HIV/AIDS in the Philippines

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HIV/AIDS infection in the Philippines might be low but growing. The estimated incidence of
HIV/AIDS in the country remains under 0.1% of the total population in 2015.[1] The Philippines has
one of the lowest rates of infection, yet has one of the fastest growing number of cases
worldwide.[2] The Philippines is one of seven countries with growth in number of cases of over 25%,
from 2001 to 2009.[2]
Cases are concentrated among men who have sex with men [3] HIV cases among men having sex
with men multiplied over 10 times since 2010.[4] HIV cases are getting younger.[2]
The first case of HIV infection in the Philippines was reported in January 1984.[5]
On December 20, 2018, Republic Act No. 11166,[6] also known as the Philippine HIV and AIDS
Policy Act of 2018, was passed. The law repealed the 21-year old Republic Act No. 8504 also known
as the Philippine AIDS Prevention and Control Act of 1998 and made health services for HIV/AIDs
more accessible to Filipinos.

At-risk groups[edit]
Most-at-risk groups include men who have sex with men (MSM), with 395 new human
immunodeficiency virus (HIV) infections among within this group from January to February 2013
alone, 96% up from 2005’s 210 reported infections. A spokesperson of the National Epidemiology
Center (NEC) of the Department of Health says that the sudden and steep increase in the number of
new cases within the MSM community, particularly in the last three years (309 cases in 2006, and
342 in 2013), is "tremendously in excess of what (is) usually expected," allowing classification of the
situation as an "epidemic". Of the cumulative total of 1,097 infected MSMs from 1984 to 2008, 49%
were reported in the last three years (72% asymptomatic); 108 have died when reported, and slightly
more MSMs were reportedly already with AIDS (30%).[13]
Among MSM's, ninety percent of the newly infected are single (up to 35% of past cases reported
involved overseas Filipino workers or OFWs and/or their spouse), with the most of the affected
people now only 20 to 34 years old (from 45 to 49 years old in the past). The highest number of
infections among MSMs is from Metro Manila. An HIV surveillance study conducted by Dr. Louie Mar
Gangcuangco and colleagues from the University of the Philippines-Philippine General
Hospital showed that out of 406 MSM tested for HIV from entertainment areas in Metro Manila, HIV
prevalence using the rapid test was 11.8% (95% confidence interval: 8.7- 15.0).[14][15] Increasing
infection rates were also noted in the cities of Angeles, Cebu, and Davao.[13] 1 to 3 percent of MSM's
were found to be HIV-positive by sentinel surveillance conducted in Cebu and Quezon cities in 2001.
Another at-risk group are injecting drug users (IDUs), 1 percent of whom were found to be HIV-
positive in Cebu City in 2005. A high rate of needle sharing among IDUs in some areas (77 percent
in Cebu City) is of concern. Sex workers, because of their infrequent condom use, high rates of
sexually transmitted infections (STIs), and other factors, are also considered to be at risk. In 2002,
just 6 percent of sex workers interviewed said they used condoms in the last week. As of 2005,
however, HIV prevalence among sex workers in Cebu City was relatively low, at 0.2 percent.[16]
The threats and effects that AIDS/HIV brings to the population is a severe cause for concern.
However, the prevalence of virus within the Philippine population remains low despite an increase in
the number of cases. In fact, the Philippines qualifies as one of the few countries where the growth
of AIDS/HIV cases has approximately increased to 25% from in a span of a couple of years from
2001-2009.[17]
The rise in the number of cases can be best categorized by specific groups in the population. First,
the age group that is most affected are 15–24 years old. Young professionals engaging in
unprotected sexual intercourse is the main cause for the contraction and it accounts for one third of
the AIDS/HIV-infected population. Furthermore, the infection within this age group is more prevalent
with homosexual relationships .[17]
The regional population that is greatly affected by AIDS/HIV is in Cebu. The prevalence rate is at
7.7% which is greater than the major cities of Manila at 6.7% and Quezon City at 6.6%. Recent data
show that the surge is not caused by transmission through sexual intercourse but through an
increase of people injecting drugs. It is not the injectable drugs but the sharing of needles, which
opens the risk of transmission of fluids, greatly exposing the risk of contracting the virus .[18]

National risk profile[edit]

