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Once we were grown-ups…

That the world is ageist – that is, discriminating against those who get old – is frequently noted. And the LGBT community is not exempted from this cruelty of looking down on the mature-aged members of the community. A Bahaghari Center for LGBT Research, Education and Advocacy (Bahaghari Center) study done by Raine Nuyles Cortes, John Ryan Nual Mendoza and Michael David dela Cruz Tan notes why this needs to be stopped, and why there is a need for inclusion of these “invisible people” particularly by a group of people that – as a whole – continues to be discriminated against.

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Select parts were completely lifted from Ginintuang Agora: The Community and Sexual Life Stories of Mature-Aged Gay Men of the Home for the Golden Gays by Raine Nuyles Cortes, John Ryan Nual Mendoza and Michael David dela Cruz Tan.

On December 4, 2010, right after the 2010 Pride March, the annual gathering of the gay, lesbian, bisexual, transgender, queer, intersex and ally (GLBTQIA) community in the Philippines, Rev. Richard Mickley, O.S.Ae, Ph.D. – the abbot of the Order of Saint Aelred, a SEC (Securities and Exchange Commission) registered religious society of mostly gay, lesbian, bisexual and transgender members – sat by himself not too far from the stage where the after-parade program was being held. He was… awaiting his turn to speak.

“They’re taking a while,” he said – not even with a hint of exasperation, just stating an observation. He then got to talking that, considering he’s already over 80 years old, he is “consolidating everything I have done (for the GLBTQIA struggle for just under 40 years).” It was a realistic way of looking at mortality.

Mickley never got to speak that night – others who were younger (thus supposedly more exciting) were given priority, leaving him no time to address the crowd. It may well be considered a slap on the face on the person who, with Pro-Gay Philippines’ Oscar Atadero, actually started the Pride March in the Philippines (and Asia, for that matter) in 1994. What can only be worse is that a few months before the parade, Task Force Pride, the organizer of the annual Pride celebration that he helped establish, was considering giving recognition to GLBTQIA leaders who shaped GLBTQIA history in the Philippines. When Mickely’s name was raised, only a handful among the members of the (then) executive committee even heard of his name, with someone even saying “must be some old queen.” All he has accomplished for the GLBTQIA community seemingly easily dismissed with reference to his age (and aging).

This highlights how aging is perceived in the GLBTQIA community – a perception that may be best summarized in what Kertzner (2006) observed as the stereotyping of gay male aging as a descent from “adolescence to obsolescence.” Within the GLBTQIA community, the “gay generation gap” has been noted by Russell and Bohan (2005) to focus between the youth and those in middle age, arguably fracturing the GLBTQIA community into groups with cohorts divided according to social and political influences.

There exists in the GLBTQIA community an emphasis on youth, so that ageism has become a serious problem in it (Knauer, 2009). The GLBTQIA community, especially the gay male community, is said to be a youth culture focused in bars (Hostetler, 2004) that – while they may have been historically important meeting places of community – reinforces the preference for youth (Hiyasaki, 2007). Indeed, “in a community where twenty-something gay men consider thirty-something gay men to be irrelevant, getting either group to take an interest in the lives and well-being of octogenarians presents an obvious challenge” (Knauer, 2009).

There exists in the GLBTQIA community an emphasis on youth, so that ageism has become a serious problem in it. The GLBTQIA community, especially the gay male community, is said to be a youth culture focused in bars that – while they may have been historically important meeting places of community – reinforces the preference for youth. Indeed, in a community where twenty-something gay men consider thirty-something gay men to be irrelevant, getting either group to take an interest in the lives and well-being of octogenarians presents an obvious challenge.

It was after noticing the ignoring of the mature-aged members of the GLBTQIA community that led to Raine Nuyles Cortes, John Ryan Nual Mendoza and Michael David dela Cruz Tan to conduct a research involving select members/residents of the Home for the Golden Gays (HGG), a one-time residence of aged men who have sex with other men (MSM). The output – entitled Ginintuang Agora: The Community and Sexual Life Stories of Mature-Aged Gay Men of the Home for the Golden Gays – captured through the life stories the issues that affect them.

As the authors stated: “In a country like the Philippines, where a dearth of information about the mature-aged population as a whole – even more so the mature-aged gay men – is noticeable, hearing the stories straight from the sources becomes not just ideal, but a must, in order for them to take a more active role in the making of impressions of themselves… (What this highlights is) how life stories become identifiers not just of the person telling his/her story, but of the community he/she belongs to/moves in. Here, an individual life story also becomes a community’s life story.”

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AGORA AND GAY

Price (2008) cited the work of Wahler and Gabbay (1997) to put a spotlight on the frequent forwarding of “pejorative stereotypes” about older gay men and lesbians, including “living lives of rejection, shame, loneliness, isolation, poor psychological adjustment, and sexual predation on younger men (p. 1,342). For Trentham (2010), this is the “stereotype of the lonely homosexual or the bitter old queen, images that as a gay man, I am all too familiar with although I have no sense of how these stereotypes came to be.”

That homosexuals are largely ignored in researches is unfortunate since the mature-aged member of this population reported concerns similar to heterosexual-identifying mature-aged men and women (Whitford, 1997). These concerns have been noted to have been exacerbated, nonetheless, by fear of loneliness in older age, a reduced social life and marginalization from the gay community (Heaphy, 2007; Hughes, 2007), as well as lack of financial resources and appropriate care and living arrangements (Bayliss, 2000).

Of interest to Cortes, Mendoza and Tan’s study were the sexual practices of mature-aged members of the GLBTQIA community, particularly gay men. This is because various studies have been highlighting the need to focus on young men who have sex with men (MSM), in the belief that they are more at risk of HIV infection (for example, McAuliffe et al., 1999; Age Concern England, 2002); but none have given mature-aged gay men the same amount of attention.

