Understanding HIV

and AIDS
Its Reality in the Philippines
Republic Act, THE HIV AND AIDS
PREVENTION AND CONTROL ACT 1998(RA
8504)
Sec 4. HIV/AIDS Education in Schools
DepEd, CHED, TESDA shall integrate HIV
information in subjects taught in public and
private schools. All teachers shall be required
to undergo training in HIV.
 HIV/AIDS
IS IT A THREAT TO
…. AN INDIVIDUAL?
… PUBLIC HEALTH?
… THE YOUNG PEOPLE?

Why HIV / AIDS is a very special

public health and
development issue?
A real life-story of transmission and despair
• Manny is a good-looking, strong, healthy and
happy young man, who had a sexual
preference for other men and has many male
sexual partners. He works in a government
office.

• Manny is the only bread earner in the family,

and has a sister and aging parents to support.
• One day, unfortunately Manny had a road
accident.
• He was taken to a hospital where he was given
untested blood (which is infected with HIV)
unknowingly.
• As a result, Manny got infected with HIV, but
was not aware of it because there were no
symptoms in the initial stages and he felt
perfectly healthy.
• Manny met Randy during a social function
and they were strongly attracted towards each
other.

• Randy, however, is married to Maya and they

have a young daughter Mona. Maya is a
housewife.

• Manny and Randy meet up after office hours

and have anal sex together, without condoms.
• As a result Manny transmitted HIV infection to
Randy through anal sex, and neither was
aware of it.

• Randy and Maya (his wife) had sex without a

condom and unknowingly the virus is
transmitted from Randy to Maya.
• Maya became infected with HIV, but was not
aware of it because there were no symptoms
in the initial stages and she felt perfectly
healthy.

• Maya became pregnant and unknowingly

passed on HIV infection to her baby.
• The baby boy (Brad) was infected with HIV.
• Over a period of time, while Mona (the young
daughter) is absolutely healthy, Randy, Maya
and the young boy (Brad) fell ill because HIV
has started destroying their bodies’ ability to
fight even the common infections.

• Randy, Maya and Brad were all seriously ill and

their healthy daughter (Mona) had to look after
the family.

• Eventually Randy, Maya and Brad died, leaving

the young daughter – Mona orphaned.
• Simultaneously, Manny, who was extremely
healthy and strong, started falling ill and lose
lots of weight. He was unable to attend office
and eventually lose his job.

• Manny’s family faced extreme hardships and

his sister had to be taken out of school
because there was no money to pay for the
fees.

• They sold their house to cover Manny’s

medical expenses.
• Manny was looked after by his sister and aging
parents and eventually Manny dies
• .
• Manny’s family is left behind – totally
shattered emotionally and financially.
IN RECAP….
• HIV is infectious.
•One gets
infected with
HIV without
knowing it.
•HIV brings
with it
problems
and
challenges.
What is HIV?
What is
HUMAN
HIV? This virus can only infect human beings

IMMUNO-Deficiency
Effect of the virus, is to create a deficiency
(a failure to work properly) within the body’s
immune system

VIRUS
This organism is a virus, which means one
of its characteristics is that it reproduces
itself taking over the machinery of the
human cell

National AIDS/STI Prevention & Control

Program
Department of Health
 HIV Attacks the Immune System
• Paradoxically, HIV attacks the immune system
at the same time the immune system attacks
it. So, much of the HIV infection
dynamic reflects an ongoing, protracted battle
between the two. Both virus and CD4 and
other immune cells are produced and
destroyed at a rapid rate.
 HIV Attacks the Immune System
• When HIV progresses, viral levels rise and CD4
levels fall. So tests developed to
measure these two things are used to monitor
disease progression – viral load and CD4
count.
 HIV Attacks the Immune System
• For the most part, HIV does not cause death
directly. Rather, the eventually impaired
immune system makes the person susceptible
to other organisms that are easily fended off
by the normal immune system.
 WHAT IS HIV INFECTION?

HIV infection is the successful entry of HIV

in the human host weakening the immune
system and leading to a spectrum of
diseases.
 What is HIV infection?
 A lifetime infection
 No vaccine to prevent it
 No cure
 People infected only develop
symptoms 2 to 5 years after the infection
HIV destroys the CD4 cells which is the
primary defense of the body against
various infections
CD4

CD4 cell helps us to fight against

various infections
National AIDS/STI Prevention & Control
Program
Department of Health
HIV
OI’s
HIV attacks CD4 cell, multiply inside and gradually
kills them. Once CD4 are destroyed our body’s
resistance to fight infections goes down and person
suffers from lots of infections
National AIDS/STI Prevention & Control
Program
Department of Health
 How HIV infects ?

