30–5.50) and 2.27 times higher (aPR 2.27; 95% CI 1.12–4.62) among seafarers who spend > 2 to 4 hours and > 4 hours each day, respectively, on social media compared to seafarers who spend only up to 2 hours. In addition, seafarers who were on social media daily for > 2 to 4 hours (aPR 1.49; 95% CI 0.86–2.60) and > 4 hours (aPR 1.34; 95% CI 0.75–2.40) had a higher prevalence of depression compared to seafarers who were on social media daily for only up to 2 hours. Non-Catholics or seafarers with ≤ 10 years of occupational experience had a higher prevalence for anxiety and depression disorders than Catholics or seafarers with > 10 years of occupational experience. Conclusions: Daily social media exposure for > 2 hours, working for ≤ 10 years, or being a non-Catholic may contribute to the increase in the seafarers’ susceptibility to depression and anxiety disorders. The establishment of support groups for cargo seafarers is warranted to promote mental health awareness and well-being.

Exposure to traffic-related air pollution is linked with acute alterations in blood pressure (BP). We examined the cumulative short-term effect of black carbon (BC) exposure on systolic (SBP) and diastolic (DBP) BP and assessed effect modification by participant characteristics. SBP and DBP were repeatedly measured on 152 traffic enforcers. Using a linear mixed-effects model with random intercepts, quadratic (QCDL) and cubic (CCDL) constrained distributed lag models were fitted to estimate the cumulative effect of BC concentration on SBP and DBP during the 10 hours (daily exposure) and 7 days (weekly exposure) before the BP measurement. Ambient BC was related to increased BP with QCDL models. An interquartile range change in BC cumulative during the 7 days before the BP measurement was associated with increased BP (1.2% change in mean SBP, 95% confidence interval (CI), 0.1 to 2.3; and 0.5% change in mean DBP, 95% CI, −0.8 to 1.7). Moreover, the association between the 10-h cumulative BC exposure and SBP was stronger for female (4.0% change, 95% CI: 2.1–5.9) versus male and for obese (2.9% change, 95% CI: 1.0–4.8) vs. non-obese traffic enforcers. Short-term cumulative exposure to ambient traffic-related BC could bring about cardiovascular diseases through mechanisms involving increased BP.