CONTINUING PROBLEM.
Seven hundred and fifty (750) new cases of HIV infection were reported in December 2016 to the HIV/AIDS & ART Registry of the Philippines (HARP). The trend for the epidemic in the country continues to be the same, with most (96%) of the cases involving males, and more than half belonging to the 25-34 year age group while 29% were youth aged 15-24 years.
With the number, 26 Filipinos now get infected with HIV every day – up from only one in 2008, and even the 17 cases per day registered only three years ago (in 2017).
“To be blunt, we’re beyond considering this as just a disturbing trend,” said Michael David dela Cruz Tan, editor of Outrage Magazine, the only LGBT publication in the Philippines, which also has HIV-related efforts. “Expect for this epidemic to only worsen, with the worsening situation something we’re not ready – or even able – to deal with. The continuing lack of attention given to this has long pushed us beyond the point of no return.”
MODES OF TRANSMISSION
As per the registry, most (734 of the 750 cases) were infected with HIV through sexual contact. Eighty-eight percent of infections transmitted through sexual contact were among men who have sex with other men (MSM). It is worth noting that in the early years of the epidemic (1984-1990), 62% (133 of 216 cases) were female. But from 1991 to present, males comprised 93% (36,718 out of 39,395) of the total number of HIV/AIDS cases in the Philippines.
Another notable mode of transmission was through needle sharing among injecting drug users (IDU, 16).
The regions with the most number of reported cases were: National Capital Region (NCR) with 267 (36%) cases, Region 4A with 136 (18%) cases, Region 3 with 74 (10%) cases, Region 7 with 59 (8%) cases, and Region 11 with 46 (6%) cases. One hundred sixty-eight (168) cases (22%) came from the rest of the country.
Three pregnant women were diagnosed with HIV in December 2016, with two cases recorded from NCR and one case from Region 7.
The HARP reported that “the absolute number of cases among females has also been increasing. Cases of HIV transmission from mother to child are more likely to increase if female patients are not linked to HIV care. Ninety-three percent (2,600) of all female cases were diagnosed when they were between 15-49 years of age.”
INVOLVING YOUNGER PEOPLE INFECTED
Those who are getting infected with HIV in the Philippines are also getting younger. While the age group with the biggest proportion of cases between 2001 to 2005 was 35-49 years, starting from 2006, the age proportion shifted to 25-34 years. The proportion of HIV positive cases in the 15-24 year age group increased from 25% in 2006-2010 to 28% in 2011-2016.
REPORTING NEWER TRENDS
Aside from HIV infecting more MSM and IDU, in December 2016, 9% (66) of the reported cases engaged in transactional sex. Most (92%) were male whose ages ranged from 19 to 72 years (median: 30 years), while five were female whose ages ranged from 21-29 years (median: 24 years). Thirty-four (34) males who engaged in transactional sex were the ones who paid for sex.
As for HARP’s definition, people who engage in transactional sex are those who report that they pay for sex, regularly accept payment for sex, or do both.
From December 2012 (when HARP started monitoring those who engage in transactional sex) to December 2016, a total of 3,522 cases reported were people who engaged in transactional sex. Ninety-six percent (3,372) were male. Of the 39,622 cases, 1,904 (5%) paid for sex, 1,062 (3%) accepted payment for sex, and 556 (1%) engaged in both.
ACCESS TO TREATMENT
In December 2016, there were 524 patients who started on ART. The median CD4 of these patients upon enrollment was 130 cells/mm3. One of these patients who started on antiretroviral treatment (ART) died within the same month.
As of December 2016, a total of 17,940 PLHIVs were presently on ART. Most (97%) were males. Ninety-five percent were on first line regimen, 4% were on second line regimen, and 1% were on other regimen.
The number of those who are currently accessing treatment is not even half the cumulative number of HIV cases in the Philippines that reach 39,622.
The first AIDS case in the Philippines was reported in 1984. From January 1984 to December 2016, there has been 39,622 HIV Ab sero-positive cases reported to the HARP. More than half (20,386 or 51%) were from the 25-34 year age group while 10,720 (27%) were youth aged 15-24 years.
HIV-RELATED DEATHS
HARP reported 37 deaths in December 2016, with 34 (92%) of them male and three (8%) female. Twenty (54%) of the reported deaths belong to 25-34 year age group, eight were 15-24 age group, seven were adult aged 35-49 years old, and two were above 50 years old.
All of these deaths were infected through sexual contact (six male-female sex, 19 male-male sex, 12 sex with both males and females).
Already, a total of 1,969 death were reported from January 1984 to December 2016.
Under-reporting is, however, acknowledged.
FINDING SOLUTIONS
Outrage Magazine’s Tan said that “a lot more needs to be done. And fast.”
Among Tan’s recommendations include “prompt and proper implementation of the RH Law that could help facilitate sex education and access to safer sexual knowledge/practices, immediate amendment of the extremely outdated AIDS Law, introduction of science-based/backed knowledge (e.g. introduction of PrEP and teachings about undetectable=untransmittable), harmonizing HIV-related efforts particularly in treatment hubs, confronting the ‘profiteering’ happening in dealing with HIV, and dealing with stigma and discrimination affecting PLHIVs.”
In a statement released to Outrage Magazine, the National Council of Churches in the Philippines (NCCP) said that “given that it is a fast growing epidemic, a comprehensive response of access to prevention, treatment care and support is necessary to bring HIV under control.”
Part of this, according to NCCP, is “a comprehensive and age appropriate sex and sexuality education through the combined efforts of government, civil society and church… to counter the flood of information or misinformation accessible to our young people.” For the NCCP, “sexuality is a gift from God” and it “subscribes to a deliberate, careful and responsible celebration of that gift. Abstinence, being drug free, fidelity and committed relationships are paramount. This should not exclude other evidence informed prevention strategies such as the use of condoms. The correct and consistent use of condoms has proven to be effective in preventing HIV transmission between discordant couples (i.e. one partner is HIV negative and the other is positive).”
The NCCP bemoaned that “there is more to be desired in addressing certain conditions in society” that make people vulnerable to HIV. “Among these are poverty and other economic imbalances, not to mention the social stigma that comes from a misinformed populace. This is true especially in the case of our youth who grow up being lesbian, gay, bisexual, transgender and intersex, and where the lack of social and religious acceptance leaves them no room to be authentic.”