Several factors put the Philippines in danger of a broader HIV/AIDS epidemic. They include
increasing population mobility within and outside of the Philippine islands; adverse to publicly
discussing issues of a sexual nature; rising levels of sex work, casual sex, unsafe sex, and injecting
drug use.[16]
There is also high STI prevalence and poor health-seeking behaviors among at-risk groups; gender
inequality; weak integration of HIV/AIDS responses in local government activities; shortcomings in
prevention campaigns; inadequate social and behavioral research and monitoring; and the
persistence of stigma and discrimination, which results in the relative invisibility of PLWHA. Lack of
knowledge about HIV among the Filipino population is troubling. Approximately two-thirds of young
women lack comprehensive knowledge on HIV transmission, and 90 percent of the population of
reproductive age believe you can contract HIV by sharing a meal with someone.[16]
The Philippines has high tuberculosis (TB) incidence, with 131 new cases per 100,000 people in
2005, according to the World Health Organization. HIV infects 0.1 percent of adults with TB.
Although HIV-TB co-infection is low, the high incidence of TB indicates that co-infections could
complicate treatment and care for both diseases in the future.[16]
Wary of Thailand’s growing epidemic in the late 1980s, the Philippines was quick to recognize its
own sociocultural risks and vulnerabilities to HIV/AIDS.[according to whom?] Early responses included the
1992 creation of the Philippine National AIDS Council (PNAC), the country’s highest HIV/AIDS
policymaking body. Members of the Council represent 17 governmental agencies, including local
governments and the two houses of the legislature; seven nongovernmental organizations (NGOs);
and an association of PLWHA.[16]
The passing of the Philippine AIDS Prevention and Control Act in 1998 was also a landmark in the
country’s fight against HIV/AIDS.[citation needed] However, the Philippines is faced with the challenge of
stimulating government leadership action in a low-HIV-prevalence country to advocate for a stronger
and sustainable response to AIDS when faced with other competing priorities. One strategy has
been to prevent STIs in general, which are highly prevalent in the country.[16]
The PNAC developed the Philippines’ AIDS Medium Term Plan: 2005–2010 (AMTP IV). The AMTP
IV serves as a national road map toward universal access to prevention, treatment, care, and
support, outlining country-specific targets, opportunities, and obstacles along the way, as well as
culturally appropriate strategies to address them. In 2006, the country established a national
monitoring and evaluation system, which was tested in nine sites and is being expanded.
Antiretroviral treatment is available free of charge, but only 10 percent of HIV-infected women and
men were receiving it as of 2006, according to UNAIDS.[16] This lack of distribution can be attributed
to the focus of health spending towards disease specific programs instead of spending on public
health which is more comprehensive and addresses multiple diseases. By spending on public health
in general, the country would be able to strengthen the health system by creating effective health
infrastructures that could carry out vertical programs without creating brain drain or hindering the
economic development of the country. Without passable local infrastructure, health improvements
would not be possible as distribution of medical care and medicines would be very limited; incidence
and prevalence reports may not be accurate, and progress of health initiatives could not be
tracked.[19]
Photographer Niccolo Cosme launched the Red Whistle campaign in 2011, inspired by red disaster
preparedness whistles, to raise awareness and understanding of HIV/AIDs in the Philippines.[20]

Treatment[edit]
The Philippines uses antiretroviral treatment (ART) to treat people with HIV/AIDS. This treatment
involves using different kinds of drugs such as zidovudine, lamivudine, and nevirapine.[21]
Another method that is being used is lab examination, which will help monitor the patient’s ART
or antiretroviral drug level. Since treatment for HIV/AIDS is based on a case to case level, this will
determine how the patient will be treated.
"The antiretroviral drug does not kill the virus that causes the disease. It’s simply a way to help fight
infection. This way, the patient prolongs his/her life even with the disease. With this being said,
patients have to go undergo lab examinations depending on their respective cases and receive this
treatment throughout their existence. It is a form of therapy that they would have to undergo."[according to
whom?]

"The government will handle most of the costs in association with the disease. The initial treatment
will costs the government P7,920 a year. As of April 20th, 2015, the Department of Health (DOH)
mentioned that they plan to buy P180 million worth of ARV or antiretroviral drugs to be used in
ART."[according to whom?][22]
Treatment is also partially covered by PhilHealth (Philippine Health Insurance Corporation), the
country's national social health insurance program through the OHAT package.[23]

Legislation[edit]
The Philippines passed a legislation on HIV/AIDS during the first decade of Filipino infections.
However, the bill's scope was minimal due to the lack of knowledge regarding the virus in the
Philippines at the time. In 2018, a new law was passed, repealing the old one. One of the major
changes was it is now allowed for 15 to 17 year olds to avail of HIV testing without the need for
parental consent. It also stipulated increased efforts to improve HIV awareness and to fight
discrimination of PLHIVs (HIV-positive people).