When transgender woman Shola Luna was diagnosed to have HIV in 1991, she remembered that antiretroviral medicines (ARVs) were not yet widely available. And so she agreed to be part of HIV treatment trials, even if – she said – “we didn’t know how things would turn out.” In the end, “I think we (PLHIVs at that time) all wanted to live longer, so we said yes (to the trials).”
Shola remembered taking 15 tablets in the morning, and another 15 tablets at night, so “the side effects were unbelievable.”
But at least for Shola, things turned out… for the better somehow. After all, she survived, even if others who were tested around the same time as her have long died (e.g. Dolzura Cortez, Sarah Jane Salazar).
But now as she grows older while living with HIV, Shola said there’s neglect of those who are aging while living with HIV, arguably particularly in the Philippines.
“(Service providers) should give importance to seniors who are also living with HIV,” she said, “because we have various needs (very specific to us).” To add – and to stress – the issues are actually layered, traversing being LGBTQIA and living with HIV.
In the case of Shola, “we’re not as strong as we once were.” This has an effect on them making a living, so that “being provided with livelihood (could also help).” Obviously, this is even more defined for LGBTQIA people who may not have families to support them, or were even disowned by family members, so that they have to find ways to survive as they age all alone.
The issues are there, but the silence is – to start – what’s apparent.
OVER-FOCUS ON THE YOUTH?
In July 2021, the DOH reported 1,045 new HIV infections in the Philippines. Fifty-two percent (52%) of the newly-infected belonged to the 25 to 34 age group. Another 30% belonged to the 15 to 24 age group.
With only 3% of those who were infected with HIV in July 2021 aged 50 years and older, most of the HIV-related responses in the Philippines focus on the effects of HIV on the youth – e.g. HIV screening and testing, .
“What is not as widely discussed – particularly in the Philippines – is how HIV is also an issue of the aged,” said Aaron Moises Bonete, managing editor of Outrage Magazine and co-host of Bahaghari Talks.
For Bonete, there are many issues worth stressing here.
For one, PLHIVs are living longer. In the US, for example, the CDC reported that in 2018, 51% of Americans with HIV were aged 50 and older. Many of them are living longer, healthier lives because of effective HIV treatment.
Secondly, “with aging, health concerns surface – from cardiovascular disease, diabetes, renal disease, and cancer.”
And thirdly, “when tackled with HIV, additional issues surface, including the emergence of multiple chronic diseases or conditions on top of HIV, and the use of multiple medications.”
It is time to talk about this, Bonete stressed.
LACKING EFFORTS
Bonete’s position was seconded by Ico Rodulfo Johnson, president of The Project Red Ribbon, one of the most active non-government organizations dealing with HIV in the Philippines.
“This issue has been raised in dialogues,” said Johnson, “however, there are no (specific) programs for the elderly/aging (in the HIV community).”
For Johnson, this sector’s needs may fall under two categories – i.e. physical needs, and psychosocial needs.
For example, aging PLHIVs may also have “common ailments linked with aging, such as arthritis – i.e. they may not be able to walk anymore, and this impedes their mobility going to and from their treatment facilities”.
PLHIVs may also have health issues linked to their long-term use of ARVs – e.g. high cholesterol build-up in the body, heart diseases, etc.
And PLHIVs may also have psychosocial issues – e.g. depression induced by the desire to be part of a community, or even of society, that may not want them because they are LGBTQIA, old/aging, and have HIV. Add to this, Johnson said, the fact that many may not have long-lasting relationships, so they have to face these struggles on their own.
For Johnson, therefore, “we have to continue pushing for reforms and inclusion in the development of the policies (related to HIV, being LGBTQIA and aging). This way, those who are over 50 years old (and belonging to these intersectional sectors) can have access to more benefits.”
WANTED: MORE ACTIVE ROLE
Johnson sees those aging with HIV as more experienced – e.g. in the struggles faced by people like them, and how they can navigate these challenges. As such, they have “more knowledge to share to those in KAPs (key affected populations), as well as those serving KAPs.”
Unfortunately, “the target of civil service organizations (rendering HIV-related services in the Philippines) are aligned with the target of the national government. And these are very, very specific – i.e. men who have sex with men/MSM, transgender people, and so on. These are targeted to those in the age range with the highest HIV cases.”
For Johnson, this is somewhat neglectful. “You have to understand that… people go towards (being seniors), we (all go) to that direction of being old. So we really also have to address the needs of this population.”
Johnson recommends for the government and CSOs to work together – e.g. in getting metrics not just in the number of senior PLHIVs, but also on the quality of life of these people. This way, they can similarly work together in offering services to ensure inclusion of a population that remains neglected. There is a need, he said, to stress that “it goes beyond the provision of ARVs; it’s more about ensuring that PLHIVs have quality life.”
In the end, “their voices need to be heard,” Johnson stressed, though “not one during talks. Instead, they’re more needed in the creation of more programs… for their own community.
NOW IS THE RIGHT TIME
With over 80% of the newly-infected under 34 years old, leading to HIV-related services targeting them, when is the “right” time to talk about HIV and aging in the Philippines?
“Today is the right time; there’s no other time but today. We have to break that mentality that we just have to focus on one population and forget the others,” Johnson said. On this, even the young now will age, and so “are we going to forget them tomorrow? The dialogue should start today; the movement should start today; the reforms should start today.”
“Every one grows old, including PLHIVs,” said Bonete, who said that the misconception that having HIV=immediately dying is “plain antiquated This is because not all PLHIVs immediately die; they survive and even thrive in spite of their HIV status.”
However, “this surviving and thriving can only really happen if HIV-related services are provided specifically to those who are aging while living with HIV. This is because they have needs that are very specific to them, and are not being answered by existing efforts.”
And so for Bonete, “if no immediate solution can be offered on this this very moment, at least start talking about it already. Before it’s too late.”
