The HIV epidemic: Why the nation should worry

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BASED on its conventional definition, the Philippines is presently in the middle of a Human Immunodeficiency Virus (HIV) epidemic.

In May 2013 alone, there were 415 new HIV cases in the Philippines. In the 10-year period up to this year, there has been a 2,600% increase over the previous decade, while the rest of the world saw the incidence of HIV shrink by 20%.

This increase is the highest ever, not only in the country but throughout most of the world. HIV cases have been on the rise in the country at a growing pace; with one new case recorded every three days in 2001; one new case per day in 2007; and two new cases every day in 2009.

From 1984 to May of this year, 13,594 HIV cases have been recorded in the Philippines. But these are just the official figures; meaning these are the patients who willingly registered with the health department as being carriers of the virus. The number of actual cases is very likely to be much, much higher.


According to the Department of Health (DOH), this number consists of only 6% of the total number of Filipinos at risk of HIV. Furthermore, two-thirds of the cases were discovered in the last three years alone. It does not help that only 28% of sexually active Filipino men use condoms, the lowest percentage in Asia.

If the spread of HIV does not slow down, the Philippines can expect to have 25,000 new cases by 2016. This is based on geometric progression if there is no skid in the growth.

On a worldwide scale, there are 34 million people infected with HIV, while 28 million people have died from the disease. In 2011 alone, there were 2.5 million new cases and 1.7 million deaths due to the virus. In certain regions in South Africa, the prevalence of HIV is as high as 40% of the population, according to Dr. Edsel Maurice T. Salvaña, Clinical Associate Professor of Medicine at the University of the Philippines Manila (UPM).

In a talk at The Manila Times, Salvaña gave a brief history of HIV and how it can be acquired and prevented; knowledge that he finds lacking in most Filipinos.

HIV and AIDS are not the same thing. The former is a causative agent or a pathogen that causes diseases or infections of the latter. Not everyone who has HIV has AIDS, but everyone who has AIDS has HIV, he said.
Anyone can catch the virus

Who can acquire HIV? Nowadays, it’s practically everyone. People of different gender and profession can acquire the virus. Salvaña even claims that he has had HIV patients from every college institution in Metro Manila.

Unlike the time when HIV/AIDS was first detected in the Philippines, spread by female sex industry workers, today’s patients are predominantly male.

Previously, Overseas Filipino Workers (OFWs) and seafarers were the ones who acquired the virus from other countries. Up until the middle of the last decade, the majority of the HIV-positive population in the country came from this group. Since 2006, however, international transmission by OFWs went down as local transmission soared, Salvaña said.

“Anong ibig sabihin noon? Naghahawaan na lang tayo dito sa loob ng Pilipinas (What does it mean? We are just spreading the virus among ourselves here in the Philippines),” he said.

Statistics show that there is a higher rate of HIV among MSM (men who have sex with men). One out of 50 MSM in the Philippines has HIV. In Manila and Quezon City, one out of 10 MSM is HIV-positive. This does not necessarily mean that they are to be blamed for the spread of the disease, Salvaña said. “Is this MSM-driven? The data looks that way.

However, we know that there is more awareness in the MSM community, ‘di ba? So sinong magpapatest? Yung mga MSM. So, hindi ka naman mada-diagnose with HIV unless magpa-test ka (Who will have themselves tested? The MSM. You will not be diagnosed with HIV unless you get tested),” he explained.

“Before we point a finger at them, before we point a finger at the MSM community, magpa-test ka muna (Have yourself tested first).”

The most effective way to transmit HIV is through sexual contact, which accounts for 99% of the spread of the disease in the Philippines. Since the virus is blood-borne, it can also be acquired through blood transfer or direct contact of bodily liquids of the infected individual on another’s open wound. Usage of infected syringes and needles could also spread HIV.

There is only one reported case of HIV transmission through deep (AKA French) kissing.

Treatment
HIV usually has no symptoms. It may take two to three weeks after infection before a person experiences minor symptoms like fever, headache, diarrhea, swollen glands, feeling tired, and weight loss. The symptoms are often mild and therefore easily disregarded. After this, a latency period where the patient would feel completely healthy and normal will occur. Signs may only surface after eight to 10 years, when HIV has already mutated into full-blown AIDS. People with tuberculosis must take extra caution. Their condition could worsen as fast as two years if infected with HIV.

There is no known cure for HIV in the truest sense, Salvaña said.

However, there exists the process of suppressing the virus. Using multiple drugs, which are mixed together, creates the highly active antiretroviral therapy or HAART. Combined, these drugs stops the virus and its progression. Because the virus mutates at a rapidly alarming rate, vaccine development for HIV is difficult. The closest thing there is to a cure is a reported case last July of two men becoming HIV-free after their bone marrow transplants. However, bone marrow transplant is used mainly for treating cancer. It is a very risky operation that could lead to death. Moreover, the cost is beyond the reach of the average Filipino.

Though it would not totally eliminate HIV, treatment could make a huge improvement in the immune system of the patient. It can even extend the lives of those whose condition has worsened into full-blown AIDS.

HAART has turned HIV from a deadly disease to a manageable affliction just like diabetes and hypertension.

Like any other disease, HIV is best treated early. As there are no symptoms, people who are sexually active, have tattoos, shared injection drugs, and had blood transfusion before November 1986, when blood donations weren’t checked for HIV, should consider getting tested.

In Metro Manila, HIV tests are offered at the Philippine General Hospital (PGH) in Taft Avenue, Manila, San Lazaro Hospital in Sta. Cruz, Manila, Research Institute for Tropical Medicine (RITM) in Alabang, Muntinlupa City, and in various social hygiene clinics. Tests are voluntary and confidential. The person could opt to use an alias for the test records.

Forcing anyone to test for HIV and revealing his/her test results without consent is illegal.

In hospitals, testing fee could amount to P295. It is free in some social hygiene clinics.

Treatment is free for Philhealth members.

Harmony Valdoz, Jemaima Rae Porter, Miguel Asistio And Lupo Quintos
With Additional Reports From Eana Maniebo and Eliza Dineros

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