HIV best practices and how the PH is playing catch-up | ABS-CBN
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HIV best practices and how the PH is playing catch-up
A guest wears a red ribbon pin, the global symbol for solidarity with HIV-positive people and those living with AIDS, as he attends the handover of human immunodeficiency virus (HIV) testers donated by the US government through USAID to the Philippines on December 1, 2022, in Sampaloc, Manila, in commemoration of World AIDS Day. Jonathan Cellona, ABS-CBN News/file
A guest wears a red ribbon pin, the global symbol for solidarity with HIV-positive people and those living with AIDS, as he attends the handover of human immunodeficiency virus (HIV) testers donated by the US government through USAID to the Philippines on December 1, 2022, in Sampaloc, Manila, in commemoration of World AIDS Day. Jonathan Cellona, ABS-CBN News/file MANILA — The Human Immunodeficiency Virus has affected many countries around the world.
MANILA — The Human Immunodeficiency Virus has affected many countries around the world.
In the Philippines, the first recorded case of HIV infection happened in 1984. Since then, the virus has continued to spread and after over three decades, confirmed HIV infections have reached over 150,000.
In the Philippines, the first recorded case of HIV infection happened in 1984. Since then, the virus has continued to spread and after over three decades, confirmed HIV infections have reached over 150,000.
The rise in infections, over 500% in the last 14 years, has once again prompted discussion on measures the country is taking and how it has seemingly fallen short in curbing further transmission.
The rise in infections, over 500% in the last 14 years, has once again prompted discussion on measures the country is taking and how it has seemingly fallen short in curbing further transmission.
But the Philippine National Aids Council (PNAC) notes that challenges in addressing infection are also because of the change in the epidemic’s image.
But the Philippine National Aids Council (PNAC) notes that challenges in addressing infection are also because of the change in the epidemic’s image.
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“Dati, kung maalala mo, karamihan sa mga pasyente natin kasi ay mga prostituted women,” he said.
“Dati, kung maalala mo, karamihan sa mga pasyente natin kasi ay mga prostituted women,” he said.
(Before, if you would remember, majority of our cases were prostituted women.)
(Before, if you would remember, majority of our cases were prostituted women.)
“Pero pagdating nitong late 2000, nag-iba eh. Mas marami ngayon, o yung tinatawag na driver ng epidemic, yung mga males having sex with males. Sumabay pa yung nagkulang kaalaman, tapos sumabay pa yung teknolohiya na kung saan mabilis ka makakakuha ng mga sexual partners, yung mga hook-up application.”
“Pero pagdating nitong late 2000, nag-iba eh. Mas marami ngayon, o yung tinatawag na driver ng epidemic, yung mga males having sex with males. Sumabay pa yung nagkulang kaalaman, tapos sumabay pa yung teknolohiya na kung saan mabilis ka makakakuha ng mga sexual partners, yung mga hook-up application.”
(But in the late 2000s, this changed. One of the drivers of the epidemic became males-having-sex-with-males. This was coupled with the lack of adequate knowledge then eventually, technology where it became easy to find sexual partners. Hook-up applications.)
(But in the late 2000s, this changed. One of the drivers of the epidemic became males-having-sex-with-males. This was coupled with the lack of adequate knowledge then eventually, technology where it became easy to find sexual partners. Hook-up applications.)
Nevertheless, measures are in place to control the spread of HIV.
Nevertheless, measures are in place to control the spread of HIV.
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Most of these measures are not new. But PNAC admits they were implemented well by some some governments which resulted in better management.
Most of these measures are not new. But PNAC admits they were implemented well by some some governments which resulted in better management.
Best Practices
Thailand is also among the countries in Southeast Asia facing a significant HIV epidemic. In 2021, some 520,000 people in the country were living with HIV, according to the United Nations Program on HIV/AIDS (UNAIDS).
Thailand is also among the countries in Southeast Asia facing a significant HIV epidemic. In 2021, some 520,000 people in the country were living with HIV, according to the United Nations Program on HIV/AIDS (UNAIDS).
Feliciano said that country intensified its information campaign which involved all sectors of society. This was coupled with easy public access to condoms.
Feliciano said that country intensified its information campaign which involved all sectors of society. This was coupled with easy public access to condoms.
“Lahat ng mga red district areas nila. Sa mga bars, sa mga sauna, for free, nagkalat ng condom.”
“Lahat ng mga red district areas nila. Sa mga bars, sa mga sauna, for free, nagkalat ng condom.”
(All of their red districts, bars, sauna, condoms were given for free.)
(All of their red districts, bars, sauna, condoms were given for free.)
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Access to and the use of condoms is a heavily debated topic in the Philippines, with conservatives resistant to the promotion of contraception.
Access to and the use of condoms is a heavily debated topic in the Philippines, with conservatives resistant to the promotion of contraception.
However, Feliciano says the approach can be different in a way that condoms are not distributed but are only accessible to the public.
However, Feliciano says the approach can be different in a way that condoms are not distributed but are only accessible to the public.