This end stage of HIV infection is called AIDS. It

takes many years for AIDS to develop and till that
time infected person usually remains healthy.

National AIDS/STI Prevention & Control

Program
Department of Health
WHO
Staging Clinical stages I – IV
System for
HIV Performance scales (modification of the
Infection in Eastern Co-operative Oncology Group
Adults & Score)
Adolescents
> 13 years Laboratory stages A - C measuring
CD4 cell count

Overview
of HIV

National AIDS/STI Prevention & Control

Program
Department of Health
 AIDS
• A life threatening condition characterized by
appearance of a spectrum of diseases and
malignancies
• Patients with AIDS usually die because of various,
overwhelming opportunistic infections
• Opportunistic infections are caused by bacteria or
viruses which normally lives in the human body but
causes no symptoms among people with no HIV
 How
HIV/AIDS is
transmitted?
HIV is found and transmitted through
blood, semen, vaginal secretions and
breast milk. It is spread in three main
ways
 HIV transmission through
UNPROTECTED PENETRATIVE SEX

Unprotected sex is any form of penetration (vaginal, anal or

oral) without a condom.
You can HIV by having unprotected sex with someone who is
already infected with HIV.
During unprotected sex, HIV can enter the body through the
lining of the vagina, penis, mouth or rectum
A man can also get infected from having unprotected with
another man who is already HIV-infected.
Notes on Sexual Intercourse:
• Anal intercourse is especially risky, for both
partners, but particularly the receiving
partner. The rectal mucosa is very vulnerable
to trauma.
• The presence of a sexually transmitted
infection (STI) that produces ulcers (such as
primary syphillis, herpes, or chancroid) greatly
increases risk of sexual transmission of HIV.
Other STIs also appear to increase risk.
• Men who are circumcised are at
markedly reduced risk of acquiring HIV.
 HIV transmission through
BLOOD TRANFUSION
• HIV cannot penetrate through intact skin.
• People get HIV when HIV-infected blood mixes
with their blood
• Infected blood can come from blood
transfusion.
 HIV transmission through
INJECTING DRUG USE (IDU) /
NEEDLE SHARING
• Infected blood can come from contaminated HIV-
positive blood.
• NEVER SHARE NEEDLES WITH ANYONE
LABORATORY
STUDIES SHOW
THAT HIV VIRUS
CAN
SURVIVE IN
USED SYRINGES
FOR A MONTH
OR MORE.
 HIV transmission through breast-milking
mother-to-child-transmission

• A woman with HIV can pass the virus to her

baby. The baby can become infected while in
the mother’s womb, when it is being born, or
through breastfeeding.
• The baby will NOT get HIV from being hugged by
the mother
• Mother to child

 during the placenta during pregnancy

 during labor itself (delivery)

 through breastfeeding
• Not all babies born by HIV + pregnant
women will be infected
 HIV does NOT
spread through:
 HIV does NOT
spread through:
MODE OF TRANSMISION

tears saliva sweat

National AIDS/STI Prevention & Control

Program
Department of Health
The Natural Course of HIV Infection
and AIDS
Crucial Importance of Early (and Late)
Stage of Infection for Infectivity
• The infectiousness of a person is directly
related to the "viral load," which
changes over the course of the disease
and presumably relates to the amount
of virus shed in semen or vaginal
secretions. Viral levels vary among
individuals.
• Importantly, viral loads are quite high in
the first few weeks, relatively low for
many years, and then rise again in late-
stage infection.
 Can you tell if
someone is infected
with HIV?

