Medicine Cabinet — Reiner W. Gloor
IT IS ALARMING how quickly the numbers of HIV/AIDS cases have risen in just the past few years here in the Philippines. Despite being still officially tagged as a low-HIV prevalence country, with less than 0.1% of the adult population estimated to be HIV-positive, more new cases are being reported today than even two years ago. As of April 2015, the Department of Health (DoH) AIDS Registry reported 24,936 cumulative cases. In that same month, there were 560 new cases reported, showing a 42% increase compared to the same period the previous year. Within the years of 2001 to 2015, the number of cases diagnosed per year increased 37 times, from just 174 cases diagnosed in 2001 to 6,552 new cases within the first 10 months of 2015 alone.
As part of our continuing story on women’s health (since March is women’s month), we want to focus on issues plaguing Filipinas today. Many of the cases of HIV/AIDS in the country are still due to men having sex with men (MSM), with a portion from intravenous drug use with infected needles. Women who engage in sexual acts with infected partners can get sick, along with those who administer intravenous drugs with infected needles. There have even been cases where a razor blade was used and reused in a barber shop, infecting others with the virus, making their female partners susceptible as well. It is also possible for an HIV-positive mother to transmit the virus to her child during pregnancy, labor, delivery, or even over the course of breast-feeding.
Because there is still little to no awareness of HIV/AIDS among the majority of the population, understanding of the disease has also been very poor. Despite many efforts by advocates, groups or even the DoH to spread awareness and understanding, many myths still abound as to how one can actually be infected by HIV/AIDS. Women are especially susceptible, especially since societal pressures and religion remain factors on how they are expected to behave.
Some misconceptions people still have are that a healthy or “clean-looking” person cannot have HIV, that mosquitoes can also carry the virus, that the act of shaking hands or hugging an infected person can also get someone sick, and that HIV can be transmitted through food.
It is all the more important to clear the air. According to the Centers for Disease Control and Prevention, these are the ways women can acquire HIV:
1.) being unaware of their male partner’s risky behaviors like intravenous drug use or MSM;
2.) vaginal or anal sex without a condom;
3.) contracting sexually transmitted diseases like gonorrhea and syphilis which can increase the risks of being infected by or spreading HIV;
4.) engaging in risky sexual behavior such as having multiple sexual partners; and
5.) sharing needles or razor blades with someone who is HIV-positive.
The World Health Organization’s country representative, Julie Hall, is very worried. She revealed recently that approximately one-third of those who abuse drugs intravenously are women.
Another group of women that is very vulnerable to this near epidemic are sex workers. Because prostitution remains illegal in the country, little is done to regulate their practice. Very few sex workers voluntarily go to health clinics to get the help they need.
According to UNICEF, adolescent females who sell sex in particular are extremely vulnerable to HIV and a host of other sexually transmitted infections and sexual and reproductive health problems, including unplanned pregnancy. They are more prone to violence than their older peers, less capable of negotiating condom use, more likely to use drugs and alcohol, and less likely to get tested.
While free HIV-related services have been made available through the DoH, PhilHealth, and many private hospitals, such as testing and counselling, efforts need to be stepped up to improve awareness.
There remains the problem of stigma and discrimination which keeps those who suspect they are sick from getting tested and finding out for sure. Fear of being shunned by their families and society keeps many more people from coming forward to get the help they need.
Because of the existing discrimination, many health workers estimate the number of actual cases to be much higher than the official number. In fact, it is alarming to note that the biggest proportion of cases comes from young people. According to the DoH, from 2000 to 2004, the majority of new cases came from the 30 to 39 years demographic. From 2005 to 2009, it was 25 to 34 years. From 2010 to 2015, it was 20 to 29 years. The proportion of People Living with HIV in the 15 to 24 age group has actually increased from 20% in 2005 to 2009 to 28% in 2010 to 2015.
There also exist real roadblocks to what is now known as the RPRH (Responsible Parenthood and Reproductive Health) Law. With the current temporary restraining order against its implementation and the bicameral committee’s cuts from its budget, the RPRH Law is straining to move forward. With the law, the government would be mandated to provide preventive and treatment services for HIV and other STDs, access to different family planning methods, and age- and development-appropriate reproductive health education, all of which could curb the rise of HIV/AIDS incidence in the country. A simple act like giving out free condoms has been proven to help significantly, but the current situation prevents local health units from performing even this simple government-mandated act.
There is indeed an HIV/AIDS crisis in the Philippines. We need to continue working together to educate the public and support the different stakeholders’ efforts. In many parts of the world, the number of HIV/AIDS cases has been going down. It would be tragic if our numbers were to keep going up, especially since catching this virus is completely preventable.
Log on to www.phap.org.ph and www.phapcares.org.ph. E-mail the author at reiner.gloor@gmail.com.
