William, who grew up in Davao City, was only 18 when he went to Metro Manila to study in one of the country’s most prestigious schools. His parents wanted him to be a lawyer. He was an outstanding student during his first year. But after meeting some friends, everything changed.
His friends brought William to a pub one evening. There, the young man was introduced to a beautiful guest relation officer. And the rest, as they say, is history. Since then, William was picking up girls here and there.
Lately, however, he started suffering from a chronic cough that lasted for more than a month. He also experienced itching in several parts of his body, aside from having swollen lymph. William decided to see a doctor and told him his problem. After hearing his woes, the doctor asked William about his sexual lifestyle.
Quite surprised at the question, the young man told his story just the same. After conducting several blood tests on William, he was asked to return a week later.
“I am sorry to tell you this William,” the doctor told him when he returned, “but you are positive of HIV.”
The doctor is referring to human immunodeficiency virus, an infectious particle that is too small to be seen with the naked eye or even a conventional light microscope. Bacteria are 1/1000 of a millimeter and can be seen with a light microscope. But with its HIV, it is 1/10000 of a millimeter in diameter and can only be seen with an electron microscope.
The first case of HIV infection in the Philippines was reported in January 1984. In July 2000, three agencies – the Health Action Information Network (HAIN), the National Economic and Development Authority (NEDA) and the United Nations Development Program (UNDP) – came up with a publication entitled, “A Matter of Time: HIV/AIDS Development in the Philippines.”
According to the book, with only 13,000 infected Filipinos, the status of HIV/AIDS in the country was described as “low and slow.” Most of these infected, at that time, believed that AIDS is a foreigners’ disease. “It’s not a Filipino disease,” one of those infected said. “I thought that since I had no foreign partners, just Filipinos, it’s impossible for me to get infected.”
Filipinos in the far-flung areas likewise believed HIV/AIDS was common only in Metro Manila, where most foreigners are living. “They said there’s no AIDS here in Davao, only in Manila,” commented a teenager who’s HIV-positive.
In 2015, Davao City was listed by the Department of Health (DOH) as one of five cities outside of Metro Manila with “high prevalence” of HIV/AIDS. The other four were the cities of Angeles, Bacolod, Cagayan de Oro and Zamboanga.
Sixteen cities and municipalities in National Capital Region were listed as “high risk areas.” Also included were Bulacan (particularly San Jose Del Monte), Antipolo, Cainta, Bacoor, Imus, Dasmariñas and Laguna (specifically Santa Rosa).
From “low and slow,” there is now “a full-blown AIDS crisis” in the country, as seen in the growing statistics. A report released by the DOH’s Epidemiology Bureau in January this year said that 27 Filipinos are infected with HIV each day. This is a big leap from one new case of HIV infection per day in 2008.
“This is actually a continuation of the ongoing upward trend in the number of Filipinos getting infected with the HIV,” wrote Outragemag.com. “On a daily basis, the number of Filipinos infected has increased to: four in 2010, nine in 2014, and 17 in 2014.”
More than a decade ago, some media personalities from Davao and other provinces were invited to attend an immersion on HIV/AIDS reporting in Cebu City. Part of the seminar-workshop was interviewing people who were engaged in sex industry.
The first stopover was a bar with women dancing in clad bikinis. After their performance, some of them came to talk with the invited journalists.
“My parents thought I am working in a restaurant here,” said Carol, who asked not to mention her complete name because she’s afraid they would find out. Only 18, she could be the next Myrna Castillo or Sarsi Emmanuelle.
“I didn’t finish high school,” continued Carol, who was from Agusan del Sur. “I have a two-month old daughter who’s living with my parents. I have to work since my boyfriend left me three months before I delivered the baby.”
She said that “if the price is right,” she sometimes went out with her customers. “I had to since I have to support my child. I don’t know of any work.” When asked if she used condom before sex, she replied that she wanted but most of her customers didn’t like the idea.
“I used to quarrel with some of my customers who don’t want to use condom,” Carol said. “But you can’t do anything if they don’t want to. They’d force you, you’d just be hurt.”
The following night, the journalists went to a casa, where “sex for hire” ladies were housed. One of those interviewed was Alma, a namesake of a famous starlet. She was beautiful and a good talker.
When asked why she worked in the world’s oldest profession, she answered without hesitation. “Actually, I don’t work for money although that’s a bonus,” she said. “I like my job here because I can actually try different sizes (referring to man’s sexual organ); the bigger, the better.
“I also select my partner,” she continued. “He may not be that handsome but he should be cleaned and doesn’t smell bad.” On condom, she said, “I usually recommend but if my partner is handsome, it’s okay if he won’t use.”
On their last day, the journalists visited a house where homosexual boys were living. “We try to suggest to our customers to use condom, but there are those who won’t,” said Rafael, the oldest among the group who is already 25 years old.
Condom is cited as one of those that can help curb the spread of HIV/AIDS. But many Filipinos don’t like using condoms when doing sex. There are those who think that condoms are not necessary.
A study conducted by the health department showed that 37.82% of Filipinos don’t use condoms because they “are unavailable.” About 26.39% said they “don’t like condoms” while 20.15% commented “condoms are unnecessary.”