A person with HIV can still look

and feel healthy
 How would a person
know if he/she is
infected with HIV?
Through HIV Antibody Test (HAT). HAT
is the blood test for determining if a
person is infected or not with HIV. HAT
determines the presence of antibodies.
HAT is anonymous and confidential.
This means that you may not use your
identity/name.
WINDOW PERIOD?!?
Window period

EXPOSURE

HIV ANTIBODIES

THREE TO SIX MONTHS

• duration is 3-6 months

• undetectable HIV antibodies during the time
• still infectious at this period
National AIDS/STI Prevention & Control
Program
Department of Health
 Why is it important to know
window period?
• If a person has been exposed to the virus and
takes the test soon after, the test results may
show up negative.
• Person can unknowingly infect another person
• People who know about the window period will
know why one has to be careful about giving and
taking blood.
• Those with negative test result will know they
need to re-test 3-6 months after
National AIDS/STI Prevention & Control
Program
Department of Health
• People who understand the significance of the
window period cannot be deceived by another
who produces a lab report in order to get
unprotected sex.

• People will know that if they have unprotected

sex while waiting to have their second test,
they are exposing themselves to HIV once
again.

National AIDS/STI Prevention & Control

Program
Department of Health
 Can you be forced to
undergo HIV Testing?

NO
HIV testing is voluntary and can’t be done
without a written informed consent. If
you’re under 18, a parent or a legal
guardian will make the consent except for
cases of anonymous testing.
 Where can I get HIV
testing and
counseling?
Testing can be done at DOH-accredited
hospitals, clinics or laboratories. All
hospitals clinics, laboratories, which offer
HIV testing, will give a free pre- and post-
test counseling

In Tuguegarao- City Health Office and

Cagayan Valley Medical Center
In Santiago- City Health Office
Are there laws that protect
the privacy of people with
AIDS?
YES
The rules and regulations of RA 8504 state that medical
confidentiality will be given to a person who is tested positive
for HIV. Results of the HIV test will only be released to:
• the person who was tested
• the parent of a minor who was tested
• the legal guardian of an insane person or an orphan
who was tested
Anyone who violates this may be imprisoned and fined .
 Prevention of
STI/HIV Infection
How to prevent
STI and HIV
infection
How to prevent
STI and HIV
infection
How to prevent
STI and HIV
infection
• Condoms can reduce the rate of HIV
transmission, by about 85-90% (that is, HIV
transmission over an extended period of time
is 85-90% less).

• But only if they are used: consistently and

correctly
 Consistent?
• Condom use tends to be more common with a
new partner. But people tend not to use
condoms in longer term relationships which
may carry significant risk.
• Condom use is susceptible to disinhibition or
"risk compensation" wherein people may
engage in risky sex thinking they will use
condoms - but then don't actually use them
correctly and consistently.
How to prevent
STI and HIV
infection
How to prevent
STI and HIV
infection
 How to prevent
STI and HIV
infection
A – ayoko muna
B – basta ikaw/ako lang
C – careful sex
D – drugs ay iwasan
E – edukasyon at early
diagnosis
 ABC of HIV Prevention

Abstinence:
Don’t have sex (or delay sex until marriage)
Don’t use drugs
Be faithful:
Reduce sexual partners (to one)
Use your own needle
Choices:
Sex with no penetration OR Use protection during sex
(condoms)
Stop injecting drugs OR Use new needles every time
What should we do to
protect ourselves from
getting infected with
HIV?
• A – Abstain from sex (No sex at all)
• B – Be faithful (mutual monogamy will reduce
chances of getting HIV)
• C – Use Condom properly and consistently
• D – Don’t share or use syringe and needles used by
another person
• E - Education
 Tracking HIV in the Philippines
1984 to 2010

• Philippine HIV & AIDS Registry

• Integrated HIV Behavioral & Serologic Surveillance
• HIV Program Reports (government & NGO)
• Researches:
Rapid assessments
Operations research
Special investigations
Evaluations, etc.
 Philippine HIV & AIDS Registry

• Official national registry of

HIV & AIDS cases in the
Philippines
• Strictly confidential
• Passive reporting system
• Does not follow-up cases after being reported
• Gives data on trends
 6,853 reported HIV cases (1984 to 2011) *
*

* As of June 2010
 The clock is ticking: 1 new case every 5 hours

2013: 4-5 new cases a day!

2009: Two new cases a day

2007: One new case a day

2000: One new case every 3 days

Source: Philippine HIV & AIDS Registry

 1,500 New Cases at the End of 2010

Doubling time: 1 yr
Number of Cases

Doubling time: 2 yrs

Doubling time: 6 yrs

Doubling time: 17 years

Source: Philippine HIV & AIDS Registry

 Your commitment
Be an
Advocate
Be Educated
Be Safe
Be Healthy
Be Happy