“Kung alam nila ang tamang informasyon tungkol sa HIV, meron silang choice o option na protesyonan yung sarili nila by using condom.”
“Kung alam nila ang tamang informasyon tungkol sa HIV, meron silang choice o option na protesyonan yung sarili nila by using condom.”
(If they have the right information about HIV, they will have the option and can make a choice to protect themselves by using a condom.)
(If they have the right information about HIV, they will have the option and can make a choice to protect themselves by using a condom.)
Another best practice widely used in the Europe and the United States is pre-exposure prophylaxis (PreP), an HIV medicine taken by those who do not have the virus. PreP is able to reduce the risk of getting infected by over 90 percent.
Another best practice widely used in the Europe and the United States is pre-exposure prophylaxis (PreP), an HIV medicine taken by those who do not have the virus. PreP is able to reduce the risk of getting infected by over 90 percent.
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PreP, though offered by certain civil society organizations, has to yet to become widely available in the Philippines.
PreP, though offered by certain civil society organizations, has to yet to become widely available in the Philippines.
Perhaps the one of the most effective ways to improve public reception, understanding and action on HIV were actions done by India and Indonesia — peer-to-peer information and education campaigns. This entailed individuals belonging to key populations leading discussions about HIV and, more importantly, encouraged testing.
Perhaps the one of the most effective ways to improve public reception, understanding and action on HIV were actions done by India and Indonesia — peer-to-peer information and education campaigns. This entailed individuals belonging to key populations leading discussions about HIV and, more importantly, encouraged testing.
“For example a man-having-sex-with-another-man will go to communities with health workers or CSOs and talk to other MSMs.”
“For example a man-having-sex-with-another-man will go to communities with health workers or CSOs and talk to other MSMs.”
Most important step
What the public must realize is that all it takes for better management of HIV in any country is taking that first, but very important step, getting tested. This is widely available in the Philippines.
What the public must realize is that all it takes for better management of HIV in any country is taking that first, but very important step, getting tested. This is widely available in the Philippines.
The Department of Health estimates the number of people living with HIV (PLHIV) to be at more than 250,000. Of this figure, only 139,610 have been diagnosed.
The Department of Health estimates the number of people living with HIV (PLHIV) to be at more than 250,000. Of this figure, only 139,610 have been diagnosed.
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This figure further declines when you look at the number of diagnosed on antiretroviral treatment.
This figure further declines when you look at the number of diagnosed on antiretroviral treatment.
This is why a common call to action by government and by CSOs is to get tested as it will lead to the next essential step in HIV management, treatment, eventually protecting not only a diagnosed individual but also their partner.
This is why a common call to action by government and by CSOs is to get tested as it will lead to the next essential step in HIV management, treatment, eventually protecting not only a diagnosed individual but also their partner.
However, one of the biggest road blocks to testing, according to Johann De Leon, HIV counselor of HIV and AIDS Support House, is the stigma which he said “drives silence and epidemics.”
However, one of the biggest road blocks to testing, according to Johann De Leon, HIV counselor of HIV and AIDS Support House, is the stigma which he said “drives silence and epidemics.”
“We should approach this with both clarity and compassion, not fear. The declaration of a public health emergency isn't about panicking, even though the fear is valid. It's more about prioritizing,” De Leon said.
“We should approach this with both clarity and compassion, not fear. The declaration of a public health emergency isn't about panicking, even though the fear is valid. It's more about prioritizing,” De Leon said.
“People need to know that HIV affects families, workplaces, classrooms, and communities all across the country. And so the response must also be just as wide, from health, education, labor, youth, and even the private sector, as much as they can.”
“People need to know that HIV affects families, workplaces, classrooms, and communities all across the country. And so the response must also be just as wide, from health, education, labor, youth, and even the private sector, as much as they can.”
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Like many other PLHIVs and organizations, De Leon also sees the need to properly integrate comprehensive sexuality education in systems to ensure that younger population groups, which account for large proportion of new infections will be fully informed of how to reduce risky behavior and make better, informed choices.
Like many other PLHIVs and organizations, De Leon also sees the need to properly integrate comprehensive sexuality education in systems to ensure that younger population groups, which account for large proportion of new infections will be fully informed of how to reduce risky behavior and make better, informed choices.
If the current rate of infection is not curbed, health authorities project figures to go up to 250,000 by the end of the year and even double to 500,000 by 2030.
If the current rate of infection is not curbed, health authorities project figures to go up to 250,000 by the end of the year and even double to 500,000 by 2030.
DOH says it has already drafted a document which lays down what needs to be done by all government agencies, private entities and civil society organization should the declaration of a national public health emergency be made.
DOH says it has already drafted a document which lays down what needs to be done by all government agencies, private entities and civil society organization should the declaration of a national public health emergency be made.
But Feliciano says the public need not wait for any declaration to be made. It is clear that current HIV figures are more than enough to say that a problem exists, therefore everyone must act fast.
But Feliciano says the public need not wait for any declaration to be made. It is clear that current HIV figures are more than enough to say that a problem exists, therefore everyone must act fast.
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