If there is no drastic intervention done now, the number of people infected with human immunodeficiency virus (HIV) will rise from an estimated 67,000 by the end of 2017 to 201,000 in 2025, according to the projected data of the epidemiology bureau of the Department of Health.
“The picture of the present epidemic shows that (the) majority of new infections are among males who have sex with males (MSM) and transgender women who have sex with males (TGW) aged 15 to 24 years old,” Health Secretary Jean Paulyn Ubial was quoted as saying the by “Philippine Daily Inquirer” recently.
According to the data, half of MSM and TGW start to have sex at 16 years old while some even become sexually active at a younger age of 12. “However, intervention measures can only be made available and accessible when they are 18 years old, and their first HIV test happens later at around 22 years old. This is compounded by the findings on the initiation of treatment among people diagnosed with HIV which occurs much later at 28 years old,” Ubial lamented.
This is very alarming indeed. In the past six years, the number of new HIV infections in the country has risen by 140%, according to a recent UNAIDS report. From 4,300 cases in 2010, it went up to 10,000 cases in 2016. Today, the Philippines has the fastest growing HIV epidemic in Asia and the Pacific region, it pointed out.
Last year, Filipinos were shocked to learn that there were 26 new HIV cases a day. But it was even more shocking when the health department issued a statement that for the first half of 2017, around 30 patients were diagnosed with HIV daily.
In Davao City, a total of 524 people had been diagnosed with HIV from January to June this year. From January 1984 to February 2016, the city was ranked fifth among the urban areas in the country with the most number of reported HIV cases.
This is the reason why the fight against HIV is among the top priorities of Mayor Inday Sara Duterte. “The RHWC has been established as one of the treatment hubs in the country for People Living with HIV and AIDS,” she said during her recent State of the City Address.
The mayor was referring to Reproductive Health and Wellness Center, which is handling cases of sexually-transmitted infections, including HIV and AIDS. The RHWC is one of the two HIV-AIDS treatment facilities in the city; the other one is in the Southern Philippines Medical Center.
HIV attacks the immune system, the body’s natural defense against illness. The website of Avert (www.avert.org) gives this basic information: “The virus destroys a type of white blood cell in the immune system called a T-helper cell, and makes copies of itself inside these cells. T-helper cells are also referred to as CD4 cells. As HIV destroys more CD4 cells and makes more copies of itself, it gradually breaks down a person’s immune system.”
If HIV is left untreated, it may take up to 10-15 years for the immune system to be so severely damaged it can no longer defend itself at all. “However, the speed HIV progresses will vary depending on age, health and background,” Avert points out.
HIV is spread through the exchange of body fluids like high viral load like cerebral fluid, amniotic fluid, blood, semen, cervical and vaginal secretions and breastmilk. It can be transmitted through sexual intercourse, blood and blood products, shared needles, and mother-to-child.
In the Philippines, a health department report cited sexual intercourse as the leading model of transmission of HIV. Vaginal intercourse, where the male sex organ penetrates the female sex organ, is the usual route of transmission. Anal intercourse, where the penis penetrates the anus of another person, can also be a route of transmission. Both are considered “high risk.”
“A single sexual encounter can be sufficient to transmit HIV,” wrote John Hubley, author of The AIDS Handbook. “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.”
Anal intercourse is more common among men having sex with men although it is also practiced among heterosexuals. “It is of particularly high risk for the transmission of HIV and this is because the wall of the lining of the anus is delicate and easily torn when the penis is inserted,” Hubley wrote.
Injection or infusion of contaminated blood, as occurs with blood transfusions, the sharing of needles or syringes, or an accidental prick rom an HIV-contaminated needle is another mode of HIV transmission.
Transfer of HIV is also possible from an infected mother to a child before birth, during birth, or after birth through the mother’s milk. “A few children contract HIV infection through sexual abuse,” points out The Merck Manual of Medical Information.