Admittedly, just as more studies on GLBTQIs are surfacing, the experiences – thus the needs – of older gay and lesbian citizens have started to also become more visible (for example, in the UK, Heaphy, Yip, & Thompson, 2004; Pugh, 2005). Mainly, not only are the studies too few, their coverage has – even now – failed to question, thereby attempt to effect the existing damaging beliefs about GLBTQIs.

Being gay and being old (also referred to as agora in gay lingo) may be considered a double whammy, a gold mine for would-be discrimination. Already identifying contrary to the heteronormative narratives, gay men who live in the fringes of the society are further discriminated against when they grow older, with all the stereotypes going with aging additionally impressed upon their already stereotyped lives.

The issue is even more obvious among transgenders (TGs) and intersex (also members of the GLBTQIA community, and who are, most times, erroneously grouped with gay men), since “the historical development of modern day biomedicine, psychology and psychoanalysis is bound up in the complex interactions of a Eurocentric, heterosexual, Judeo-Christian viewpoint” (Witten, 2002). The “restriction of the underlying theoretical construct of sex and gender to the dualistic genital sex model has eliminated all biomedical and psychosocial healthcare research on behalf of both the intersex population” (Witten, 2002) and “gender-variant individuals” (South, 2000).

FACING ISSUES

That the mature-aged members of the GLBTQIA community has issues to contend with goes without saying.

Internal homophobia, for instance, helps create the “other” – i.e. how a heteronormative society may consider GLBTQIs; and how gay men, for example, may treat each other.

Combinations of the risk factors when mature-aged gay men engage in sexual acts therefore become problematic. The HGG interviewees, for example, openly discuss having anal sex without the use of condoms, “basta bata ang ka-sex para siguradong malinis (as long as you do it with a young man to be sure he’s clean),” Mother Leony said. He added that, “of course, huwag magpaputok sa loob (as long as he doesn’t orgasm/cum inside you).” That proper information do not reach them, even if they are still actively engaging in sexual activities, make their every sexual encounter a gamble in getting infected or, hopefully, not.

Greg, a resident of HGG, proudly claims being “heterosexual-looking” – akin to the Western concept of “straight-looking and/or straight-acting,” which supposes that gays, by their very being, act more like women than like men (since genders are defined, in this view, only between the biological men and women, with gays believed to mimic women and lesbians believed to mimic men). “Noon pa, ganito na ako (From way back, I have always been like this),” he said. Acting as “straight” (i.e. not crossdressing) gave Greg a sense of “normalcy – hindi ako naiiba sa mga tao (I don’t differ from others).”

His very reason for avoiding to be identified as an outsider of the mainstream, however, made Greg help in the treatment of the other HGG inhabitants as the “others”, the outsiders in heteronormative discourses. “Matanda na kasi tayo, dapat behave na (We’re already old, we should behave now),” he said. “Nakakahiya kasi (maging) matandang baklang ang arte-arte (It’s embarrassing being a flamboyant old gay man).”

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Financial capability is, of course, also an issue in pushing the otherness of mature-aged gay men.

Mother Leony, a resident of HGG, used to be a sex worker when he was younger. Now in his 80s, he has largely been dependent on HGG (e.g. for accommodation and food) and distant family members (who send him his daily allowances). Only recently, he underwent a hernia operation, one of the many he had had in the past years.

This time, “dinala ako sa ospital, sa Tondo Medical Center (I was taken to a hospital, at the Tondo Medical Center),” he recalled. “‘Yung ospital ni Madame Imelda (To the hospital of Imelda Marcos).” His visit was actually only made possible after “tinawagan ko na lahat (I called everyone) – Mayor (Pasay City’s Antonino Calixto), mga konsehal, at kung sinu-sino pa. Kung wala akong contacts, ewan saan ako pupulutin (I called everyone – the Pasay City mayor, councilors and whoever I could call. If I didn’t have contacts, I don’t know where that would have left me)”.

Mother Leony could easily recall how, while in the hospital, many were asking him how he could have afforded having his own room, while others had to share not just rooms, but even beds due to the lack of available facilities for “people like us – mga walang pera (people who do not have resources),” he said, laughing. “Hindi nila alam nangolekta na ako (ng kabayaran) sa lahat ng nagawa ko (They don’t know I collected the returns of all the favors I did).”

While he could not recall how much he had to pay to Tondo Medical Center [“Alam mo na, matanda na ako, sira na memories ko (You know I’m already old, my memory isn’t what it used to be)], in an earlier surgery, when his eyes had to be fixed, Mother Leony remembered having to pay PhP 25,000.00 for a two-night stay at the Manila Sanitarium Hospital in Pasay City, the health facility closest to HGG. “Kuwarto pa lang ‘yan (That’s just for the room),” he said. “Saan naman tayo kukuha ng ganoong pera, di ba (Where could I get an amount like that)?”

Basically, “kung wala akong pera, dedma sila (If I don’t have money, I am ignored),” Mother Leony summarily said.

Numerous studies have already stressed how poverty is linked with access to healthcare, thus to good health. In 2005, for example, the WHO estimated that, annually, 25 million households (more than 100 million people) are forced into poverty by illness and the difficulty to pay for healthcare. This development – “referred to as the income erosion effect of ill health for poor households” by Tagoe (2010) – was noted in the bottom 15% to 20% of the population of Bangladesh (Sen, 2003), with the risks that poor households face posing greatest threat to their lives and livelihoods (Krishna, 2004; Noponen & Kantor, 2004).

SEX WITH THE INVISIBLE MEN

A common notion about the mature-aged population is their supposed asexuality or at least have inactive sexual live, with the belief persisting despite survey results that show the opposite (Cahill et al., 2000). In the popular imagination, sex among people aged over sixty-five is largely considered as unappealing, and is even unlikely. This is a misconception, since, contrary to the prevailing stereotype, mature-aged people actually want to, and are still able to, have an active, satisfying sex life (National Institutes of Health, 1981; Reinisch & Beasley, 1990; Wooten-Bielski, 1999).

