If nothing is done, the Philippines may wake up one day as the “epicenter of a growing HIV epidemic in the region,” warned Dr. Edsel Maurice Salvana, a molecular epidemiologist who’s one of the few scientists in Asia doing advanced biomolecular or genomic studies to determine the mutation of the HIV.
HIV stands for human immunodeficiency virus, the microorganisms that weaken a person’s immune system until he or she is unable to fight off even minor illnesses. If not treated, it may lead to acquired immunodeficiency syndrome (AIDS).
“If we’re not vigilant, we just might be a few mutations away from a resurgence of the AIDS virus which can cause pandemic spread of the disease,” warned Dr. Salvaña, an infectious disease doctor who works as Professor 3 at the University of the Philippines-Philippine General Hospital and adjunct faculty for global health at the University of Pittsburgh.
He said those words two years ago. While the overall trend of HIV incidence and AIDS-related deaths are declining around the world, it is the exact opposite in the country. There is an increase in new cases, as per records from the HIV/AIDS and ART Registry of the Philippines showed. From 2012 to 2023, there was a 411% increase in daily incidence.
As of 2025, the Philippines is experiencing an increase in HIV cases, with 6,703 new cases reported from January to April. This translates to an average of 56 new cases each day, marking a 44% rise compared to the same timeframe in 2024.
Currently, there are 148,831 confirmed HIV cases in the country, with a notable surge in infections among the youth, especially a 500% increase among young Filipinos.
This has raised concerns within the Department of Health (DOH). “If we do not manage to control the increase in HIV cases, we will exceed 400,000 individuals living with HIV,” said Health Secretary Dr. Teodoro “Ted” Herbosa.
This alarm caused Dr. Salvana to share some thoughts in his social media account. “I see people going at each other’s throats about who or what is to blame for the increase in HIV cases,” he wrote. “There are those who say it’s people’s bad choices that caused the increase. There are those who say that it’s because of increased testing, which is a good thing.”
Let’s stop this blame game. It’s time to face the problem. As he puts it: “So many accusations and acrimonious statements have been made and it’s not getting us anywhere. People are dying and all this bickering is not going to help and may in fact make it worse.”
Dr. Salvana wanted to get to the bottom of it. “I’ve been working on this HIV epidemic since 2008 and I’ve been in the thick of things and I think I have a bit of knowledge in separating myths from facts,” he pointed out.
There are those who claim that the increase in HIV is driven by an increase in testing. “Partially true,” Dr. Salvana wrote. “Certainly, there is more testing now than 10 or 20 years ago and this is a big win for the advocates who have been pushing better testing to get people treated as soon as possible, recover their immune system and stop transmitting HIV.”
But the Philippines still has a long way to go with testing. “Also, going by the continued median low CD4 count at diagnosis, we are still diagnosing a lot of people late,” he wrote. A CD4 count is a blood test that measures the number of CD4 cells, a type of white blood cell that plays a crucial role in the immune system. CD4 cells help fight infections and are particularly important for individuals with HIV, as their count indicates how well the immune system is functioning.
“Compared to ten years ago, the median CD4 count at the time of diagnosis has increased a bit from below 200 to above 200 (normal is 500) and so there is progress,” Dr. Salvana continued. “But the tremendous rate of increase is definitely driven by a large absolute number of cases – many more people are getting infected ON TOP of increased testing.
“If I were to estimate the contribution of increased testing to the totals, I would say it is about 10 to 15% due to increased testing but the rest of the 85 to 90% is increased infections,” he surmised. “So, while it is good to celebrate increased testing, there is so much more work to be done and it should not be used as an excuse for the increase in cases.”
Of those who believed that the increase in HIV is due to bad choices, he said it is also partially true. “The predominant mode of transmission in the Philippines is sexual transmission (about 90%) and a significant proportion of that is acquired through unsafe sex.”
Religious organizations, particularly the Catholic church, assert that if individuals would simply refrain from engaging in sexual activity until marriage, the incidence of HIV would be nonexistent.
“Certainly, not having sex will result in no HIV transmission but is that a realistic expectation?” Dr. Salvana asked. “Studies have looked at the effect of ‘purity pledges’ which ask the youth to commit to waiting before marriage to have sex. Upon following up on this group after five years, scientists found that 85% of pledgers denied ever making the pledge.
“There was also no difference in unwanted pregnancies and sexually transmitted infections (STIs) between pledgers and non-pledgers, and pledgers were less likely to use protection against STIs and pregnancy. In other words, the pledges didn’t work and increased the risk of the pledgers to STIs and pregnancy. While I applaud those who can stick to their pledges, it isn’t an effective public health policy.”
There are also those who believe that not all HIV infection is the result of bad personal choices. “I know several married women who only had sex with their partners from whom they got HIV,” Dr. Salvana penned. “Some of them were pregnant and because there was a delay in getting diagnosed (they didn’t have any usual risk factors) and getting treatment, their baby got HIV as well.
“Starting antiretrovirals in HIV-infected pregnant women prevents perinatal infection of the baby. These women and children did not make any kind of bad choices and to lump them in with such an insensitive judgement on HIV is completely inappropriate.”
Now, on the positive side. “Even though our cases of HIV are increasing, the chances of surviving HIV infection in the Philippines in this day and age are higher than ever,” he pointed out. “Our government in partnership with the HIV advocacy community has made huge strides in setting up many, many treatment hubs and ensuring the availability of lifesaving, free antiretroviral drugs.”
Dr. Salvana further assured: “The earlier someone is diagnosed to have HIV, the better their prospects of having a long and fruitful life. Once their viral load is undetectable (in about 3 months, assuming no drug resistance and good adherence to treatment), they can no longer transmit to anyone and can even have kids the normal way.”
