The rising number of HIV (Human Immunodeficiency Virus) cases, especially among Philippine youth, is cause for alarm, according to health advocates.

Based on the 2022 Global AIDS Monitoring Report, the Philippines has shown a 327% increase in new infections, and a 401% increase in AIDS related deaths from 2010-2021 across all age groups.

UNAIDS data reveals that from 1984 to 2023, young people 15-24 years old account for 21% or 635 of AIDS-related deaths in the country. They make up almost 30% of all reported infections in this period, 98% of whom were infected through sexual contact.

In the 2022 Integrated HIV Behavioral and Serological Survey, majority of the respondents report that they first had sex at 16 and anal sex at 17 but did not use condoms until the age of 19.

To call attention to this, advocates held a candlelight ceremony to mark the commemoration of the International AIDS Candlelight Memorial on May 21, 2023.

Among those who attended were Philippine National AIDS Council Secretariat officer-in-charge Dr. Joselito Feliciano, who outlined a multi-stakeholder approach in a seventh AIDS medium term plan.

“Nakasalalay sa planong ito for 6 years ang lahat ng ating mga programa, ang maganda po rito, hindi lang health, kung hindi non-health ang involved sa ating mga programa. Mayroon pong mga programa ang ating mga National Government Agency, simula sa DSWD, DOJ, DOLE, at lahat po ng miyembro ng Philippine National Aids Council. Marami rin po tayong partners na hindi miyembro ng Philippine National Aids Council at kasama rin po natin ang ating private sector, civil society organizations, at mga development partners. Sa ngayon, we are bombarding with information and education, hindi lamang mula mga bata hanggang sa ating matatanda, So tulong-tulong, together we will get there.”

Detection, diagnosis, treatment, prevention

Feliciano said the Department of Health is procuring testing kits and are targeting the right population for their testing efforts.

“Gusto natin mapalakas ang ating diagnosis, mas mapalakas sa mga mada-diagnose ng positive ay madala natin ito sa treatment at mabigyan ng gamot, kasi alam naman natin na basta mayroon silang gamot, makakainom ng gamot, puwedeng bumaba ang kanilang viral load at lesser ang chances na mahawa sila dahil dito, kung sakaling mame-maintain nila ang pag-inom ng gamot, kaya nilang mabuhay tulad ng isang normal at productive individual.”

Ico Rodolfo Johnson of Project Red Ribbon added that there are now more innovations available to make HIV testing more accessible.

“Yung mga testing na nasa Amerika, nasa Europe, ay nandito na sa Pilipinas, lalong-lalo 'yung self-testing. Dati natatakot ang mga taong magpatest sa mga HIV facilities, baka ma-stigmatize o ma-discriminate sila. Ngayon puwede na madeliver sa mga bahay nila ang self-testing.”

Johnson said the self-test kits are available through Project Red Ribbon.

“Kami ay nagpapadala na ng mga self-test sa mga bahay para hindi na sila pumunta, para 'yung mga agam-agam yung takot pumunta ay hindi na maging balakid o obstacle.”

Another innovation that can help prevent the spread of HIV is PrEP, or pre-exposure prophylaxis. It is medication for people at risk for HIV take to prevent getting HIV from sex or injection drug use.

PrEP can stop HIV from taking hold and spreading in a person's body. According to the US HIV website, PrEP reduces the risk of getting HIV from sex by about 99% when taken as prescribed. Among people who inject drugs, it reduces the risk by at least 74% when taken as prescribed.

Johnson said there is enough PrEP supply in the Philippines and that it is free. “Kailangan lang maging aware ang mga tao na isa itong paraan to prevent HIV transmission.”

HIV PEP or HIV PEP, or post-exposure prophylaxis, is a short course of HIV medicines taken within 3 days (72 hours) after possible exposure to HIV to prevent the virus from taking hold in the body.

Unlike PrEP, however, it is not yet free, but Johnson hopes that it will no longer be the case in the future.

For those who are reactive, Johnson said, “Kung kayo ay nag reactive sa HIV test, huwag matakot. Una, ang mga serbisyo ng Department of Health ay nandito na, libreng konsultasyon, libreng ARVs o anti retro viral medicines at marami na tayong treatment facilities na nagbibigay ng libreng health services. Pangalawa, huwag kayong matakot kasi mayroon tayong mga non-health services katulad ng DSWD, kung kayo ay walang pera at sa tingin ninyo ay mahihirapan kayong pumunta sa treatment facilities or mayroon na kayong AIDS-related infections, nagbibigay sila ng medical financial assistance, livelihood assistance, mayroon silang educational assistance, and even burial.”