There is a need to to put a spotlight on the frequent forwarding of “pejorative stereotypes” about older gay men and lesbians, including living lives of rejection, shame, loneliness, isolation, poor psychological adjustment, and sexual predation on younger men. There is this “stereotype of the lonely homosexual or the bitter old queen, images that as a gay man, (we may be) all too familiar with although (we) have no sense of how these stereotypes came to be.”

According to Grossman (1995), while it is true that HIV and AIDS may sometimes be misdiagnosed in older people because “many of its symptoms mimic other illnesses that affect older people”, mature-aged gay men are particularly at risk to be infected with HIV due to various reasons, including societal beliefs, myths, and stereotypes emanating from ageism, homophobia, denial of risk, alcohol and other substance use, and anonymous sexual encounters. The risk of HIV transmission among mature-aged gay men (and among MSM, in general) has been noted to have been exacerbated during intercourse, too, due to the normal aging changes (Moore & Amburgey, 2000), including the thinning of the epithelial structure of the anal area, a physiological changes “allow for more microscopic tearing during sexual penetration and therefore, provide a direct route for HIV transmission” (Rural Center for AIDS/STD Prevention, 2006).

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Combinations of the risk factors when mature-aged gay men engage in sexual acts therefore become problematic. The HGG interviewees, for example, openly discuss having anal sex without the use of condoms, “basta bata ang ka-sex para siguradong malinis (as long as you do it with a young man to be sure he’s clean),” Mother Leony said. He added that, “of course, huwag magpaputok sa loob (as long as he doesn’t orgasm/cum inside you).”

That proper information do not reach them, even if they are still actively engaging in sexual activities, make their every sexual encounter a gamble in getting infected or, hopefully, not.

IN NEED OF ATTENTION

Cortes, Mendoza and Tan’s research noted steps needed to be taken to include the mature-aged MSM into mainstream GLBTQIA discussions. Also, “while the mature-aged gay men of HGG have individual stories to tell, their narratives are actually intertwined to show patterns that may then be used for the drawing of inferences on how their community works”.

The authors’ recommendations include: further researches to “gather even more information – be it through qualitative or quantitative approaches – on a population that is often neglected”; broadening of existing HIV and AIDS programs for prevention and sexual health education to also target the mature-aged gay men population because they are also at risk given that they also practice MSM behavior; the need to inform government policy makers of the specific needs of mature-aged gay men, since existing laws “fail to consider the variations of the experiences of the sub-populations within the generalized mature-aged population”; and the need to “indiginize” the solutions provided to this population.

FORMING COMMUNITY

A key point of the study is the importance of the community among GLBTQIAs – including the mature-aged MSM. And “emphasizing on the community is important since, in the case of mature-aged gay men, for example, where they are will affect how they will define their identity, thus its expression”. According to Grossman, D’Augelli and Hershberger,

“Gays have been known to create ‘alternative’ families due to the failings of hetero-dictated norms of family formations – i.e. friends and the support they provide serve a unique function in mitigating the effects of stigmatization.” (Grossman, D’Augelli, & Hershberger, 2000)

For Weston (1991), “community” in the context of gay and lesbian lives is “as multifaceted in meaning as it is ubiquitous.” He, therefore, proposes for it to be considered sans territorial bounds, but as “a category implicated in the ways lesbians and gay men have developed collective identities, organized urban space, and conceptualized their significant relationships” (p. 124).

This is how, borrowing Weston’s (1991) words, “chosen families” are formed – with the shared identities coming together. Dorrell (1991) referred to this as the family “of comradery and caring.”

What exists at the core of this community is friendship. As Manasse and Swallow stressed:

“The way a lot of gay men and lesbians come out in the world is very alienating. For many of us, building families of linkage and connection is very healing. It’s important for us to feel that love and connection because it’s the antithesis of the alienation of homophobia. It’s important for us to say, ‘This is the innermost circle’” (Manasse & Swallow, 1995, p. 153).

And so it is that it remains worth highlighting how the GLBTQIA community truly needs to embrace all its members, even those already in their golden years…

The full research – Ginintuang Agora: The Community and Sexual Life Stories of Mature-Aged Gay Men of the Home for the Golden Gays – may be requested from Raine Nuyles Cortes, John Ryan Nual Mendoza and Michael David dela Cruz Tan.

SELECT REFERENCES

Bayliss, K. (2000). Social work values, anti-discriminatory practice and working with older lesbian service users. Social Work Education, 19, 45-53.
Cahill, S., South, K., & Spade, J. (2000). Outing Age: Public Policy Issues Affecting Gay, Lesbian, Bisexual, and Transgender Elders. Policy Institute of the National Gay and Lesbian Task Force Foundation.
Heaphy, B., Yip, A.K.T. and Thompson, D. (2004). Ageing in a non-heterosexual context. Ageing and Society, 24, 881-902.
Hiyasaki, E. (2007). For Gays, A Generation Gap Grows, L.A. TIMES, May 18, 2007. Retrieved on January 22, 2011 from http://articles.latimes.com/2007/may/18/nation/na-gays18.
Hostetler, A. J. (2004). Old, Gay, and Alone? The Ecology of Well-Being Among Middle-Aged and Older Single Gay Men. In G. Herdt and B. de Vries – Eds., Gay and Lesbian Aging: Research and Future Directions. New York: Springer.
Kertzner, R.M. (2006). Beyond Coming Out: Gay Men, HIV and Age. Focus, 21(10). San Francisco: UCSF AIDS Health Project.
Knauer, N.J. (2009). LGBT Elder Law: Toward Equity in Aging. Harvard Journal of Law & Gender, Vol. 32.
Krishna A. (2004). Escaping poverty and becoming poor: who gains, who loses, and why? World Development, 32, 121-136.
National Institutes of Health. (1981). Age Page: Sexuality in Later Life (DHHS publication 19a5-461-308/200007). Washington, DC: US Government Printing Office.
Noponen, H., & Kantor, P. (2004). Crises, setbacks and chronic problems: The determinants of economic stress events among poor households in India. Journal of International Development, 16, 529-545.
Price, E. (2008). Pride or prejudice? Gay men, lesbians and dementia. British Journal of Social Work, 38(7), 1137-1352.
Russel, G.M. & Bohan, J.S. (2005). The Gay Generation Gap: Communicating Across the LGBT Generational Divide. Policy Journal of the Institute for Gay and Lesbian Strategic Studies. Retrieved on A1pril 2, 2011 from http://www.iglss.org/media/files/Angles-81.pdf.
Sen, B. (2003). Drivers of escape and descent: changing household fortunes in rural Bangladesh. World Development, 31, 513-534.
Wahler, J., & Gabbay, S. G. (1997). Gay male aging: A review of the literature. Journal of Gay and Lesbian Social Services, 6(3), 1–20.
Whitford, G.S. (1997). Realities and hopes for older gay males. Journal of Gay and Lesbian Social Services, 6, 79-95.
Wooten-Bielski, K. (1999). HIV and AIDS in older adults. Geriatric Nursing, 20 (5), 268-272.

