AIDS: The other pandemic.
Even with Covid-19 affecting the delivery of HIV-related services – that were already problematic even pre-pandemic – the country is still reporting 21 new HIV cases per day. This is according to the latest (for October 2020) report from the HIV/AIDS & ART Registry of the Philippines (HARP) of the Department of Health’s (DOH) Epidemiology Bureau.
Specific to October 2020, there were 735 new HIV-positive individuals reported to HARP; and 21% (153) of them had clinical manifestations of advanced HIV infection at the time of testing.
MEN IN MOST CASES
A big chunk of the newly infected are still male; and not just members of the LGBTQIA community, it must be emphasized.
Ninety-six percent (704) of the reported new cases were male. The median age was 28 years old (age range: 3-60 years old). More than half of the cases (52%, 379) were 25-34 years old and 28% (204) were 15-24 years old at the time of diagnosis.
More than a third (40%, 295) were from the National Capital Region (NCR). Region 4A (20%, 146), Region 3 (16%, 121), Region 6 (7%, 54), and Region 12 (5%, 36) comprised the top five regions with the most number of newly reported cases for this reporting period, together accounting for 88% of the total cases.
Sexual contact remained as the predominant mode of transmission or MOT (99%, 725). Among the newly reported cases infected through sexual contact, 60% (437) reported transmission through male-to-male sex, 28% (200) through males who have sex with both males and females, and 12% (88) were through male-to-female sex.
There were nine cases (1%) that had no data on mode of transmission.
YOUTH AND HIV
Even if there are less HIV services, trends noted in the past continue – e.g. youth continue to be greatly affected by HIV.
In October 2020, 204 (28%) cases were among youth 15-24 years old; and 94% of them were male. Almost all (99%, 201) were infected through sexual contact (20 male-female sex, 136 male-male sex, 45 sex with both males & females), and 1% (3) had no data on the MOT.
Children (<10) and adolescents (10-19) were also infected.
There were 27 newly diagnosed adolescents. Of these, six were 15-17 years old and 21 were 18-19 years old. All newly reported adolescent cases were infected through sexual contact (five male-female sex, 20 male-male sex, two sex with both males and females ).
Further, one child was diagnosed with HIV in this reporting period was infected through vertical transmission (formerly: mother-to-child transmission).
HIV AMONG OFWs
Fifty-four Filipinos who worked overseas within the past five years, whether on land or at sea, were newly diagnosed in October 2020. They comprised 7% of the total cases for this period. Of these, 93% (50) were male.
All of the male cases were infected through sexual contact (eight male-female sex, 27 male-male sex, and 15 sex with both males and females).
The ages of male OFWs ranged from 23 to 54 years (median: 33 years). More than half (54%, 27) of the male cases were 25-34 years old at the time of testing and 36% (18) were 35-49 years old. Among the four female OFWs, all where infected through male-female sex.
Seventy-five percent (3) were 25-34 years older at the time of testing and 25% (1) were 35-49 years old. The age range among diagnosed female OFWs were from 27 to 35 years (median: 32 years old).
PREGNANT WOMEN LIVING WITH HIV
Still in October, 13 were reported pregnant at the time of diagnosis. Five cases each were from NCR and Region 4A; and one case each from Regions 3, 10 and 12.
Reporting of pregnancy status at the time of diagnosis was included in the HARP only starting year 2011. From January to October 2020, there were 85 HIV positive women reported pregnant at the time of diagnosis. Of these, 35% (30) were from NCR, 22% (19) were from Region 4A, 16% (14) were from Region 3 and 27% (22) were from the rest of the country. The age of diagnosis ranged from 15 to 45 years old (median age: 25).
TRANSACTIONAL SEX
In October 2020, 13% (93) of the newly diagnosed engaged in transactional sex. Ninety-nine percent (92) were male and aged from 19 to 57 years old (median: 30 years). Fifty-two percent (48) of the males reported paying for sex only, 29% (27) reported accepting payment for sex only and 18% (17) engaged in both. Further, there was one female aged 23 years old who had engaged in transactional sex and was reported to have accepted payment for sex only.
People who engage in transactional sex are those who reported that they either pay for sex, regularly accept payment for sex, or do both. Reporting of transactional sex was included in the HARP starting December 2012.
TREATMENT FOR PLHIVs
In October 2020, there were 579 patients who were initiated on ART. The median CD4 of these patients upon enrollment was 153 cells/mm3.
To date, a total of 47,013 PLHIVs are on ART. This is only a little more than half of the total 81,169 HIV cases in the country as of end-October.
Most (96%) of those using ART are males. The age of reported cases ranged from 1 to 79 years (median: 31 years old). Ninety-five percent were on first line regimen, 4% were on second line, and 1% were on other line of regimen.
DEATHS AMONG PEOPLE WITH HIV
Perhaps the number of deaths among PLHIVs highlight the under-reporting in the country as far as HIV is concerned. Since data was gathered in January 1984, only 4,444 deaths were reported, and the real figure may be much higher though affected by both under- and non-reporting.
In October 2020, specifically, there were 248 reported deaths due to any cause among PLHIVs. Ninety-six percent (238) were males. One case (<1%) was less than 15 years olds at the time of death, 29 (12%) cases were 15-24 years olds, 109 (44%) were 25-34 years olds, 79 (32%) were 35-49 years olds, and 27 (11%) were 50 years and older.
Ninety-five percent (235) of the cases were reported to have acquired the infection through sexual contact (37 through male-female sex, 124 through male-male sex, 74 through sex with both males and females), 3% (7) through sharing of infected needles, and <1% (1) were infected through mother and child. Five (2%) reported deaths had no data on MOT.