Being infected with HIV is no longer a death sentence these days. “There is effective antiretroviral treatment (ART) available so people with HIV can live a normal, healthy life,” Avert said. “The earlier HIV is diagnosed, the sooner treatment can start – leading to better long term health.”
A 2011 trial has confirmed that if an HIV-positive person adheres to an effective ART regimen, the risk of transmitting the virus to their uninfected sexual partner can be reduced by 96%.
However, in order to be treated, you need to know if you have HIV. And you get to know that only if you undergo HIV testing. “Testing for HIV and other sexually-transmitted infections is strongly advised for all people exposed to any of the risk factors,” the World Health Organization (WHO) said in its website. “This way people learn of their own infection status and access necessary prevention and treatment services without delay.”
However, all HIV testing services must follow the 5 principles recommended by WHO: consent (informed), confidentiality, counselling, correct test results, and connection (linkage to care, treatment and other services).
Recently, I went to a private hospital in Davao City to get tested. I was referred to go to where bloods are tested – for drug testing, blood samples for those who are sick or admitted to the hospital.
There were so many people inside the room. I took a number and waited for my number to be called. When my number came, I went to receptionist and told her my reason. When she heard about it, she wrote something and said I had to pay first to the cashier. She also gave a paper where I wrote my name and had it signed.
After paying to the cashier, I returned back to the receptionist, who called someone to accompany me. “Sir, you have to undergo counselling first before we will take your blood sample,” she said.
When I entered the room, I was greeted with a smile. Then, she explained to me how the process. There are only two results, she said. “If the test says you are reactive, this means you have HIV. If the test says you are non-reactive, this means you don’t have HIV.”
If the result is non-reactive, the person is immediately given the paper stating so. But for those who are reactive, they have to wait a month or so before they get the result. “Generally, if the blood has been found to be positive, it is sent to the San Lazaro Hospital in Manila for confirmation,” she said.
The counselor also inquired if a doctor referred me to the hospital. I replied that there was none and I was doing it on my own. This is a requirement of Philippine Law (Republic Act No. 8504). Under the law, the privacy rights of those seeking to get tested need to be respected.
After that, she went on asking some questions which are private matters like the first time to have sex, sexual preferences, acts done during sexual encounter, the last time I had sex, and anything pertaining to sexual life.
“Once I start questions people about these things,” the counselor said, “they are immediately turned off. But it’s part of the process. There are those who want to skip this question and answer portion and just proceed with blood testing.”
After that, I went back to where I started. I went to the receptionist and told me to wait. When my number was called again, I went to a cubicle where a blood sample was taken. After that, I was asked to return that same day to get the result.
When the time came, I returned to the counselor to get the result. She asked my name again and when she found it in her computer, she printed a copy. She placed it in a white envelope and handed it to me.
I was adamant to open it. But after a few moments, I finally opened it. It reads: “Non-Reactive.” I told the counselor, who said: “Congratulations!” She gave me some words of advice. I thanked her profusely and left.
Aside from helping HIV patients, the RHWC is also very active in encouraging people to be tested for HIV as treatment is available for those detected at an early stage, said a press statement released by the City Information Office.
Previously, the health department provided ART only to those whose CD4 count is below 200. CD4 or CD4 T-lymphocytes, according to an article, “are the cells in the body being attacked by HIV. It is the most important indicator of how well the immune system of an HIV patient is and the strongest predictor of the progression of HIV into AIDS.”
But regardless of the CD4 count, the health department will now be giving ART to HIV-positive individuals. “We want 90% of high risk tested and 90% treated,” Ubial told “Philippine Star.” “That’s the only way we can reverse (the) epidemic… This is how other countries are able to reverse the HIV epidemic in their countries.”
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, a health expert reiterated.
“HIV is highly preventable,” the health expert said. “The government can only provide you information, diagnosis, and treatment. But the most effective way of preventing HIV is still heavily depends on the practices of informed individuals.”