The founder of Outrage Magazine, Michael David dela Cruz Tan is a graduate of Bachelor of Arts (Communication Studies) of the University of Newcastle in New South Wales, Australia. Though he grew up in Mindanao (particularly Kidapawan and Cotabato City in Maguindanao), even attending Roman Catholic schools there, he "really, really came out in Sydney," he says, so that "I sort of know what it's like to be gay in a developing and a developed world". Mick can: photograph, do artworks with mixed media, write (DUH!), shoot flicks, community organize, facilitate, lecture, research (with pioneering studies under his belt)... this one's a multi-tasker, who is even conversant in Filipino Sign Language (FSL). Among others, Mick received the Catholic Mass Media Awards (CMMA) in 2006 for Best Investigative Journalism. Cross his path is the dare (read: It won't be boring).

#KaraniwangLGBT

Paolo, naked

Paolo Dumlao, a pansexual Filipino performance artist, uses his naked body as a canvas, believing that art can help the people – both the artist and those who see the artworks. “It makes people think, ask… and feel,” he said, all relevant because “we’re not robots; we’re humans.”

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Four years ago, Paolo Dumlao, a pansexual Filipino, did his first performance art “as mema lang (out of whim),” he said. At that time, he just wanted to “tick off something from my bucket list.” But he fell in love with the form, and so stayed with it.

Here’s the thing: In his performances, Paolo is always without clothes since he is a nude artist.

There is reason behind this, he said. “It’s not because it’s something different, or because it’s something new since it’s been done before… but because for me, the feeling (when one is nude) is very vulnerable, and I think it’s my most vulnerable form, and I want to be in that state when I perform so I can emphasize with people.”

To be clear, Paolo is not a performing artist; instead, he is a performance artist.

Performance art is different from performing arts. With the latter, “you are portraying a character that is not you. So you’re using your body as a canvas to create another character. When it comes to performance art, you yourself are the character, and the message you relay is different outside of the text,” he said. “At least that’s what I am doing.”

Paolo noted that there are people who see performances of nude artists as sexual, and he said that this is not necessarily true.

On the one hand, just because one is naked doesn’t mean the piece is sexual, as “it could be pure, it could be wholesome (even if the performer is not clothed). And I am able to show these (through my performances), and that (things aren’t) just black and white.”

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And so, it is worth stressing, “it is not pornography; I am not selling my body, I am just using my body as canvas for my art.”

Paolo said that malice needs to be removed when viewing particularly his performances – i.e. “We don’t give malice when seeing a naked child, so why give malice when seeing a naked adult?” This is particularly true when “they’re not doing anything malicious or anything sexual.”

On the other hand, Paolo said with emphasis, even if the piece is also sexual, it’s not like there’s something wrong with that. “We’re all different; sensuality is different for everyone, just as sexuality is different for everyone. You can be modest and that empowers you, and that’s fine. You could be very, very promiscuous and very sexual, and that empowers you, and that’s fine, too. As long as you’re responsible with yourself, you’re responsible when dealing with other people, and you know for a fact you’re not stepping on other people’s toes.”

Though Paolo has been inspired by various artists, his main inspiration are the people he deals with while performing. “My interaction creates an experience for me, and from that experience, I get inspired to make more art,” he said.

Paolo said he gets two reactions when he performs. For one, there are people who get “the vulnerability,” he said. And, secondly, “there are times when (people) get intimidated.” But with performance art, “your art is effective when you get a reaction, once it creates discourse.” And so for Paolo, the piece still works “even if only one person gets it.”

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There are members of his family who disapprove of what he does, though Paolo said this is largely due to security/safety issues – e.g. he could get harassed, or he could be accused of harassing and could get in trouble for this. But Paolo said that he is actually cautious when planning performances, making sure that – yes – he does so in a safe space where he won’t be harassed, and only in contexts where he won’t knowingly end up harassing people.

For those who oversimplify what he’s doing as “just getting naked”, Paolo said performing is actually very draining, not just mentally but also physically. Which is why “I look after my body,” he said, “because I use my body as my canvas and I need to take care of it. I always make sure I am ready for it; it’s strenuous.”

If there’s one lesson his performances taught him, it’s that “we share similar stories,” Paolo said. “We share similar pain, we share similar happiness or success… The levels may be different on how we deal with these, but they’re similar.”

And after his performances, if there is one thing he wants those who see him to take away from seeing him, it’s the ability to “ask questions,” Paolo said. “Never be afraid to ask questions. It’s a start of being curious, of interacting with other people. So if possible, ask all the questions you can ask. It’s a way to grow as a person.”

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Worsening #ARVshortage in the Phl?

