An estimated 8,700 people were living with HIV in The Philippines in 2009. The country has traditionally had a very low HIV prevalence, with under 0.1% of the population infected. Even in groups such as sex workers and MSM that are typically associated with higher levels of HIV, prevalence rates above 1% have not yet been detected. In the case of sex workers, this is possibly due to efforts to screen and treat those selling sex since the early 1990s. However, there are reasons to believe that this situation may not last. In early 2010 the Department of Health in the Philippines stated the country was now on the brink of a "concentrated epidemic", due to a rise in prevalence. Condom use is not the norm in paid sex, drug users commonly share injecting equipment in some areas, and among Filipino youth, there is evidence of complacency about AIDS. National HIV prevalence among the most at risk populations which includes sex workers, men who have sex with men and injecting drug users, has increased more than five fold from 0.08 % in 2007 to 0.47 % in 2009.