From Sarah Jane to Vincent: The changing face of HIV

MANILA, Philippines – The last time I saw Sarah Jane Salazar was weeks before her death at the National Center for Mental Health where she was confined for a psychological disorder emanating from her HIV infection.

She was delirious, but she remembered who I was. She asked if I was there to interview her, and I said no, I was there to visit. I told the hospital director that I had to give up the interview even after going through a long process to be allowed inside.

The sight of the restless young woman, who put a face to AIDS in the 1990s, suddenly very ill, staring at a few days to her death was not a compassionate situation for an interview. It would have been my last interview with her, but I was still thankful that I saw her for the last time.

In June 2000, Sarah Jane died of complications from AIDS. Some news reporters revealed her real name when they wrote their stories, and the names of her two children. They said she was already dead anyway, ignoring what her real identification might have caused her family. (Even Wikipedia disregarded the confidentiality clause, because it states her real name.)

The second Filipino known to go public with her HIV infection after Dolzura Cortez, then 19-year-old Sarah Jane, was introduced through a press conference in 1994 at the Department of Health, which made her a banner girl for advocating HIV prevention.

There were differing versions of her story, but a common thread was that she was infected through sexual contact with a foreign client while earning her keep as a sex worker in Japan and Manila. She finished high school and was studying to be a nurse when fast money in sex work beckoned. Doctors observed that she was smart, as she understood her health situation.

But her time in the media limelight was not without notoriety. Within two years, she had sexual relations with a 16-year-old boy, with whom she had a child, and in which she faced charges of child abuse. She had a drug addiction. Many times, she was unruly in public. The attendant drama and spectacle about her inspired a movie, “The Secrets of Sarah Jane.”

There were others who went public before and after her, some good, others troublesome. There was Esther Nahum (not her real name), the first president of Pinoy Plus, the country’s first organization of Filipinos with HIV. There was the couple Susan and Mel, who sold their HIV-infected blood to commercial blood banks to earn money. There were Cathy, Archie and Liza Enriquez (not her real name). Even with a death wish looming from behind their brave faces, they all worked for HIV prevention under the government program.

The shift

Then there were a few years when HIV was set aside in the realm of the news media. The faces also faded out, but HIV infections increased steadily until 2008 when the health department declared a shift in the mode of predominant transmission – from heterosexual to homosexual. The DOH recorded increases of infection among men having sex with men (MSM) that were tremendously in excess of the expected trend.

It was also in that year that Wanggo Gallaga, the son of film director Peque Gallaga, went public with his HIV infection. The coming out of Gallaga, a writer, also occurred with the beginning of the shifting trend to a different face to HIV – that of young professionals who are articulate and who can assert their social and economic standing in a society that finds it difficult to shake off stigma on persons living with HIV, not to mention discrimination persons with homosexual and bisexual orientation.

The shift could be discerned from among the names and faces currently speaking on behalf of HIV awareness and prevention, and responsible sexual behavior.

Take the case of Vincent, a young professional working in a large global computer company, who spoke before journalists attending a media seminar on HIV reporting last October. Journalists who listened to his story were in awe at the casual way he shared his HIV status without the expected drama of sob stories the media have seen in recent years.

Seeing Vincent with a bit of strangeness, however, assured them of a person who was educated about his environment and what he could do about it. “I didn’t like the media – they’re rude, have no emotions, and were only concerned about their deadlines. But I decided to face you because I thought it could be helpful,” Vincent told the journalists.

He cautioned that his story was nothing theatrical: one afternoon during a break from work, he decided to have himself tested for HIV when he heard a newscast about the rising HIV cases. He tested positive. The first thing he asked the doctor was if he could still have children because he wanted to have a family. He also asked about organizations doing HIV prevention advocacy where he could volunteer.

It took 9 months before Vincent told his partner about his HIV status, but he never disclosed it to his parents and family because he wanted to spare them of the difficulty of knowing two things – their son’s HIV status and sexual orientation.

Vincent is one of the peer educators and counselors of the AIDS Society of the Philippines (ASP), a professional, civil society organization, where he engages in chatting with his peer through the social networks. He educates about having oneself tested especially if there is a risky behavior involved such as unprotected sex with a partner or having multiple sex partners. He also urges HIV-positive persons to seek medical help, or, for a start, talk to someone like him who could provide support.

“Don’t be afraid to get tested. If you don’t, you could damage someone else’s life,” he said.

“Do not be silent about it. Know about HIV. Fight fear with facts.” He said one of his friends who never sought treatment for HIV infection died of pneumonia, one of the infections that attack a person whose immunity is impaired by AIDS, the end stage of HIV infection. His friend was treated in hospital as a regular pneumonia patient and not for AIDS.

Dr. Jose Narciso Melchor Sescon, president of ASP, said advocates of HIV awareness and prevention are happy to work with the new faces such as Vincent.

“Coming out in the open would entail that much courage to put a face and help in AIDS advocacy,” he said. “It reinforces and answers the question ‘who are vulnerable to the AIDS virus?’ I say it cuts across gender, race, social status, education, and religion. It’s all about behavior and what one practices that matters most.”

Rising cases

Historically, Dr. Sescon recounted that in 1985, the first persons who were tested happened to be female sex workers plying their trade in the former US military bases during disease surveillances funded by the US Naval Medical Research Unit. More sex workers, both female and male, were reported as HIV-positive throughout the 1990s.

Affected age groups and sectors changed with more studies and researches. Infections boomed starting in 2000 among overseas contract workers who were required by their host countries to undergo HIV tests before deployment or during contract renewals. This set an alarm to the international development organization Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM) that helped intensify health and testing services that surfaced more migrant workers and this time, young men who have sex with men (MSM) aged 24 to 35 as the affected groups.

In 2003, the health department recorded the six-fold rise of infections in a span of 3 years. In 2007, Metro Manila, Cebu and Davao reported the most number of cases, and it was among young people, mainly MSM but now younger – 15 to 24. They still dominate the health department’s HIV registry today. For October 2012, the registry recorded 295 new infections. There are nine people who get infected every day. The affected sectors are MSM and injecting drug users.

Even if public attention has also shifted from sex workers like Sarah Jane to young professionals like Vincent, Dr. Sescon said all professional groups and people in all economic brackets are now getting infected.

Aidan, another HIV-positive peer educator and is a physical therapist by profession, believes that the change of faces in the advocacy only “proves that HIV does not discriminate” and that “it has led to the understanding of the fact that HIV affects everyone.”

But even with the changing times, he is concerned that young MSM professionals who give a face to the infection would be branded as promiscuous and irresponsible people. This worsens the situation because he said, “this might generalize HIV infection as occurring only to the MSM community as what has happened to the people in prostitution during Sarah Jane’s reign in the 1990s.”

Aidan said there is a need not just for young professionals to come out and speak up about their experiences, more so, “an event wherein a group of persons living with HIV, probably more than 20, to come out and give face to HIV.” He foresees this as “an impactful initiative from the positive community that will make people realize deeply that HIV is actually around us and that we should all act now before HIV comes to our doors and starts infecting our own family and loved ones.” –DIANA G. MENDOZA, Rappler.com