On Jan. 9, the Philippines gained a new HIV and AIDS law that is supposed to better the lives of Filipinos living with HIV. But many in the HIV community mark this day with distress, largely because of the worsening ARV shortage.

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In September 2018, Xander (not his real name; anonymity requested), a Filipino living with HIV, claimed that he was told by the person working in the pharmacy of his hub to “consume already-expired medicines (the three-in-one tablet of Lamivudine/Tenofovir/Efavirenz)”, and that “it is “still good for three months after the expiration date.”

Since dealing with ARV-related issue is not new to him (it happened to him in the last quarter of 2013), he complained and was given newer meds. Noticeably, “those who didn’t complain – like I did – ended up using the expired meds,” he said.

Xander can only recall how he earlier lamented – again in 2013 – that the ARV shortage will happen again, particularly considering the continuing denial of the Department of Health (DOH) about this issue.

TAINTED ‘SUCCESS’

The 9th of January is supposed to be a happy day particularly for Filipinos living with HIV and their advocates. On that day, the newly-signed Republic Act 11166 or the Philippine HIV and AIDS Policy Act was released after it was signed into law by Pres. Rodrigo Roa Duterte. By replacing the 20-year-old Republic Act 8504 or the Philippine National AIDS and Control Act of 1998, this new law is supposed to boost the government’s response to HIV and AIDS by making health services for HIV and AIDS more accessible to Filipinos.

But many in the HIV community mark this day with distress, largely because of the worsening ARV shortage, which is not helped by the denial of the issue by various heads of offices – including government officials, as well as those helming treatment hubs/facilities and even select non-government organizations (NGOs).

In an unsigned statement (as if so that no one can be “chased” to be held accountable for the same statement), the DOH seemed to belittle the issue by outright claiming that there’s an ‘alleged’ shortage of ARVs; even as it also stated that they take the issue of HIV infection in the country seriously. Part of this is to take “great steps to ensure that access for HIV treatments are available for those who are diagnosed with HIV.”

The DOH statement added:
“As of October 2018, we have enrolled 32,224 persons living with HIV for treatment with ARV such as Nevirapine, Lamivudine/Tenofovir. The DOH has been providing free ARV to Filipinos living with HIV through our HIV treatment hubs.
“Based on our records, there are 3,200 registered PLHIV who are on Nevirapine and 1,791 PLHIV on Lamivudine/Tenofovir, as of December last year.

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That just about half of the total PLHIVs in the Philippines use ARVs is worth noting, even if it’s another issue altogether.

But the mention of these two meds/cocktails is important because the complaints reaching – among others – Outrage Magazine, Bahaghari Center for SOGIE Research, Education and Advocacy, Inc. (Bahaghari Center) other and HIV-related community-based organizations/non-government organizations particularly currently mention these.

In Quezon City, for instance, at least eight PLHIVs alleged that they have been given incomplete medications – i.e. they were supplied with either Lamivudine/Tenofovir or Lamivudine/Zidovudine, but they have not been receiving Nevirapine because this is not available. These people are, therefore, taking incomplete meds.

Pinoy Plus’s hotline, PRC, has received similar allegations of non-delivery of Nevirapine.

In Cavite (Imus, Bacoor and Dasmariñas), at least three clients surfaced to allege about the same issue. PLHIVs are now “borrowing” each others’ Nevirapine supply just so they don’t miss their required dosage because their hub does not have supplies from the DOH.

There are similar allegations in Cagayan de Oro City, Davao City and Zamboanga City.

And in Alabang, the pharmacy of a treatment hub even posted on January 8, 2019 an announcement that “due to the shortage and delay of the deliveries at DOH, only one bottle will be dispensed of the following medicines: Nevirapine (200mg tablet); Lamivudine (150mg)/Zidovudine (300mg tablet); and Lamivudine (300mg)/Tenofovir (300mg tablet).” The same hub is telling its clients to “wait for further announcement on stock availability.”

Note that the RITM-AIDS Research Group’s pharmacy is putting the blame on the DOH.

DOH’s CLAIM

The same DOH statement stressed that “the latest data, as of January 4, confirms that Nevirapine has already been delivered to the 16 treatment hubs to meet the requirements for February-April 2019. For Lamivudine/Tenofovir, a month’s supply has also been delivered to Regions X, VI and I. The rest of the regions will expect deliveries within this week.”

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Noticeably, the DOH statement responds to issues only this January, even if this concern has been circulating in the PLHIV community since 2018, and only peaked now.

There are fewer ARV refills now. If, in the past, the usual practice is for hubs to give PLHIVs three bottles of ARV to last them for three months, a growing number are now complaining about the supply being cut to one month in numerous hubs – e.g. there’s that post in RITM’s pharmacy. Some allege that they are even supplied ARVs just for a week or even just for three days.

Due to the ARV shortage that the DOH is not outright confronting, expired medicines are allegedly being given to PLHIVs – as in the case of Xander.

Also due to the ARV shortage, the medication of a number of PLHIVs are allegedly being changed not because it’s medically sound, but because their usual medicines are not readily available. In Mandaluyong City, there are PLHIVs who claimed to have been told to use Lamivudine/Tenofovir/Efavirenz because it’s the only available ARV. If they refuse to do so, then they will have to stop taking their usual medications until such time when the delivery of supplies are normalized again.

To allow the DOH to respond to these claims, Outrage Magazine repeatedly reached out to the government body. Upon calling the media relations unit (at +63 2 651-7800 loc. 1126), we were turned over to the office of Dr. Gerard Belimac (+63 2 651-7800 locs. 2355, 2352, 2354). Five attempts were made to speak with Belimac or any other authority in his office, but he has been unavailable at those five times; and even after leaving requests for a statement from him on the ARV shortage, as of press time, the publication has not heard back.

As this is a continuing story, coordination will continue to – eventually hopefully – extensively hear from the DOH on this issue.

WHAT NOW?