Feliciano said stigma and discrimination are the major obstacles to testing and treatment.

“Ito yung pinaka-nahihirapan tayong labanan. Dahil dito, nahihirapan nating ma-test ang ating PLHIV (Persons Living with HIV) which is the first step para malaman at matulungan natin sila.”

The law offers protection from discrimination. DOJ Deputy State Prosecutor Margaret Castillo-Padilla said the Department of Justice has an HIV and AIDS policy in the workplace wherein any form of discrimination or stigmatizing attitudes is considered a misconduct.

“Mayroon tayong joint administrative circular with the Commission on Human Rights kung saan naka-enumerate doon yung mga available na redress mechanisms ng ating PLHIV, one of which is the DOH Action Center under the Office of the Secretary of Justice that provides free legal advice to all PLHIV clients regardless of their socio economic status. Kahit hindi sila indigent, puwede namin sila maserbisyuhan.”

She added that there are also measures to protect the PLHIV’s privacy, wherein court proceedings are kept confidential and their identity is not divulged.

More Awareness Needed

Atty. Kaka Bag-ao, former governor and congresswoman of the Dinagat Islands and principal author of Republic Act No. 11166, said there is a need to strengthen the Philippine response to the public health concern.

“Hanggang ngayon, habang tumataas ang bilang ng persons living with HIV sa bansa, hindi pa rin lubos na nauunawaan ng marami ang isyu ng HIV at AIDS. Kasama na rito ang mga Local Government Units na nasa frontline dapat pag dating sa pagtugon. May budget ang bawat LGU na nakalaan para sa HIV and AIDS awareness and prevention. Sana mas palawakin at palalimin pa ang kaalaman nila para makagawa ng mas epektibo at rights-based na mga programa upang mapigilan ang HIV transmission at maipagtanggol ang mga PLHIV. Magiging mas maayos ang response sa HIV and AIDS issue kung talagang magkapit-bisig ang national government sa pamamagitan ng Department of Health at Philippine National AIDS Council, mga local government unit, at civil society organizations na handang tumulong at tumugon.”

Bag-ao, an active member of the Akbayan Partylist, added, “Sabi ko nga noong bumoto ako ng 'yes' para sa House Bill No. 6617 na naging RA 11166, ‘Sa dulo ng lahat, ang anumang batas na nagsusulong ng pagpapalawak ng kaalaman at pagkakapantay-pantay ay isang batas na nagsusulong ng pagmamahal sa kapwa tao. Sa mga PLHIV na nakilala ko sa mga committee hearing at forum, sa mga nakikita ko sa social media na hindi mailagay ang tunay nilang mukha at pangalan dahil sa takot sa stigma at diskriminasyon, para sa inyo po ito. Nawa’y maramdaman ninyo na may boses kayo sa loob ng Kongreso’.”

She called for an end to discrimination and noted the role of the government.

“Itigil na natin ang stigma na dala ng HIV at AIDS at nagpapahirap sa mga PLHIV. Simulan dapat ito ng gobyerno sa pamamagitan ng mga programang magpapalawak sa isip at magbubukas sa puso ng mga mamamayan na mahalin ang kapwa tao nilang PLHIV.”

UNAIDS Country Director Dr. Louie Ocampo emphasized the urgency of the situation.

“At this age with advanced treatment regimen, no one should die from AIDS-related causes. Despite the availability of free access to HIV services including life-saving medicines, many people living with HIV particularly young people are not on treatment or initiated very late. These deaths are unacceptable."

"We call on the government to test more and treat more. And do it fast by addressing barriers to access HIV services by eliminating stigma and discrimination, institutionalizing comprehensive sexuality education, expanding innovative approaches to deliver HIV services to reach more key populations, increased investments in prevention and social support services, and strong political will to cover the most vulnerable and most stigmatized sectors in society. This commemoration shall serve as a wakeup call that we are not doing enough, and that we must gather our acts together, and continue fighting the HIV epidemic in the country,” Ocampo added.