by Jovic Yee, Philippine Daily Inquirer, 22 Oct 2019
MANILA, Philippines — The Philippines has bucked the trend of a steady global decline in HIV cases, becoming the country with the “fastest growing epidemic” of the sexually transmitted infection, according to the Joint United Nations Program on HIV/AIDS (UNAIDS).
A UNAIDS study found that from 2010 to 2018, the Philippines saw new HIV (human immunodeficiency virus) infections grow by 203 percent, when cases worldwide had declined by at least 18 percent.
Only two other countries in the Asia-Pacific region registered an increase in HIV cases. Pakistan posted a jump of 57 percent, and Malaysia, 4 percent.
Vietnam and Thailand had significant drops in HIV cases—64 percent and 59 percent, respectively.
While the total number of HIV cases in the Philippines is “still very low” compared with those in African countries where cases run in the hundreds of thousands, its growth rate is the “fastest” in the world, UNAIDS country director Louie Ocampo said in a forum on Monday.
In June, the Department of Health (DOH) reported that 6,372 new cases had been recorded since the start of the year, up 40 percent from the same period last year.
The new cases in the first half of the year accounted for about 10 percent of the total reported cases of 68,401 since 1984.
Access to contraceptives
Ocampo attributed the growth of HIV cases to vulnerable populations, such as the youth, which do not have access to contraceptives like condoms, or do not effectively use these.
It doesn’t help that HIV testing and treatment remain to be wanting, he added.
Of the total number of Filipinos living with HIV, 80 percent are aged 15 to 34.
From 2010 to 2017, 81 percent contracted the virus through male-to-male sex.
While condoms are proven to be “very effective in preventing HIV transmission,” Ocampo said 45 percent of men having sex with men (MSMs) aged 15 to 24 “did not buy or get free condoms” during their last sex.
Ignorant of transmission
Studies also showed that only 37 percent of youth MSMs knew how HIV was transmitted and could be prevented, he said.
Awareness of HIV services provided by local government health centers and of available treatments was low at 35 percent and 6 percent, respectively.
Further increasing the risk of HIV transmission is the fact that MSMs’ “risky behaviors start early but protective behaviors start very late,” Ocampo said.
He noted that the first sexual encounter usually occurred at 15 years old, while first condom use only happened at 18. They only have themselves tested for HIV at 22.
“This is where the chance of getting infected is very high. The problem here is we are testing [these] young people very late. Most of the time, they are already on the end-stage and there are already several infections,” Ocampo said.
“[By then], providers can only do so much. But if we can diagnose early, without any signs and symptoms, the better the chances are of being virally suppressed early on,” he added.
77,000 with HIV
By end-2018, there were an estimated 77,000 people living with HIV in the country. But of this number, only a little more than 62,000 had been tested, leaving some 15,000 “not detected or diagnosed.”
Of those diagnosed, only half or 33,593 took antiretroviral treatment (ART).
To help halt the epidemic, Ocampo said local governments should have a higher level of commitment to confront the disease, such as putting in place a functional local AIDS council and setting aside an investment plan.
He noted that because of the country’s fragmented health system, linkage to care was low, the conduct of tests was delayed, and referral systems for testing and treatment were not in place.
Ocampo said psychosocial support should continuously be provided to those living with HIV, noting that 19 percent of those under ART were no longer getting medications.
Left unchecked, the problem may cause drug resistance among patients since ART should be taken for life.
Ocampo said it was important to “destigmatize and mainstream” condom use and to provide pre-exposure prophylaxis (PrEP) to high-risk groups.
Currently, PrEP is only given by some HIV advocacy groups and not yet part of the national program.