A deeper look at HIV in the Philippines

Part 2 of 2

Last Thursday, we published the first part of our interview with The SHIP Foundation’s medical director Dr. Katerina Leyritana and physician Dr. Khaled Alim on the current state of HIV in the Philippines, particularly the underlying issues. Today, we are continuing what we started. Here is the rest of that eye-opening discussion:

“The numbers aren’t very encouraging.”

This is what Dr. Leyritana thinks of the rates of public awareness. She’s talking about figures found in the Integrated HIV Behavioral and Serologic Surveillance report, which reveals that in 2013, only 35 percent of MSM answered all five knowledge questions correctly, down six percentage points from 2011. Condom use “during last anal sex with a male” partner in 2013 was up only two percentage points from 2011 at 37 percent. (The national target is 80 percent.)

The same report found that 57 percent of MSM believe they were at risk of having HIV. Of that number, 55 percent think that way because they have multiple sex partners while 37 percent said that it’s because they don’t always practice safe sex.

Support is very important.

Once diagnosed with HIV, patients struggle with a myriad of issues, which is why support from family and friends is paramount. As people living with HIV, they are faced with emotional trials at every stage and are especially vulnerable when they find out they are infected.

“The struggle that they all have in common is coming to terms with their condition. Some of the patients enter a denial phase and pretend that nothing happened. A support system (friends/family) is very important in helping them come to terms with being PLHIV (people living with HIV),” Dr. Alim observes.

“Each step of the HIV care cascade is an opportunity to ‘lose’ a patient,” Dr. Leyritana adds, as “crisis points occur at each turn.” She narrates the following scenario:

Counselors, as well as family and friends, have to support the patient at diagnosis to accept the situation and disclose their condition to family, partners, friends and employers while watching out for possible medical complications.

When treatment is commenced, side effects and compliance become issues. For continuing treatment, the patient needs to strictly comply with it, and the cost may sometimes be prohibitive, which leads to financial struggles. Treatment fatigue and despair may also be observed, together with occurrence of physical illness and recognition of new symptoms as the disease progresses. As such, drastic lifestyle changes are necessary, further adding to the emotional burden. The patient may also be diagnosed with AIDS and that is a major ordeal.

These take a toll not only on the patient but on the caregiver/s, who are most likely close family members, as well. This is why, Dr. Leyritana says, HIV medicine needs to be supported by counseling services for the whole family.

What else can be done?

No matter how supportive family and friends are, it’s all for naught if PLHIV don’t receive proper and continued healthcare. To achieve “universal access to HIV care,” Dr. Leyritana lists down the following things that should be addressed:

* Further increase provisions for HIV service delivery in all Category A and B areas; more treatment hubs, more public-private-community clinics.

* Create a network of all HIV centers so that wherever a patient may be, continuity of care will be ensured.

* Have consistent dialogues between policy-makers and the HIV community.

* Resolve the HMO coverage issue of HIV and other related diseases.

* Provide a grievance/legal help desk for human rights issues and discrimination.

* Provide shelters for end-of-life care and the abandoned.

* Provide an HIV-proficient drug rehabilitation facility.

Meanwhile, on a personal level, she recommends a healthy discussion among friends on (1) the avoidance of risky behaviors that increase HIV transmission, (2) the logic behind having an HIV test, and (3) the continued love and support that will be given if one of you becomes HIV-positive. The more we talk about it, she believes, the more we eliminate the stigma attached to it, and the less people will be afraid to know their status.

A final word of advice: “Make the HIV test part of your routine health practice. If you are sexually active, take the test at least twice a year. The earlier you know about your status, the better your outcome will be.”

The SHIP Foundation is a one-stop shop that offers services free from judgment and discrimination. The institution is a safe place for everyone seeking for private, discreet and confidential care. Services range from HIV-screening, laboratory tests for all kind, sexually transmitted infection (STI) treatment and management, HIV treatment, care and support (TCS) provision, HIV and STI prevention intervention, condoms and lubricant provision, and other health related complications management.

The facility, located on 566 Shaw Blvd in Mandaluyong, is open from 1 p.m. to 7 p.m. everyday, except on Thursdays. It can accommodate clients up to 9 p.m. For more information, go to www.facebook.com/TheSHIPFoundation.

–Ed Biado, Manila Standard Today