The DOH statement also stated that it is “working closely with our suppliers to ensure that there are no gaps in our supply chain. In fact, we are waiting for deliveries of an additional 12,375 bottles of Nevirapine good for another three months and 7,024 bottles of Lamivudine/Tenofovir good for another two months.”

READ:  Research finds ‘LGBT community financially sound but concerned’

The DOH also claimed that it is continuing to explore “for more partners in providing excellent support for Filipinos living with HIV-AIDS and in ending the deadly disease.”

As if wanting to pacify the complaining PLHIVs, the DOH statement transferred to responsibility to “HIV doctors to explore possible options”, or visit Facebook page (PLHIV Response Center) or email dohnaspcphiv@gmail.com. Note the use of a gmail account for a body with millions in budget.

No investigations on where the errors in the supply chain is happening so that these can be fixed is forthcoming. No one being held accountable here.

THE NEED TO GO BEYOND LIP SERVICE

Incidentally, Article V, Sec. 33 of the newly signed HIV law states: “The DOH shall establish a program that will provide free and accessible ART and medication for opportunistic infections to all PLHIVs who are enrolled in the program… A manual of procedures for management of PLHIV shall be developed by the DOH.”

The IRR is not even there yet, but this mandate to provide life-saving meds is now already cast in doubt.

Xander – who only had a refill of his ARVs – said that many like him who posted about this issue online were told to stop doing so “because we are supposedly creating panic among PLHIVs.”

He now says that people who cover up this issue are “as worse as those paid to work on this issue. Because if you go to the HIV community, we’ve long lived with worrying that our meds may not be given us at any moment. If some people think complaining about this is wrong, then they shouldn’t be in HIV advocacy, but work as PR people of those failing to do their jobs.”

In the end, “this needs to be resolved fast. Enough with discussing semantics on what we’re having is a shortage or a stockout; the fact remains that there are PLHIVs not getting their supplies. Lives are at stake. So supply the ARVs; now.”

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PSA tackles in Filipino Sign Language what happens after rapid HIV test

What happens after you get tested for HIV? Particularly to “help simplify the HIV discussion for the Deaf community in the Philippines,” a public service announcement was released on getting tested for HIV in the Philippines, and what happens after one gets tested.

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One of the biggest confusions re HIV testing in the Philippines is answering the question on “what happens after one gets tested for HIV,” said Disney Aguila, board member of Bahaghari Center for SOGIE Research, Education and Advocacy, Inc. (Bahaghari Center) and concurrent president of Pinoy Deaf Rainbow (PDR).

The confusion is not helped by numerous factors – e.g.: various testing facilities are, in a way, “autonomous”, so there are varying practices; and information about post-testing remains limited.

No matter the reason/s for the confusion, “the effect is the same: it discourages many people from getting HIV testing and/or screening,” Aguila said.

To demystify particularly rapid HIV screening to “help simplify the HIV discussion for the Deaf community in the Philippines,” a public service announcement (PSA) was released on getting tested for HIV in the Philippines, and what happens after one gets tested.

The PSA is the third in a series of PSAs produced as part of a Bahaghari Center project backed by a collaboration between Youth LEAD and Y-PEER (Asia Pacific Center), which eyed to address Sexual Reproductive Health and Rights (SRHR) needs of Young Key Populations (YKPs) in Asia and the Pacific.

PSA on HIV basics released in Filipino Sign Language

Particularly pertaining rapid HIV test, “we want to educate particularly Deaf Filipinos about post-testing – that, if you are non-reactive, there are steps you can do to stay non-reactive; and if you’re positive, help is available to help you access treatment, care and support (including getting antiretroviral medicines) so you can live a long, healthy life.”

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PSA on getting tested for HIV released in Filipino Sign Language

Aguila stressed that knowing one’s HIV status is important to protect oneself and others around him/her.

If one is HIV-positive, then he/she can start taking antiretroviral medicine (ARV) that will prevent the HIV (virus) from replicating and thereby help him/her stay healthy and live longer/normal lives.

And if one is HIV-negative, then he/she can take steps to stay negative (for example, by practicing safer sexual practices).

“It starts with getting oneself tested,” Aguila said, “which is why we encourage people to get tested.”

Most hospitals and clinics can give HIV testing.

Social hygiene clinics (SHC) located in select barangays can also give HIV testing and/or HIV screening.

Various non-government organizations also offer HIV testing and/or screening.

There are also people who are certified to give rapid HIV test.

A series of community-based HIV testing trainings are given to select members of the Deaf community in Metro Manila/Luzon, Visayas and Mindanao is to “empower members of the Deaf community to be more proactive in dealing with HIV by allowing the Deaf to help the Deaf.” These trainings are provided by The Red Ribbon Project, Inc.

Other supporters of the project include: Outrage Magazine, Fringe Publishing, Pinoy Deaf Rainbow, TransDeaf Philippines, Deaf Dykes United and Pinoy Deaf Queer.

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PSA on getting tested for HIV released in Filipino Sign Language

To demystify particularly rapid HIV testing/screening to “help simplify the HIV discussion for the Deaf community in the Philippines,” a public service announcement (PSA) was released on the getting tested for HIV in the Philippines.

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Getting tested for HIV is – as it is – already challenging for Hearing people, but “it can be argued that this is doubly difficult for Deaf people,” said Disney Aguila, board member of Bahaghari Center for SOGIE Research, Education and Advocacy, Inc. (Bahaghari Center) and concurrent president of Pinoy Deaf Rainbow (PDR). This is because “aside from dealing with the ‘usual’ issues related to getting tested for HIV that are encountered by Hearing people (including dealing with stigma and discrimination), we also have to contend with language barrier.”

Eyeing to demystify particularly rapid HIV testing/screening to “help simplify the HIV discussion for the Deaf community in the Philippines,” a public service announcement (PSA) was released on the getting tested for HIV in the Philippines.