Other reasons included: “their partner objected” (8.07%), “forgot to use condom” (2.92%), “don’t know how to use condom (1.7%) and “condoms are expensive” (1.18%).
Meanwhile, the AIDS Institute suggests that you use correct condom and do it consistently. “Latex condoms are highly effective at preventing transmission of HIV and some other sexually transmitted diseases,” it explains.
The Mayo Clinic adds this information: “Use only water-based lubricants. Oil-based lubricants can weaken condoms and cause them to break. During oral sex, use a non-lubricated, cut-open condom or a dental dam – a piece of medical-grade latex.”
Carlos H. Conde, of the Human Right Watch, commented: “Raising awareness is a key part of tackling the Philippines HIV epidemic, now the fastest-growing in the world. But by omitting HIV prevention measures for men-who-have-sex-with-men (MSMs) and the people who inject drugs (PWIDs), the AIDS Hour is the government’s latest missed opportunity to educate and assist people at highest risk of contracting the virus.”
In Davao City, most of the HIV cases come from MSMs, according to Alma Mondragon, the Mindanao executive director of Alliance Against AIDS in Mindanao. The latest AIDS update from the health department said that 89% of HIV cases were transmitted through sexual contact among MSMs.
Conde reported that HIV epidemic among PWIDs is concentrated in Cebu City. Quoting a report from the Philippine National AIDS Council’s report, he said that “a staggering 52% of people who inject drugs were infected with HIV” in 2013, up from 0.4% in 2007.
Iris Gonzales, in a blog, New Internationalist, wrote: “Dr. Joven Cuanang, neurologist and chair of a private hospital in the Philippines, said that because of the growing incidence of HIV in the Philippines, the medical community feels the urgent need to raise the public’s awareness of the issue, adding that ‘It’s already an epidemic.’”
HIV is a stage where there are no physical symptoms visible. In AIDS, the disease is manifested with malignancies and infections. “Between HIV and AIDS, there is a window period of as much as five years,” said Dr. Jordana P. Ramiterre, chief of the Reproductive Health and Wellness Center of the Davao City Health Office.
AIDS is caused by a deficiency in the body’s immune system. “It is a syndrome because there are a range of different symptoms which are not always found in each case,” explains Dr. John Hubley, author of The AIDS Handbook. “It is acquired because AIDS is an infectious disease caused by a virus which is spread from person to person through a variety of routes. This makes it different from immune deficiency from other causes such as treatment with anti-cancer drugs or immune system suppressing drugs given to persons receiving transplant operations.”
The origin of HIV and AIDS is still a mystery until now. There have been many theories but none so far have been proven. During the early stages of the AIDS epidemic, the flimsiest evidence was used to blame AIDS on certain groups, countries, or animals. Kenneth Kaunda, former president of Zambia, urged: “It is not important to know where it came from but rather where it is going!”
HIV is present in all body fluids of an infected person but is concentrated in blood, semen and vaginal fluids. Virtually, it is present in all body tissues and organs including the brain and spinal cord. It can be found in tears, saliva and breast milk although these last three are not considered significant routes of infection.
“A single sexual encounter can be sufficient to transmit HIV,” Dr. Hubley wrote. “Although the risk from an individual sexual act may be low, the more times a person has sex, the greater the likelihood that transmission will take place. Women appear to be more at risk than men from heterosexual sex. The transmission of HIV from man to woman is believed to take place more easily than from woman to man.”
“The great majority of reason how it is acquired however is really through unprotected sex and drug use,” Dr. Ramiterre pointed out. “We again say that it is not who you are but what you do which poses you the risk of having AIDS.”
Dr. Willie T. Ong, an internist-cardiologist and author of several health books, said there are four stages of HIV/AIDS. In Stage 1, known as primary infection, the person experiences “flu-like” symptoms and will test positive for HIV. In Stage 2 (called asymptomatic illness), the person is HIV-positive and yet doesn’t have any symptoms of the disease (last around 3-10 years).
As the immune system weakens because of HIV, the person now develops symptoms such as fever, fatigue, night sweats and weight loss. This is Stage 3 or symptomatic illness. It goes to Stage 4 or advanced disease when “the disease takes a turn for the worse and the person develops so-called opportunistic infections from bacteria, viruses and fungi.”
The question is: how will you know that you are an HIV carrier? It can only be answered by testing for HIV. “The HIV test works by detecting antibodies produced by a person after exposure to the virus,” Dr. Ong explained. “A common problem here is when to do the HIV test. If a person has become infected with the HIV virus, how long is the lag time before the person test positive?”
According to studies, most persons will develop a positive HIV test within 2-8 weeks after exposure. “Around 97% will develop these antibodies within 3 months of exposure,” Dr. Ong said. “A few rare cases (less than 3%) will take 6 months to become positive. Because of this, experts recommend that a person gets an HIV test at 6 weeks and at 3 months after exposure. It is optional to take another test at 6 months after exposure.”
Like most diseases, HIV can be prevented – as easy as ABC: abstain from sex, be faithful to your partner, use condoms, especially if you have multiple partners, don’t share needles, and be educated on HIV, Dr. Ong reiterated.