The PSA is actually one in three PSAs produced as part of a Bahaghari Center project backed by a collaboration between Youth LEAD and Y-PEER (Asia Pacific Center), which eyed to address Sexual Reproductive Health and Rights (SRHR) needs of Young Key Populations (YKPs) in Asia and the Pacific.

PSA on HIV basics released in Filipino Sign Language

Particularly pertaining rapid HIV test, “we want to educate people that all it takes is a prick, and a person can already find out his/her HIV status… in less than 20 minutes,” Aguila said.

Knowing one’s HIV status is important, Aguila added, as a means to: protect oneself and others around him/her.

If one is HIV-positive, then he/she can start taking antiretroviral medicine (ARV) that will prevent the HIV (virus) from replicating and thereby help him/her stay healthy and live longer/normal lives.

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And if one is HIV-negative, then he/she can take steps to stay negative (for example, by practicing safer sexual practices).

“But it all starts with getting oneself tested,” Aguila said, “which is why we encourage people to get tested.”

If these are more accessible, most hospitals and clinics can give HIV testing.

Social hygiene clinics (SHC) located in select barangays can also give HIV testing and/or HIV screening.

Various non-government organizations also offer HIV testing and/or screening.

There are also people who are certified to give rapid HIV test.

A series of community-based HIV testing trainings are given to select members of the Deaf community in Metro Manila/Luzon, Visayas and Mindanao is to “empower members of the Deaf community to be more proactive in dealing with HIV by allowing the Deaf to help the Deaf.” These trainings are provided by The Red Ribbon Project, Inc.

Other supporters of the project include: Outrage Magazine, Fringe Publishing, Pinoy Deaf Rainbow, TransDeaf Philippines, Deaf Dykes United and Pinoy Deaf Queer.

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PSA on HIV basics released in Filipino Sign Language

HIV 101 in Filipino Sign Language (FSL).

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To “help simplify the HIV discussion for the Deaf community in the Philippines,” a public service announcement (PSA) was released on the “HIV basics,” according to Disney Aguila, board member of Bahaghari Center for SOGIE Research, Education and Advocacy, Inc. (Bahaghari Center) and concurrent president of Pinoy Deaf Rainbow (PDR).

The PSA is actually one in three PSAs, all of them forming part of a Bahaghari Center project backed by a collaboration between Youth LEAD and Y-PEER (Asia Pacific Center), which eyed to address Sexual Reproductive Health and Rights (SRHR)needs of Young Key Populations (YKPs) In Asia and the Pacific.

There will also be accompanying trainings for Deaf community members to know about rapid HIV testing, so that “Deaf Filipinos can start HIV testing among themselves.”

Aguila said that often, when discussing SHRH, differently-abled people – such as the members of the Deaf community – are often not included in discussions. “And so even if we’re just as affected by this global social issue, solutions to deal with them often remain hard to reach for us,” she said. From this perspective, “efforts that empower our community members are good should be done; and they should be done fast.”

IN THE PHILIPPINES

In 2012, Michael David C. Tan – publishing editor of Outrage Magazine, the only LGBTQI publication in the Philippines, and head of Bahaghari Center – conducted “Talk to the Hand”, the first-of-its-kind study that looked at the knowledge, attitudes and related practices of Deaf LGBT Filipinos on HIV and AIDS. The study had numerous disturbing findings.

To start, majority of the respondents (33 or 54.1%) were within the 19-24 age range at the time of the study, followed by those who are over 25 (21 or 34.3%).

Most of them (53 of 61 Deaf respondents) had sex before they reached 18, the legal age of consent in the Philippines. Many (36.1%) of them also had numerous sexual partners, with some respondents having as many as 20 sex partners in a month.

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Only 21 (34.4%) use condoms, and – worryingly – even among those who used condoms, 12 (19.7%) had condom breakage during sex because of improper use.

Perhaps the unsafe sexual practice should not be surprising, considering that not even half (29, 47.5%) of the respondents heard of HIV and AIDS, with even less that number (23, 37.7%) knowing someone who died of HIV or AIDS-related complications. And with not even half of the total respondents (29) familiar with HIV and AIDS, not surprisingly, only 19 (31.1%) consider HIV and AIDS as serious, with more of them considering HIV and AIDS as not serious (20, 32.8%) or maybe serious (22, 36.1%).

The study also noted that the level of general knowledge about HIV and AIDS is low, with 40 (65.6%) of them falling in this category. Only about 1/5 of them (12, 19.7%) had high level of knowledge about HIV and AIDS. Even fewer (9, 14.8%) may be classified as having moderate knowledge level.

But this issue is not limited ONLY to the LGBTQIA members of the Deaf community. This issue also affects the SRHR of the Deaf community, as a whole.

For the World Health Organization (WHO), health is a “state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” Specific to reproductive health, WHO stresses that it “implies that people are able to have a responsible, satisfying and safer sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so.”

It is nonetheless unfortunate that various studies – including Tan’s – highlight how the Deaf community continues to be left behind because they are not able to access safe, effective, affordable and acceptable methods of fertility regulation/s of their choice.

READ:  Research finds ‘LGBT community financially sound but concerned’

For instance, a study carried out by Deafax (EARS Campaign, 2012) revealed “higher than average levels of STIs, pregnancy and inappropriate behavior within the Deaf community.” This study specifically showed that: 35% of Deaf people did not receive any sex education at school; 65% said that sex education was inaccessible; and 36% learned through direct sexual experience.”

Dealing with SRHR vis-à-vis HIV is obviously just as tricky in the Philippines.

From January 1984 to July 2018, sexual contact among men who have sex with men (MSM) was the predominant (84%, 44,929) mode of transmission among males. Just as that moniker suggests, many of these MSM are not necessarily gay/homosexual, but also engage in sex with opposite sex partners.

This is connected to the population of those most vulnerable to risks associated with sexual activity getting younger, including HIV. But while this has been noted in the Hearing population, the Deaf community is largely ignored, with no existing data on HIV prevalence among them.

In fact, also from January 1984 to July 2018, 16,074 (28%) of the reported cases were 15-24 years old; and broken down, 1,813 were infected through male-female sex, 9,031 from male-male sex, and 4,662 from sex with both males and females.

This means that so long as the HIV infection rate among MSM increases, so do the risk for infection among women.

As it is, the number of diagnosed HIV infections among females in the Philippines has already increased. Females diagnosed with HIV from January to July 2018 (362) was almost three times the number of diagnosed cases compared to the same period of 2013 (126). Ninety-three percent (3,426) of all female cases were in the reproductive age group (15-49 years old) at the time of diagnosis.

With the dearth – if not complete absence – of information for the Deaf community in the Philippines about HIV, Deaf Filipinos (irrespective of their SOGIE) continue not to be informed of and have access to safe, effective, affordable and acceptable methods of birth control; as well as appropriate health care services of sexual, reproductive medicine and implementation of health education program.

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To highlight, as the case is in the Philippines: Even with glaring worrying data, there continue to be no specific program to give the Deaf population access to HIV-related efforts in the Philippines.

The law, for instance, mandates that people who get tested should receive counselling; and yet not one HIV counsellor knows of Filipino Sign Language (FSL).

And for Deaf Filipinos who were able to get tested for HIV and tested HIV-positive, accessing medical services is also problematic because of the lack of interpreters, particularly those familiar with HIV and those who can actually provide HIV testing.

INCLUDING THE DEAF IN THE CONVERSATION

The PSA discusses HIV basics – from what HIV is, how one may get infected with it, and misconceptions surrounding HIV.

A second PSA will be subsequently released, tackling HIV testing (particularly rapid HIV test); while a third PSA will discuss what happens after people get tested for HIV in the Philippine context.

Also, “because any PSA can only do so much to actually make people get themselves tested for HIV,” Aguila said, a series of trainings will be given to select members of the Deaf community in Metro Manila/Luzon, Visayas and Mindanao. This is to “empower members of the Deaf community to be more proactive in dealing with HIV by allowing the Deaf to help the Deaf.”

These trainings will be provided by The Red Ribbon Project, Inc.

Other supporters of the project include: Outrage Magazine, Fringe Publishing, Pinoy Deaf Rainbow, TransDeaf Philippines, Deaf Dykes United and Pinoy Deaf Queer.

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Relevance of public & private sectors’ support highlighted in Quezon City’s 2018 Pride parade

Highlighting the importance of the participation of all stakeholders, not just the LGBTQIA community but also including the public and the private sectors, Quezon City in Metro Manila held one of the last Pride parades in the Philippines for 2018.

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Highlighting the importance of the participation of all stakeholders, not just the LGBTQIA community but also including the public (including government) and the private sectors, Quezon City in Metro Manila held one of the last Pride parades in the Philippines for 2018.

Hanz Defensor, who helms Quezon City Pride Council (QCPC), the organizer of the annual gathering, told Outrage Magazine in an exclusive interview that Quezon City is “quite fortunate” that it now has an anti-discrimination ordinance (ADO) that protects LGBTQIA people from discrimination.

Signed by mayor Herbert Bautista (whose term ends in May 2019), City Ordinance 2357-2014, otherwise known as The Quezon City Gender-Fair Ordinance, eyes to “to actively work for the elimination of all forms of discrimination that violate the equal protection clause of the Bill of Rights enshrined in the Constitution, existing laws, and The Yogyakarta Principles; and to value the dignity of every person, guarantee full respect for human rights and give the highest priority to measures that protect and enhance the right of all people; regardless of sexual orientation, gender identity and expression (SOGIE).”

But Defensor said that, “admittedly, kulang pa rin (this is still lacking).” This is because – even if they already have the ADO and its implementing rules and regulations (IRR), the actual implementation continues to be challenging.

Quezon City, Defensor noted as an example, has “a lot of business establishments, and while they know that discriminating against LGBTQIA people in the city is prohibited by law, not all of them actually have a copy of the ADO and the IRR to know the small details.”

READ:  Research finds ‘LGBT community financially sound but concerned’

As he encouraged particularly those affected by the ADO to “download (the same) from Quezon City’s official website”, he is also encouraging other local government units to already take steps to also protect their LGBTQIA constituents, perhaps learning from Quezon City’s example.

The same sentiment was expressed in a letter sent to QCPC by Pres. Rodrigo Duterte, who remarked that Quezon City’s ADO – which also mandates the annual holding of the Pride parade – “has become a source of inspiration for advocates of gay rights in the Philippines and the rest of the world” because “it has institutionalized the city’s progressive and inclusive policy that eliminates discrimination on the basis of SOGIE.”

Though criticized for pinkwashing, Duterte still expressed hope that Pride further strengthens “the solidarity of (the) community so you may inspire the entire nation with the diversity and dynamism of your talents and skills.”

To contextualize, past administrations did not openly support Pride-related events.

Also, even if Akbayan partylist – which is aligned with Liberal Party that helmed the country under Pres. Benigno Aquino III prior to Duterte’s term – has been sponsoring the anti-discrimination bill for almost 20 years now, it still fails to gain traction, including during Aquino’s administration when it was largely ignored.

As an FYI, Quezon City actually hosted the largely accepted first Pride March in Asia.

On June 26, 1994, ProGay Philippines and Metropolitan Community Church helmed a march in Quezon City. Dubbed as “Stonewall Manila” or as “Pride Revolution”, it was held in remembrance of the Stonewall Inn Riots and coincided with a bigger march against the imposition of the Value Added Tax (VAT).

READ:  San Juan hosts 2nd Pride parade to stress city’s support for ‘equality in diversity’

Defensor stressed the need to be pro-active when confronting LGBTQIA-related discrimination. While the ADO is there, he said that should LGBTQIA people from Quezon City experience discrimination, “seek help” and know that “QCPC is here, and the LGU will back you.”

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